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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...
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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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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 V: Nursing Management01:26

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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 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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Angina II: Classification01:27

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Angina, also known as angina pectoris, is a chest pain resulting from diminished blood flow to the heart muscle and is often a symptom of coronary artery disease. Angina presents several variants with distinctive attributes, etiologies, and therapeutic approaches. The main types of angina include stable, unstable, variant (Prinzmetal's), microvascular, intractable, and silent ischemia.Stable angina is caused by atherosclerosis, which leads to the formation of plaques that narrow the coronary...
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Transient Intussusception Mimicking Acute Coronary Syndrome.

Hiroshi Imamura1, Yuichiro Kashima1, Yujiro Hamano1

  • 1Department of Emergency and Critical Care Medicine, Shinshu University, Matsumoto, Japan.

Case Reports in Gastrointestinal Medicine
|October 18, 2023
PubMed
Summary

Adult intussusception, though rare, can mimic acute coronary syndrome. This case highlights idiopathic ileocecal intussusception presenting as chest pain, emphasizing its role in differential diagnosis.

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Area of Science:

  • Gastroenterology
  • Cardiology
  • Radiology

Background:

  • Adult intussusception is uncommon and typically linked to underlying organic pathology.
  • Idiopathic and transient intussusceptions are increasingly recognized, particularly with advancements in computed tomography (CT).

Observation:

  • An 80-year-old male with a history of myocardial infarction presented with symptoms suggestive of acute coronary syndrome, including chest pain, sweating, and vomiting.
  • Coronary angiography showed no new significant lesions, but abdominal CT revealed ileocecal intussusception without bowel obstruction.

Findings:

  • The patient's pain resolved spontaneously, and he was discharged without specific intervention for the intussusception.
  • This case demonstrates ileocecal intussusception presenting atypically as cardiac pain.

Implications:

  • Physicians should consider intussusception as a differential diagnosis in patients presenting with chest pain and a normal coronary arteriogram.
  • Idiopathic intussusception's potential for spontaneous resolution necessitates awareness in clinical practice.
  • This highlights the importance of cross-disciplinary diagnostic considerations in emergency medicine.