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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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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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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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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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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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[Non-ST elevation acute coronary syndrome: CRAC register experience].

R Hakim1, C Thuaire1, C Saint-Etienne2

  • 1Service de cardiologie, les hôpitaux de Chartres, Chartres, France.

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|November 5, 2018
PubMed
Summary

Nonagenarians with non-ST elevation acute coronary syndrome (ACS) exhibit more severe coronary artery disease and worse outcomes. This study highlights the increased risks and specific characteristics of ACS in the oldest patient population.

Keywords:
Non-ST-segment-elevation acute coronary syndromesNonagénairesSCA sans sus STnonagenarians

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Area of Science:

  • Cardiology
  • Geriatric Medicine
  • Clinical Research

Background:

  • Non-ST elevation acute coronary syndrome (ACS) is a critical cardiovascular event.
  • Understanding the unique clinical profiles of elderly patients with ACS is essential for tailored treatment strategies.

Purpose of the Study:

  • To compare clinical, angiographic, therapeutic, and prognostic features of nonagenarians (≥90 years) with non-ST elevation ACS against younger patients.
  • To identify specific challenges and outcomes in the nonagenarian ACS population.

Main Methods:

  • Utilized the CRAC registry (2014-2017) database from 6 catheterization laboratories.
  • Selected patients with positive-troponin non-ST elevation ACS for epidemiological and procedural data.
  • Analyzed antiplatelet therapy, and hospital/one-year follow-up data for patients from the 2014-2015 period.

Main Results:

  • 133 nonagenarians (2.2%) were identified among 5,964 patients with non-ST elevation ACS.
  • Nonagenarians had higher rates of arterial hypertension, prior coronary angioplasty, multivessel disease, and left main disease.
  • Higher one-year stroke, hospital, and one-year mortality rates were observed in nonagenarians.

Conclusions:

  • Nonagenarians with positive-troponin non-ST elevation ACS present with more complex coronary artery disease.
  • This elderly cohort experiences a significantly poorer prognosis compared to younger individuals.