风湿性关节炎患者的心血管疾病风险评估:范围审查
Louise Murphy1,2, Mohamad M Saab3, Nicola Cornally3
1Catherine McAuley School of Nursing and Midwifery, University College Cork, Cork, Ireland. 99928302@umail.ucc.ie.
Clinical rheumatology
|May 11, 2024
概括
患有类风湿性关节炎 (RA) 的患者面临更高的心血管疾病 (CVD) 风险. 目前在RA护理中CVD风险评估策略多样化,缺乏标准化,突出需要更好地实施和研究实践模式.
科学领域:
- 类风湿病学 类风湿病学
- 心脏病学 心脏病学
- 公共卫生 公共卫生
背景情况:
- 患有类风湿性关节炎 (RA) 的患者表现出心血管疾病 (CVD) 的风险增加.
- 尽管有指导方针,但在常规护理中不一致地应用RA患者的CVD风险评估.
- 早期识别有风险的个体对于预防策略和个性化治疗至关重要.
研究的目的:
- 审查在常规护理中对RA患者进行心血管疾病风险评估的策略.
- 确定参与提供这些评估的医疗保健专业人员.
- 确定用于RA中CVD风险评估的复合措施.
主要方法:
- 在多个数据库和灰色文献来源中进行了系统的文献搜索.
- 遵循了乔安娜·布里格斯研究所的方法指南.
- 来自12项纳入研究的研究结果使用叙事方法进行了综合.
主要成果:
- 包括多学科合作和教育在内的各种基于系统的干预措施支持RA的CVD风险评估.
- 报告了不同的复合措施,其中一些针对RA特定因素进行了调整.
- 有限的证据表明,在RA常规护理中进行心血管疾病风险评估的标准化模型.
结论:
- 目前在RA中对心血管疾病风险评估的策略多样化,但尚未为常规实践标准化.
- 在了解医疗保健专业人员如何在现实环境中进行这些评估方面存在重大差距.
- 进一步的研究是至关重要的,以确定在临床实践中对RA患者的CVD风险评估的实际程度.
相关概念视频
01:23Assessment of the Cardiovascular System I: Subjective Data
320
A thorough health history and physical assessment are essential for identifying cardiovascular disease (CVD) symptoms and distinguishing them from other health issues.
Initial Enquiry
Ask the patient about their primary concern and thoroughly explore all reported symptoms.
Medical History
Investigate past illnesses affecting the cardiovascular system, such as angina, anemia, rheumatic fever, congenital heart disease, stroke, thrombophlebitis, dysrhythmias, varicosities
Inquire about symptoms...
Initial Enquiry
Ask the patient about their primary concern and thoroughly explore all reported symptoms.
Medical History
Investigate past illnesses affecting the cardiovascular system, such as angina, anemia, rheumatic fever, congenital heart disease, stroke, thrombophlebitis, dysrhythmias, varicosities
Inquire about symptoms...
320
01:29Assessment of the Cardiovascular System II: Inspection
227
Inspection is the initial step in assessing the cardiovascular system. It involves a detailed visual examination that provides crucial information about a patient's circulatory and cardiac health. This systematic process, conducted from head to toe, helps identify signs of cardiovascular conditions by observing physical appearance, skin and mucous membranes, jugular and carotid pulsations, chest symmetry, and the condition of the extremities.
Head and Neck
Head and Neck
227
01:27Assessment of the Cardiovascular System III: Palpation
318
Palpation involves feeling the body to evaluate texture, size, consistency, and tenderness for assessing cardiovascular health. The following steps are organized in a head-to-toe order:
Jugular Venous Pressure (JVP) Measurement
Position the patient at a thirty- to forty-five-degree angle or in a semi-fowler's position. Look for the highest point of pulsation in the internal jugular vein and measure the vertical distance to the angle of Loius or sternal angle. A normal JVP is 3-4 cm above...
Jugular Venous Pressure (JVP) Measurement
Position the patient at a thirty- to forty-five-degree angle or in a semi-fowler's position. Look for the highest point of pulsation in the internal jugular vein and measure the vertical distance to the angle of Loius or sternal angle. A normal JVP is 3-4 cm above...
318
01:27Psychoneuroimmunology: Cardiovascular Disease
30
Psychoneuroimmunology (PNI) is a multidisciplinary field that examines how psychological factors, particularly stress, interact with the immune system and impact physical health. Research in PNI has shown that chronic or traumatic stress can disrupt both the hypothalamic-pituitary-adrenal axis and the sympathetic nervous system. These disruptions contribute to serious health conditions, including cardiovascular diseases.
A key area of focus in PNI is the relationship between stress and coronary...
A key area of focus in PNI is the relationship between stress and coronary...
30
01:19Blood Studies for Cardiovascular System II: CRP, Hcy, and Cardiac Natriuretic Peptide Markers
80
Cardiac biomarkers are critical in diagnosing, prognosing, and managing cardiovascular diseases. Routine measurement of specific biomarkers such as B-type natriuretic peptide (BNP), C-reactive protein (CRP), and homocysteine (Hcy) is common practice in clinical settings to evaluate heart function and predict cardiovascular events.
These markers indicate stress or strain on the heart muscle:
Natriuretic Peptides (BNP)
Cardiac myocytes produce these hormones in response to ventricular stretching...
These markers indicate stress or strain on the heart muscle:
Natriuretic Peptides (BNP)
Cardiac myocytes produce these hormones in response to ventricular stretching...
80
01:20Blood Studies for Cardiovascular System I: Cardiac Biomarkers
141
Cardiac biomarkers are enzymes, proteins, and hormones released into the blood when cardiac cells are injured. They are powerful tools for triaging.
The essential diagnostic tools for detecting myocardial necrosis and monitoring individuals suspected of having acute coronary syndrome (ACS) include:
Troponins
Troponins, particularly cardiac troponins I and T, are the most precise and sensitive markers of myocardial injury. They are detectable within 4-6 hours of myocardial injury and remain...
The essential diagnostic tools for detecting myocardial necrosis and monitoring individuals suspected of having acute coronary syndrome (ACS) include:
Troponins
Troponins, particularly cardiac troponins I and T, are the most precise and sensitive markers of myocardial injury. They are detectable within 4-6 hours of myocardial injury and remain...
141