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Related Concept Videos

Ischemic Heart Disease: Overview01:17

Ischemic Heart Disease: Overview

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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.
Atherosclerosis, the primary malefactor, orchestrates this dangerous condition. It manifests as the accumulation of fatty deposits, akin to insidious plaques, within arterial walls. As time elapses, these plaques metamorphose, hardening and...
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Myocarditis I: Introduction01:21

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Myocarditis is inflammation of the myocardium, which is the muscular layer of the heart.EtiologyMyocarditis has a diverse etiology, including a wide range of infectious and non-infectious causes:Infectious CausesViral: Common viruses include Coxsackie A and B, adenovirus, parvovirus B19, enteroviruses, and influenza A.Bacterial: Examples include infections caused by Streptococcus, Staphylococcus, and Mycoplasma species.Rickettsial: Infections like Rocky Mountain spotted fever can result in...
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Peripheral Artery Disease I: Introduction01:30

Peripheral Artery Disease I: Introduction

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Peripheral artery disease (PAD) predominantly results from atherosclerosis, which involves the accumulation of fatty deposits, or plaques, within the walls of arteries. This causes them to narrow and harden, significantly reducing blood flow. PAD predominantly affects the legs, particularly the arteries supplying the thighs and calves. In rare cases, it may involve other arteries, including those in the arms.Etiology of PAD:The principal cause of PAD is atherosclerosis, which results from fatty...
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Angina II: Classification01:27

Angina II: Classification

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Angina, also known as angina pectoris, is a chest pain resulting from diminished blood flow to the heart muscle and is often a symptom of coronary artery disease. Angina presents several variants with distinctive attributes, etiologies, and therapeutic approaches. The main types of angina include stable, unstable, variant (Prinzmetal's), microvascular, intractable, and silent ischemia.Stable angina is caused by atherosclerosis, which leads to the formation of plaques that narrow the coronary...
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Coronary Artery Disease III: Clinical Manifestations01:30

Coronary Artery Disease III: Clinical Manifestations

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Coronary Artery Disease (CAD) is a primary health risk worldwide, leading to significant morbidity and mortality. The condition arises from the buildup of atherosclerotic plaques within the coronary arteries, resulting in diminished blood supply to the heart muscle.The clinical manifestations of CAD vary widely, from asymptomatic stages to severe, life-threatening conditions. Understanding these manifestations is crucial for early diagnosis and effective management.Angina Pectoris: The Warning...
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Acute Coronary Syndrome I: Introduction01:30

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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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Multimodality Diagnosis of Mesenteric Ischemia
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Mesenteric Ischemia: A Deadly Miss.

Manpreet Singh1, Brit Long2, Alex Koyfman3

  • 1Department of Emergency Medicine, Harbor-UCLA Medical Center, David Geffen School of Medicine at UCLA, Torrance, 1000 W. Carson Street, Box 21, Torrance, CA 90502, USA.

Emergency Medicine Clinics of North America
|October 9, 2017
PubMed
Summary
This summary is machine-generated.

Mesenteric ischemia, a condition with multiple causes, presents variably. Early diagnosis relies on clinical suspicion, with computed tomography angiography as the preferred imaging method.

Keywords:
Acute arterial emboliAcute arterial thrombosisMesenteric ischemiaMesenteric venous thrombosisNonocclusivePain out of proportionTime is bowel

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Area of Science:

  • Gastroenterology
  • Vascular Surgery
  • Emergency Medicine

Background:

  • Mesenteric ischemia encompasses four primary etiologies: arterial embolus, arterial thrombosis, venous thrombosis, and nonocclusive causes.
  • Clinical presentation is highly variable, lacking definitive diagnostic history or physical examination findings.
  • Early symptoms may include pain disproportionate to physical findings and early satiety, progressing to peritoneal signs with transmural infarction.

Purpose of the Study:

  • To review the diagnostic challenges and optimal management strategies for mesenteric ischemia.
  • To emphasize the importance of clinical suspicion and risk factor assessment in diagnosing mesenteric ischemia.
  • To highlight the role of computed tomography angiography in diagnosis and multidisciplinary treatment approaches.

Main Methods:

  • Review of existing literature on mesenteric ischemia diagnosis and management.
  • Analysis of clinical presentations, diagnostic modalities, and treatment outcomes.
  • Emphasis on the integration of clinical assessment, imaging, and timely intervention.

Main Results:

  • No single clinical feature reliably diagnoses mesenteric ischemia.
  • Computed tomography angiography is identified as the optimal imaging modality.
  • Effective treatment necessitates surgical and interventional radiology consultation, supportive care (fluids, antibiotics), and anticoagulation.

Conclusions:

  • Physicians must maintain a high index of suspicion for mesenteric ischemia, particularly in patients with "pain out of proportion."
  • Prompt diagnosis and multidisciplinary management are critical for improving patient outcomes.
  • The physician's bedside assessment remains a crucial component in the diagnostic process.