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Related Concept Videos

Myocarditis III: Medical Management01:14

Myocarditis III: Medical Management

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Myocarditis: Comprehensive Medical ManagementMyocarditis, the heart muscle inflammation, requires a comprehensive medical management strategy that addresses the underlying cause, provides supportive care, manages symptoms, and reduces cardiac workload.Infections and Autoimmune CausesAdminister appropriate antimicrobial therapy when an infectious agent causes myocarditis. For instance, penicillin treats infections caused by Group A Streptococcus. In cases where autoimmune processes are...
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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

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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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Myocarditis is an inflammatory condition of the myocardium requiring meticulous nursing management for optimal patient outcomes. Effective management begins with a thorough assessment of the patient's medical history, paying close attention to past infections, autoimmune disorders, travel history, and exposure to toxins or drugs. Recent viral infections and systemic diseases are particularly relevant due to their potential role in triggering myocarditis.Physical Examination and MonitoringThe...
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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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Related Experiment Video

Updated: Nov 27, 2025

Postconditioning with Lactate-enriched Blood for Cardioprotection in ST-segment Elevation Myocardial Infarction
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Naltrexone-Associated Non-ST-Elevated Myocardial Infarction.

James C Gubitosa1, Toby Terwillliger2, Adanna Ukazu3

  • 1Medicine, University Hospital - Rutgers New Jersey Medical School, Newark, USA.

Cureus
|December 3, 2020
PubMed
Summary

Opioid withdrawal can rarely cause serious cardiac events like heart attacks, even with medication-assisted treatment (MAT). Careful patient education on medication timing is crucial to prevent these dangerous complications.

Keywords:
ascvdcardiac troponindemand ischemiamedication for opioid use disorder (moud)medication-assisted treatmentnaltrexonenon-st segment elevation myocardial infarction (nstemi)opioid agonist therapy (oat)opioid use disordersopioid withdrawal

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Area of Science:

  • Cardiology
  • Addiction Medicine
  • Pharmacology

Background:

  • Medications for opioid use disorder (MOUD) and opioid agonist therapy (OAT) are standard treatments for opioid use disorder.
  • Initiating these therapies requires caution to prevent precipitated opioid withdrawal.

Observation:

  • A patient with opioid use disorder and multiple cardiac risk factors experienced nausea, vomiting, and lightheadedness after taking naltrexone post-buprenorphine.
  • She presented with hypertension, tachycardia, elevated troponin, and was diagnosed with non-ST-elevation myocardial infarction (NSTEMI) and hypertensive emergency during opioid withdrawal.

Findings:

  • The patient's NSTEMI was likely caused by demand ischemia from opioid withdrawal, exacerbated by her pre-existing cardiac risk factors.
  • Her condition stabilized after blood pressure management, aspirin, atorvastatin, and a modified OAT regimen with buprenorphine.

Implications:

  • Cardiac events during opioid withdrawal are rare but potentially lethal, especially in patients with underlying cardiovascular disease.
  • Healthcare providers must educate patients on proper medication dosing schedules when initiating opioid therapy or MOUD/OAT to mitigate risks.