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Related Concept Videos

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 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 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 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...
Coronary Artery Disease V: Interprofessional Care01:27

Coronary Artery Disease V: Interprofessional Care

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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A Research Method For Detecting Transient Myocardial Ischemia In Patients With Suspected Acute Coronary Syndrome Using Continuous ST-segment Analysis
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Large Language Model-Based Identification of Acute Coronary Syndrome Management Delays.

Verity Schaye1, Bijal Rajput2, Lexi Signoriello3

  • 1Department of Medicine, Division of General Internal Medicine and Clinical Innovation, NYU Langone Health, New York, New York; Institute for Innovations in Medical Education, NYU Grossman School of Medicine, New York, New York; Department of Medicine, Division of Hospital Medicine, NYU Langone Health, New York, New York.

The American Journal of Cardiology
|June 8, 2026
PubMed
Summary

A new large language model (LLM) system can identify delays in acute coronary syndrome (ACS) care. Older patients, females, and those with non-English/Spanish preferred languages were more likely to experience delays.

Keywords:
acute coronary syndromediagnostic errorslarge language modelsmanagement delay

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Area of Science:

  • Cardiology
  • Artificial Intelligence
  • Healthcare Informatics

Background:

  • Prompt treatment of acute coronary syndrome (ACS) is crucial, but identifying management delays is challenging.
  • Existing methods for detecting delays in ACS care are often manual and time-consuming.

Purpose of the Study:

  • To develop and validate a large language model (LLM) system for identifying management delays in acute coronary syndrome (ACS).
  • To characterize patient demographics and clinical factors associated with ACS management delays.

Main Methods:

  • A LLM system was developed to analyze internal medicine resident admission notes and cardiology consult notes for ACS management initiation.
  • Ground truth was established by physician review of discordant cases using a validated tool.
  • Demographic and clinical data of patients with and without delays were compared.

Main Results:

  • The LLM system identified ACS management delays with a 52% positive predictive value.
  • Older age, female sex, and non-English/Spanish preferred language were associated with a higher likelihood of management delay.
  • Patients experiencing delays had significantly longer times to receiving heparin, aspirin, and cardiac catheterization.

Conclusions:

  • The developed LLM-based system effectively identifies ACS management delays at scale.
  • Findings can inform targeted interventions to improve the quality of ACS care and reduce disparities.