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Related Concept Videos

Acute Coronary Syndrome I: Introduction01:30

Acute Coronary Syndrome I: Introduction

168
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 V: Nursing Management01:26

Acute Coronary Syndrome V: Nursing Management

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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

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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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 III: Clinical Manifestations01:30

Coronary Artery Disease III: Clinical Manifestations

89
Coronary Artery Disease (CAD) is a primary health risk worldwide, leading to significant morbidity and mortality. The condition arises from the buildup of atherosclerotic plaques within the coronary arteries, resulting in diminished blood supply to the heart muscle.The clinical manifestations of CAD vary widely, from asymptomatic stages to severe, life-threatening conditions. Understanding these manifestations is crucial for early diagnosis and effective management.Angina Pectoris: The Warning...
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Acute Coronary Syndrome Presenting With Hiccups.

Jacquelyn Hovey1, Talha Perwez2, Prudhvi Regula2

  • 1Internal Medicine, University of Alabama at Birmingham (UAB) School of Medicine, Montgomery, USA.

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|August 10, 2021
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Summary

Persistent hiccups can signal acute coronary syndrome (ACS), a serious heart condition. This case highlights the importance of considering cardiac causes for unexplained, prolonged hiccups in at-risk patients.

Keywords:
acute coronary syndromecoronary artery bypass grafthiccupmyocardial infarctionmyocardial ischemia

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Area of Science:

  • Cardiology
  • Neurology

Background:

  • Acute coronary syndrome (ACS) often presents with classic chest pain.
  • Atypical symptoms of ACS can include various non-cardiac complaints.
  • Persistent hiccups are rarely recognized as a potential indicator of myocardial ischemia.

Observation:

  • A 62-year-old male with hypertension, type II diabetes mellitus, and prior ischemic stroke presented with persistent hiccups.
  • Coronary angiography revealed severe triple vessel coronary artery disease.
  • Hiccups resolved post-coronary artery bypass graft surgery.

Findings:

  • This case represents the first reported instance of hiccups as a primary symptom of severe triple vessel coronary artery disease.
  • The persistent hiccups are hypothesized to result from phrenic nerve irritation due to myocardial infarction, activating the hiccup reflex arc.

Implications:

  • Highlights a rare but significant association between persistent hiccups and acute coronary syndrome.
  • Emphasizes the need for a high index of suspicion for cardiac ischemia in patients presenting with unexplained, persistent hiccups, particularly the elderly and those with cardiovascular risk factors.