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The heart, an organ critical to survival, gets nourishment not from the blood it pumps but from a separate circulation system known as coronary circulation. This is the shortest circulation in the body and is responsible for supplying the heart with the nutrients it needs to function effectively.
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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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Coronary Artery Disease I: Introduction01:30

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Coronary Artery Disease (CAD): An Overview with Scientific InsightsCoronary Artery Disease (CAD), often referred to as C-A-D, is a prevalent blood vessel disorder classified under the broader category of atherosclerosis. Atherosclerosis is a pathological process characterized by the hardening and narrowing of arteries due to the accumulation of atherosclerotic plaques. These plaques are composed of cholesterol, fatty substances, inflammatory cells, calcium, and fibrin, reducing blood flow to...
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Coronary Artery Disease II: Pathophysiology01:26

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Coronary Artery Disease (CAD) originates from a series of events that impair the function of coronary arteries, the blood vessels responsible for delivering oxygen-rich blood to the heart muscle. The pathophysiology of CAD is closely linked to atherosclerosis, a chronic inflammatory and lipid-driven condition affecting the vascular endothelium.1. Endothelial DamageThe process begins with damage to the vascular endothelium, which serves as a protective barrier between the blood and the vessel...
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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 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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Interventional Diagnostic Procedure: A Practical Guide for the Assessment of Coronary Vascular Function
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Dynamic coronary roadmapping during percutaneous coronary intervention: a feasibility study.

Kerstin Piayda1, Laura Kleinebrecht1, Shazia Afzal1

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A new Dynamic Coronary Roadmap software provides high-quality, real-time coronary artery visualization during percutaneous coronary interventions (PCI). This tool demonstrated excellent feasibility and accuracy in a study of 36 elective PCI procedures.

Keywords:
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Area of Science:

  • Cardiovascular Imaging
  • Medical Software Development
  • Interventional Cardiology

Background:

  • A novel Dynamic Coronary Roadmap software was developed for real-time coronary tree overlay on fluoroscopy.
  • The software aims to aid navigation during percutaneous coronary interventions (PCI) after automatic generation during angiography.

Purpose of the Study:

  • To investigate the feasibility of real-time dynamic coronary roadmapping.
  • To assess the consecutive coronary overlay accuracy during elective PCI.

Main Methods:

  • Analysis of 936 overlay runs from 36 elective PCI procedures.
  • Evaluation of roadmap quality (vessel imaging integrity) and overlay quality (anatomical congruence).
  • Assessment of procedural success and major adverse cardiac and cerebrovascular events (MACCE).

Main Results:

  • Roadmap quality was "fit for use" in 99.5% of runs; overlay quality was "fit for use" in 97.4%.
  • Low inter- and intra-observer variability was observed for both roadmap (ICC R=0.84) and overlay quality (ICC R=0.75).
  • Procedural success rate was 100%; MACCE occurred in 5.6% of patients and were unrelated to the software.

Conclusions:

  • Dynamic coronary roadmapping offers >98% sufficient roadmap quality with accurate coronary overlay and good inter/intra-observer reliability.
  • Future randomized trials are recommended to evaluate potential benefits such as reduced procedure time and contrast medium usage.