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Related Concept Videos

Acute Coronary Syndrome I: Introduction01:30

Acute Coronary Syndrome I: Introduction

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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 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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Acute Coronary Syndrome III: Diagnostic Studies01:30

Acute Coronary Syndrome III: Diagnostic Studies

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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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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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Blood Studies for Cardiovascular System I: Cardiac Biomarkers01:20

Blood Studies for Cardiovascular System I: Cardiac Biomarkers

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Cardiac biomarkers are enzymes, proteins, and hormones released into the blood when cardiac cells are injured. They are powerful tools for triaging.
The essential diagnostic tools for detecting myocardial necrosis and monitoring individuals suspected of having acute coronary syndrome (ACS) include:
Troponins
Troponins, particularly cardiac troponins I and T, are the most precise and sensitive markers of myocardial injury. They are detectable within 4-6 hours of myocardial injury and remain...
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Myocarditis II: Clinical Features and Diagnostic Tests01:27

Myocarditis II: Clinical Features and Diagnostic Tests

171
Myocarditis is an inflammation of the heart muscle. The symptoms vary widely, encompassing asymptomatic presentations to severe, acute manifestations.Clinical PresentationAsymptomatic cases: In some instances, myocarditis may be asymptomatic, with the infection resolving without intervention. These cases often go undetected unless discovered incidentally through diagnostic imaging or tests conducted for other reasons.General Early Symptoms: Early symptoms of myocarditis are non-specific and can...
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Related Experiment Video

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A Research Method For Detecting Transient Myocardial Ischemia In Patients With Suspected Acute Coronary Syndrome Using Continuous ST-segment Analysis
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Sex-Based Differences in Unrecognized Myocardial Infarction.

M Yldau van der Ende1, Luis Eduardo Juarez-Orozco1, Ingmar Waardenburg1

  • 1Department of Cardiology University Medical Center Groningen University of Groningen The Netherlands.

Journal of the American Heart Association
|June 24, 2020
PubMed
Summary

Many myocardial infarctions go unrecognized, particularly in women. This highlights missed opportunities for crucial preventive therapies and underscores the need for better detection strategies in both sexes.

Keywords:
cohort studyepidemiologyincidencesex differencesunrecognized myocardial infarction

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Area of Science:

  • Cardiology
  • Epidemiology
  • Public Health

Background:

  • Myocardial infarction (MI) is a leading cause of death and disability globally.
  • Women often present with atypical or absent symptoms, potentially leading to unrecognized MIs.
  • Undiagnosed MIs result in missed opportunities for timely preventive treatments.

Purpose of the Study:

  • To investigate sex-based differences in the incidence and recognition of myocardial infarction.
  • To identify predictors and symptom profiles associated with unrecognized MIs.
  • To assess the impact of unrecognized MIs on secondary preventive therapy utilization.

Main Methods:

  • Analysis of data from the Lifelines Cohort Study (n=97,203) with baseline and follow-up ECGs (median 3.8 years).
  • Calculation of age- and sex-specific incidence rates for myocardial infarction.
  • Determination of unrecognized MIs based on symptom reporting and ECG changes.

Main Results:

  • Higher incidence rate of MI in men (3.30/1000 person-years) than in women (1.92/1000 person-years).
  • A substantial proportion of MIs were unrecognized: 30% in women versus 16% in men.
  • Unrecognized MIs were associated with fewer specific cardiac symptoms and predictors including hypertension, smoking, and elevated blood glucose.

Conclusions:

  • A significant percentage of myocardial infarctions remain unrecognized, with women disproportionately affected.
  • Undiagnosed MIs lead to underutilization of secondary preventive therapies.
  • Improved diagnostic strategies are needed to identify unrecognized MIs, especially in women.