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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 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 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...
Angina V: Nursing Management01:20

Angina V: Nursing Management

Angina, a symptom of myocardial ischemia, requires a structured nursing management approach to ensure effective care and prevent complications like myocardial infarction. Comprehensive nursing care involves assessing, diagnosing, planning, implementing interventions, and evaluating outcomes, all tailored to the individual patient's needs.Patient AssessmentNursing assessment begins with a detailed subjective evaluation of symptoms, which typically include chest pain or pressure radiating to the...
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,...
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...

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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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In Hospital Assessment and Management of High Bleeding Risk in Patients with ST-Elevation Myocardial Infarction

Sanghoon Kim1,2, Alberto Piserra-López3,4, Salvatore Giordano2,5

  • 1Department of Cardiology, CHA Bundang Medical Center, CHA University, Seongnam 13497, Republic of Korea.

Journal of Cardiovascular Development and Disease
|May 26, 2026
PubMed
Summary

Assessing bleeding risk is crucial for ST-elevation myocardial infarction (STEMI) patients. A dynamic, phase-specific framework is proposed for better in-hospital bleeding risk assessment and management.

Keywords:
ST-elevation myocardial infarction (STEMI)antithrombotic therapybleeding risk stratificationhigh bleeding riskpercutaneous coronary intervention

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Area of Science:

  • Cardiology
  • Clinical Medicine
  • Patient Safety

Background:

  • Bleeding risk assessment is vital for ST-segment elevation myocardial infarction (STEMI) management.
  • Current bleeding risk scores have evolving predictive performance in STEMI populations.
  • Bleeding risk is dynamic, influenced by clinical status, procedures, and antithrombotic strategies.

Purpose of the Study:

  • To review current evidence on identifying high bleeding risk in hospitalized STEMI patients.
  • To discuss the clinical implications of high bleeding risk in STEMI.
  • To propose a dynamic, phase-specific framework for in-hospital bleeding risk assessment and management.

Main Methods:

  • Narrative review of existing literature.
  • Synthesis of evidence on bleeding risk identification and prevention.
  • Development of a conceptual framework for dynamic risk assessment.

Main Results:

  • Bleeding risk stratification in STEMI is complex and requires continuous reassessment.
  • Bleeding avoidance measures like radial access and tailored antithrombotic therapy are key.
  • Balancing ischemic and bleeding risks necessitates individualized management strategies.

Conclusions:

  • Refining risk stratification tools and integrating evidence-based prevention are essential.
  • A dynamic, phase-specific approach to bleeding risk assessment is proposed for STEMI patients.
  • Effective bleeding management improves prognosis in STEMI.