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Related Concept Videos

Ischemic Heart Disease: Overview01:17

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Ischemic heart disease occurs when the heart's blood supply dwindles, causing an ominous lack of oxygen and nutrients. This deficiency, stemming from reduced or obstructed blood flow, spells danger, leading to heart muscle damage and dysfunction.
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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 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 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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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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Acute Coronary Syndrome V: Nursing Management01:26

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Nursing Assessment:Nursing management of acute coronary syndrome (ACS) involves taking the patient's history, focusing on primary complaints such as chest pain, dyspnea, and excessive sweating (diaphoresis), as well as other symptoms like back or jaw pain, nausea, vomiting, palpitations, dizziness, and fatigue. The nurse also reviews the patient's history of cardiac events, risk factors such as hypertension, diabetes, smoking, family history, and current medications.In the objective assessment,...
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Brain Infarct Segmentation and Registration on MRI or CT for Lesion-symptom Mapping
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Facing the Time Window in Acute Ischemic Stroke: The Infarct Core.

C J Maurer1, K Egger2, A-K Dempfle2

  • 1Department of Neuroradiology, University Medical Center Freiburg, Breisacher Straße 64, 79106, Freiburg, Germany. christoph.johannes.maurer@uniklinik-freiburg.de.

Clinical Neuroradiology
|February 6, 2016
PubMed
Summary
This summary is machine-generated.

This study found no significant time dependency in brain tissue viability for ischemic stroke patients with carotid T or M1 occlusions within 6 hours of onset. Early infarct size appears determined by collateral circulation, not time alone.

Keywords:
DWIInfarct volumeMagnetic resonance imagingStroke

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Area of Science:

  • Neurology
  • Stroke Medicine
  • Neuroimaging

Background:

  • Brain tissue viability decreases rapidly after ischemic stroke onset, necessitating timely treatment.
  • Current endovascular stroke treatment trials may not fully reflect this critical time dependency.
  • This study investigates the time dependency in embolic carotid T or M1 occlusions within the first 6 hours post-stroke.

Purpose of the Study:

  • To evaluate the existence and extent of time dependency on brain tissue viability.
  • To analyze the relationship between time from stroke onset and infarct volume.
  • To assess factors influencing early infarct development in specific stroke types.

Main Methods:

  • Retrieved patient data from the Freiburg stroke data bank.
  • Analyzed diffusion-weighted images (DWIs) acquired between 49 and 357 minutes post-onset.
  • Segmented ischemic lesions and assessed occlusion location, thrombus length, and collateral status (hyperintense vessel sign).

Main Results:

  • Included 155 patients with carotid T or M1 middle cerebral artery occlusions.
  • Infarct volumes ranged from 0.3 to 180.2 mL.
  • No correlation found between infarct size and time to DWI, occlusion location, thrombus length, or collateral status.

Conclusions:

  • No significant time dependency of brain tissue viability was observed for embolic carotid T or M1 occlusions within 1-6 hours post-stroke.
  • Early infarct volume is likely determined by leptomeningeal collateral quality in the hyperacute phase.
  • Infarct size appears relatively stable within this 1-6 hour time window.