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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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Myocarditis IV: Nursing Management01:22

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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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Acute Coronary Syndrome III: Diagnostic Studies01:30

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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

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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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Acute Coronary Syndrome II: Pathophysiology and Clinical Manifestations01:19

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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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Myocarditis II: Clinical Features and Diagnostic Tests01:27

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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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Updated: Sep 4, 2025

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North American COVID-19 Myocardial Infarction (NACMI) Risk Score for Prediction of In-Hospital Mortality.

Payam Dehghani1, Christian W Schmidt2, Santiago Garcia2

  • 1Prairie Vascular Research Inc, Regina, Saskatchewan, Canada.

Journal of the Society for Cardiovascular Angiography & Interventions
|July 18, 2022
PubMed
Summary

A new risk score effectively predicts in-hospital mortality for patients with ST-segment elevation myocardial infarction (STEMI) and COVID-19. This score uses eight clinical variables, offering a vital tool for managing high-risk cardiac patients during the pandemic.

Keywords:
COVID-19NACMI, North American COVID-19 Myocardial InfarctionPCI, percutaneous coronary interventionSTEMI, ST-segment elevation myocardial infarctionTIMI, Thrombolysis in Myocardial Infarctionmortalitymyocardial infarctionrisk score

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Area of Science:

  • Cardiology
  • Infectious Diseases
  • Critical Care Medicine

Background:

  • In-hospital mortality is elevated in ST-segment elevation myocardial infarction (STEMI) patients with COVID-19.
  • Predictive factors for this increased mortality remain poorly understood.
  • This necessitates the development of tools to identify at-risk individuals.

Purpose of the Study:

  • To develop and validate a risk score for predicting in-hospital mortality in STEMI patients with COVID-19.
  • To identify key clinical variables associated with mortality in this patient cohort.
  • To improve risk stratification and clinical management strategies.

Main Methods:

  • Utilized data from the North American COVID-19 Myocardial Infarction registry.
  • Employed univariable and multivariable logistic regression to identify independent predictors of mortality.
  • Developed a weighted integer risk score based on identified predictors.

Main Results:

  • In-hospital mortality occurred in 28% of the 425 patients studied.
  • Eight variables (elevated respiratory rate, cardiogenic shock, low oxygen saturation, age >55, chest x-ray infiltrates, kidney disease, diabetes, dyspnea) were identified as independent predictors.
  • The risk score demonstrated strong association with mortality (3.6% to 60%) and good discriminative power (c-statistic = 0.81).

Conclusions:

  • A novel risk score accurately predicts in-hospital mortality in COVID-19 patients with STEMI.
  • The score is derived from readily available clinical information, facilitating practical application.
  • This tool aids in identifying high-risk patients for targeted interventions and improved outcomes.