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Related Concept Videos

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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Coronary Artery Disease V: Interprofessional Care01:27

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Interprofessional care for coronary artery disease includes pharmacological therapy and revascularization procedures.Pharmacological therapy for Coronary Artery Disease (CAD) aims to manage symptoms, prevent complications, and improve patient outcomes through various classes of medications:Antiplatelet Agents:Aspirin and Clopidogrel: These medications inhibit platelet aggregation, preventing blood clots, which is crucial for avoiding heart attacks and strokes. Doctors often prescribe these...
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Acute Coronary Syndrome II: Pathophysiology and Clinical Manifestations01:19

Acute Coronary Syndrome II: Pathophysiology and Clinical Manifestations

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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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Coronary Artery Disease IV: Preventive Measures01:26

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Effective preventive measures for coronary artery disease (CAD) focus on controlling modifiable risk factors, including cholesterol abnormalities and lifestyle changes.Cholesterol ManagementFirst, the Mediterranean diet and the American Heart Association advocate for maintaining low-density lipoprotein (LDL) cholesterol levels below 100 mg/dL, with a more stringent recommendation of below 70 mg/dL for individuals at high risk. LDL cholesterol, often termed "bad cholesterol," can lead to the...
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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 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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Decrease and Delay in Hospitalization for Acute Coronary Syndromes During the 2020 SARS-CoV-2 Pandemic.

Gioel Gabrio Secco1, Chiara Zocchi2, Rosario Parisi3

  • 1Department of Cardiology, Interventional Cardiology and Cardiac Surgery, Azienda Ospedaliera SS, Antonio e Biagio e Cesare Arrigo, Alessandria, Italy; Department of Cardiology, Azienda Ospedaliera SS Antonio e Biagio e Cesare Arrigo, Alessandria, Italy.

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Summary

The COVID-19 pandemic led to fewer acute coronary syndrome (ACS) hospitalizations. Patients experiencing ACS during the outbreak faced longer treatment times and worse outcomes, increasing cardiovascular mortality risk.

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Area of Science:

  • Cardiology
  • Public Health
  • Infectious Diseases

Background:

  • The severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) pandemic prompted significant public health interventions.
  • Restrictive measures implemented during the pandemic impacted healthcare delivery for non-SARS-CoV-2 conditions.

Purpose of the Study:

  • To evaluate the impact of the initial SARS-CoV-2 outbreak in Italy on patients admitted with acute coronary syndromes (ACS).
  • To compare ACS patient characteristics and outcomes during the outbreak versus the preceding year.

Main Methods:

  • Retrospective analysis of ACS patients admitted to three high-volume hospitals.
  • Comparison of data from the first month of the Italian SARS-CoV-2 outbreak (2020) with the same period in the previous year (2019).

Main Results:

  • Hospital admissions for ACS significantly decreased in 2020 (84 patients) compared to 2019 (162 patients).
  • Patients admitted in 2020 experienced longer door-to-balloon and symptom-to-percutaneous coronary intervention times.
  • Higher admission levels of high-sensitive cardiac troponin I, reduced left-ventricular function, and increased predicted late cardiovascular mortality (higher GRACE scores) were observed in 2020.

Conclusions:

  • The COVID-19 outbreak led to a substantial reduction in ACS hospitalizations.
  • Patients with ACS during the outbreak faced delays in treatment and poorer clinical outcomes, suggesting a negative impact on cardiovascular care.