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Related Concept Videos

Acute Coronary Syndrome I: Introduction01:30

Acute Coronary Syndrome I: Introduction

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...
Acute Coronary Syndrome II: Pathophysiology and Clinical Manifestations01:19

Acute Coronary Syndrome II: Pathophysiology and Clinical Manifestations

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...
Acute Coronary Syndrome III: Diagnostic Studies01:30

Acute Coronary Syndrome III: Diagnostic Studies

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...
Acute Coronary Syndrome IV: Interprofessional Care01:28

Acute Coronary Syndrome IV: Interprofessional Care

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...
Acute Coronary Syndrome V: Nursing Management01:26

Acute Coronary Syndrome V: Nursing Management

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,...
Aneurysm II: Clinical Manifestations and Diagnostic Studies01:21

Aneurysm II: Clinical Manifestations and Diagnostic Studies

Thoracic, aortic arch and abdominal aneurysms are significant vascular conditions that can present with various clinical manifestations and lead to serious complications. Understanding these manifestations and the appropriate diagnostic studies is essential for effective management and treatment.Thoracic Aortic AneurysmsThoracic aortic aneurysms often remain asymptomatic until they reach a size that impinges on adjacent structures. They typically cause deep, diffuse chest pain that radiates to...

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A Research Method For Detecting Transient Myocardial Ischemia In Patients With Suspected Acute Coronary Syndrome Using Continuous ST-segment Analysis
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Evaluating current acute aortic syndrome pathways: Collaborative Acute Aortic Syndrome Project (CAASP).

Jim Zhong1,2, Aminder A Singh3,4, Nawaz Z Safdar2,5

  • 1Department of Diagnostic and Interventional Radiology, Leeds Teaching Hospitals NHS Trust, Leeds, UK.

BJS Open
|September 19, 2024
PubMed
Summary

Acute aortic syndrome diagnosis and treatment pathways were evaluated in 620 patients. Delays in diagnosis and treatment impact patient outcomes, highlighting areas for improved acute aortic syndrome care strategies.

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Area of Science:

  • Cardiovascular Medicine
  • Vascular Surgery
  • Medical Imaging

Background:

  • Acute aortic syndrome (AAS) diagnosis is complex, with significant perihospital mortality.
  • Evaluating patient care pathways and timelines is crucial for improving outcomes.

Purpose of the Study:

  • To assess current patient care pathways for acute aortic syndrome.
  • To understand the chronology of AAS patient care from presentation to treatment.

Main Methods:

  • Retrospective review of 620 consecutive AAS patients diagnosed via imaging across 15 UK sites.
  • Data collected from January 2018 to June 2021, with 6-month follow-up.
  • Coordinated by the UK National Interventional Radiology Trainee Research and Vascular and Endovascular Research Network.

Main Results:

  • Type-A dissection (41.8%) and Type-B dissection (34.5%) were most common; 41.2% had complicated AAS.
  • Median time to hospital presentation was 3.1 hours; time to imaging diagnosis was 3.2 hours.
  • Delays in diagnosis and treatment, particularly interhospital transfers, were observed. Factors like age >70, complicated disease, and no critical care admission correlated with higher mortality.

Conclusions:

  • This study provides longitudinal data linking diagnostic and treatment delays to clinical outcomes in AAS.
  • Findings can inform research priorities to optimize AAS patient care pathways.
  • Streamlining patient care is essential to reduce mortality associated with acute aortic syndrome.