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Related Concept Videos

Acute Coronary Syndrome I: Introduction01:30

Acute Coronary Syndrome I: Introduction

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Acute Coronary Syndrome (ACS) encompasses a spectrum of heart conditions caused by sudden obstruction of coronary arteries, typically resulting from the rupture of an atherosclerotic plaque and subsequent thrombus (blood clot) formation. This obstruction can lead to partial or complete blockage of blood flow, causing varying degrees of myocardial ischemia or infarction.ACS includes the following clinical entities:Unstable Angina (UA)Non-ST-Elevation Myocardial Infarction (NSTEMI)ST-Elevation...
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Acute Coronary Syndrome II: Pathophysiology and Clinical Manifestations01:19

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The pathophysiology of Acute Coronary Syndrome [ACD] involves several key processes:The main underlying cause of ACD is atherosclerosis, a chronic inflammatory disease characterized by the buildup of lipid-laden plaques within the coronary arteries.As the atherosclerotic plaque grows in the coronary artery, it may become unstable due to the formation of a lipid-rich core and a thin fibrous cap. Inflammatory cells within the plaque, such as macrophages, secrete enzymes that degrade the...
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Acute Coronary Syndrome IV: Interprofessional Care01:28

Acute Coronary Syndrome IV: Interprofessional Care

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IntroductionThe management of Acute Coronary Syndrome (ACS) aims to minimize myocardial damage, preserve myocardial function, and prevent complications.Initial ManagementInpatient management involves continuous cardiac monitoring, preferably in an ICU, focusing on blood pressure, serum sodium, potassium, and creatinine levels, and urine output. Ongoing pharmacologic management is crucial for stabilizing the patient.Supplemental Oxygen: Administer supplemental oxygen if oxygen saturation is...
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Peripheral Artery Disease V: Postoperative Nursing Management01:23

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During the postoperative period, it is crucial to focus on maintaining circulation, identifying and managing potential complications, and planning for discharge.Nursing AssessmentVital signs monitoring: Regularly monitor vital signs, including blood pressure, heart rate, respiratory rate, and temperature, to detect early signs of complications such as bleeding and infection.Circulation assessment: Monitor pulses, perform Doppler assessments, and check capillary refill, color, temperature, and...
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Peripheral Arterial Disease II: Clinical Manifestations and Diagnostic Evaluation01:21

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Clinical manifestationsPeripheral Arterial Disease (PAD) manifests through a range of symptoms, from the characteristic intermittent claudication to atypical presentations and severe complications in advanced stages. Intermittent claudication, a hallmark symptom of PAD, presents as exercise-induced muscle pain that typically resolves within minutes of rest. This pain is reproducible and stems from inadequate blood flow, leading to the accumulation of lactic acid produced during anaerobic...
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Acute Coronary Syndrome III: Diagnostic Studies01:30

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Diagnosing acute coronary syndrome or ACS begins with a thorough patient history. Notable symptoms include central, crushing chest pain radiating to the left arm, neck, jaw, or back, along with shortness of breath, sweating (diaphoresis), nausea, vomiting, dizziness, and palpitations.It is crucial to note any history of cardiac illnesses and assess risk factors, including age, gender, smoking, hypertension, diabetes, hyperlipidemia, and a sedentary lifestyle.During physical examination, vital...
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Acute compartment syndrome.

Alessio Giai Via1, Francesco Oliva1, Marco Spoliti2

  • 1Department of Orthopaedic and Traumatology, University of Rome "Tor Vergata", School of Medicine, Rome, Italy.

Muscles, Ligaments and Tendons Journal
|April 17, 2015
PubMed
Summary

Acute compartment syndrome (ACS) is a critical orthopedic emergency causing severe pain due to increased pressure in muscle compartments. Early diagnosis and fasciotomy are crucial to prevent irreversible tissue damage.

Keywords:
acute compartment syndromecomplicationsfasciotomyfractureintracompartmental pressuremyofascial compartment

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Area of Science:

  • Orthopedics and Traumatology
  • Surgical Emergencies

Background:

  • Acute compartment syndrome (ACS) is a painful condition resulting from increased interstitial pressure within osteofascial compartments, impairing local circulation.
  • It commonly occurs in the legs and arms following severe trauma but can also arise from minor or iatrogenic causes.
  • Diagnosis is challenging, relying on physical examination and intracompartmental pressure (ICP) measurements, with ICP > 30 mmHg indicating compartment syndrome.

Purpose of the Study:

  • To highlight the critical nature of acute compartment syndrome as a surgical emergency.
  • To underscore the diagnostic difficulties and treatment controversies surrounding ACS.
  • To emphasize the need for further research to improve ACS diagnosis and management.

Main Methods:

  • Diagnosis based on clinical presentation and repeated intracompartmental pressure (ICP) measurements.
  • Utilizing ICP thresholds (e.g., >30 mmHg) to guide surgical intervention.
  • Surgical intervention via fasciotomy to decompress the affected compartment.

Main Results:

  • Delayed fasciotomy leads to irreversible ischemic damage to muscles and nerves.
  • Prompt surgical decompression is essential once ACS is diagnosed.
  • Current diagnostic and treatment protocols require further refinement.

Conclusions:

  • Acute compartment syndrome is a true surgical emergency requiring immediate attention.
  • There is ongoing debate regarding specific ICP thresholds for fasciotomy and optimal wound closure timing.
  • Further research is necessary to enhance diagnostic accuracy and therapeutic strategies for ACS.