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Related Concept Videos

Acute Coronary Syndrome III: Diagnostic Studies01:30

Acute Coronary Syndrome III: Diagnostic Studies

122
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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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 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...
513
Coronary Artery Disease V: Interprofessional Care01:27

Coronary Artery Disease V: Interprofessional Care

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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 V: Nursing Management01:26

Acute Coronary Syndrome V: Nursing Management

181
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 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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Updates in Spontaneous Coronary Artery Dissection.

Chayakrit Krittanawong1,2, Jacqueline Saw3, Jeffrey W Olin4

  • 1Section of Cardiology, Baylor School of Medicine and the Michael E. DeBakey VA Medical Center, 1 Baylor Plaza, Houston, TX, 77030, USA. Chayakrit.Krittanawong@bcm.edu.

Current Cardiology Reports
|August 12, 2020
PubMed
Summary

Spontaneous coronary artery dissection (SCAD) primarily affects women and presents diagnostic challenges. Management strategies for SCAD vary, recommending conservative approaches for low-risk cases and revascularization for high-risk SCAD.

Keywords:
Cardiac rehabilitationCoronary revascularizationRecurrent SCADSCADSCAD preventionSpontaneous coronary artery dissection

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Area of Science:

  • Cardiology
  • Vascular Biology

Background:

  • Spontaneous Coronary Artery Dissection (SCAD) predominantly impacts women lacking traditional cardiovascular risk factors.
  • SCAD diagnosis and management are complicated by its heterogeneity, poorly understood mechanisms, diverse phenotypes, and limited robust clinical evidence.

Purpose of the Study:

  • To comprehensively review the epidemiology, pathogenesis, diagnostic approaches utilizing novel imaging, management strategies, and recurrence prevention of SCAD.
  • To provide an in-depth analysis of the current body of evidence on SCAD.

Main Methods:

  • Review of current scientific literature and clinical evidence pertaining to SCAD.
  • Analysis of diagnostic utility of emerging non-invasive imaging modalities such as coronary computed tomography angiography, cardiac magnetic resonance, and myocardial perfusion imaging.
  • Evaluation of management strategies including conservative treatment, cardiac rehabilitation, and coronary revascularization.

Main Results:

  • Conservative management with cardiac rehabilitation is recommended for SCAD cases exhibiting low-risk features.
  • Coronary revascularization should be considered for SCAD patients presenting with high-risk features.
  • Non-invasive imaging modalities are crucial for diagnosing specific SCAD phenotypes.
  • Standard guideline-based medical therapy for acute coronary syndrome is advised for SCAD, barring contraindications.

Conclusions:

  • Management of SCAD should be individualized, considering patient profiles and risk stratification.
  • Discharge counseling and follow-up care for SCAD patients should leverage emerging imaging techniques on a case-by-case basis.