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Related Concept Videos

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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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 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 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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Coronary Artery Disease V: Interprofessional Care01:27

Coronary Artery Disease V: Interprofessional Care

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Interprofessional care for coronary artery disease includes pharmacological therapy and revascularization procedures.Pharmacological therapy for Coronary Artery Disease (CAD) aims to manage symptoms, prevent complications, and improve patient outcomes through various classes of medications:Antiplatelet Agents:Aspirin and Clopidogrel: These medications inhibit platelet aggregation, preventing blood clots, which is crucial for avoiding heart attacks and strokes. Doctors often prescribe these...
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Pericarditis IV: Nursing Management01:25

Pericarditis IV: Nursing Management

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Pericarditis, an inflammation of the pericardium, necessitates diligent nursing management to ensure effective patient care and recovery. The initial step in managing pericarditis is a comprehensive patient medical assessment.The patient reports chest pain aggravated by breathing, coughing, and swallowing, which worsens when lying supine. The pain often improves when sitting up and leaning forward. Additional symptoms may include fever, malaise, and, in severe cases, signs of heart failure.
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Palliative Care in Acute Cardiovascular Hospitalizations: A National Inpatient Sample Analysis.

Leah McAleer1, Abrar Mamun1, Nicholas Lorusso2

  • 1University of Texas Southwestern Medical Center (L.M., A.M., M.S.S.), Dallas, Texas, USA.

Journal of Pain and Symptom Management
|December 29, 2025
PubMed
Summary

Palliative care (PC) use in acute cardiovascular disease (CVD) hospitalizations is low and influenced by patient demographics and hospital type, not just illness severity. Interventions are needed to ensure equitable access to PC for all CVD patients.

Keywords:
Cardiovascular palliative carecardiovascular diseasehealth disparitieshealthcare utilizationnational inpatient sample

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Area of Science:

  • Cardiology
  • Palliative Care
  • Health Services Research

Background:

  • Palliative care (PC) is crucial for cardiovascular disease (CVD) patients.
  • Utilization of PC during acute CVD hospitalizations remains suboptimal.
  • Understanding predictors of PC use is essential for improving care.

Purpose of the Study:

  • To identify demographic, clinical, and institutional factors associated with PC utilization in acute CVD hospitalizations.
  • To analyze disparities in PC access among diverse patient populations.
  • To inform strategies for increasing equitable PC referral rates.

Main Methods:

  • Analysis of 2016-2019 National Inpatient Sample (NIS) data for acute CVD hospitalizations.
  • Identification of PC interventions using ICD-10-CM code Z51.5.
  • Multivariate logistic regression and ANOVA to assess predictors of PC utilization.

Main Results:

  • Only 3.9% of 823,232 acute CVD hospitalizations included PC.
  • PC recipients were more likely older, female, White/Asian, Medicare-insured, and from higher-income areas.
  • Higher PC rates were observed in larger, suburban/urban, and teaching hospitals; cardiogenic shock had highest utilization (25.4%).
  • PC was linked to lower procedure burden but higher length of stay, charges, and mortality, indicating referral of sicker patients.

Conclusions:

  • PC utilization in acute CVD hospitalizations is significantly influenced by sociodemographic and institutional factors.
  • Clinical impact alone does not fully predict PC referral.
  • Targeted interventions addressing patient and hospital factors are necessary to promote equitable PC access.