• Title/Summary/Keyword: Acute Coronary Syndrome

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Takotsubo Cardiomyopathy Associated with Guillain-Barré Syndrome (길랑-바레 증후군에서 발생한 Takotsubo 심근병)

  • Kang, Chul-Hoo;Oh, Jung Hwan;Song, Sook Keun;Kang, Sa-Yoon
    • Annals of Clinical Neurophysiology
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    • v.17 no.2
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    • pp.73-75
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    • 2015
  • A 69-year-old woman presented with a progressive limb weakness. Both clinical and neurophysiological findings were consistent with diagnosis of Guillain-$Barr{\acute{e}}$ syndrome (GBS). Two days after admission, the patient suffered from an acute coronary syndrome without stenosis at coronary arteriography. Echocardiography revealed left ventricular inferior wall and apical akinesia and decreased ejection fraction. A diagnosis of Takotsubo cardiomyopathy was then made. Left ventricular dysfunction and electrocardiography normalized within one month. Takotsubo cardiomyopathy can be developed as a complication of GBS.

Predicting Factors of Smoking and Emotional Stress among Male Patients with Acute Coronary Syndrome (급성관상동맥증후군 남성 환자의 흡연과 스트레스에 영향을 미치는 요인)

  • Kim, Eun-Young;Hwang, Seon-Young
    • Korean Journal of Adult Nursing
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    • v.23 no.1
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    • pp.100-109
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    • 2011
  • Purpose: This study was conducted to identify the factors that predict a current smoking behavior and higher emotional stress among male patients with acute coronary syndrome (ACS). Methods: The study was approved by an institutional review board from a university hospital, 2010. A face to face interview using questionnaires was performed with 185 first-time ACS male patients who were undertaken a percutaneous coronary intervention at a cardiovascular care unit. Data were analyzed using SPSS/WIN 15.0. Results: About 54% of the study subjects were currently smoking. The current smokers had dyslipidemia and reported bad eating habits compared to the non-smokers. The current smokers were younger, living alone, and reported lower perceived benefit on smoking cessation than the non-smokers, and 15% of them did not consider quitting (precontemplation stage). Smoking status was not significantly related to emotional stress. Logistic regression analysis revealed that being employed including professional or labor increased the odds of current smoking four or three times compared to the non-employed or retired. Low income or dyslipidemia also increased the likelihood of current smoking 2.8 and 2.1 times, respectively. Blue collar workers or heavy drinkers had 2.9 and 2.8 times more risks of having higher level of stress. Conclusion: An occupational background and health habits should be considered to develop an effective educational strategy for smoking cessation and stress reduction among male patients with ACS.

Comparison of Clinical Manifestations and Treatment-Seeking Behavior in Younger and Older Patients with First-time Acute Coronary Syndrome (성인과 노인 관상동맥증후군 초발 환자의 임상적 특성 및 치료추구행위 비교)

  • Hwang, Seon-Young
    • Journal of Korean Academy of Nursing
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    • v.39 no.6
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    • pp.888-898
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    • 2009
  • Purpose: This study was conducted to examine and compare clinical manifestations and predicting factors for treatment-seeking delay among patients <65 and ${\geq}65\;yr$ with first-time acute coronary syndrome (ACS). Methods: A total of 288 patients who were diagnosed with ACS were individually interviewed at C university hospital in G-city from November 2007 to December 2008. Results: Median pre-hospital delays for younger and older patients were 5 and 12 hr, respectively. Younger patients were more likely to be current smokers, heavy drinkers, obese, stressed, and have an unhealthy diet and family history, and to complain of chest pain, left shoulder and arm pain, perspiration, and nausea. Older patients were more likely to have hypertension and diabetes, and to complain syncope and dyspnea. Logistic regression analyses showed that after adjustment for age, gender and education, progressive onset of symptom and no attribution to cardiac problem significantly predicted pre-hospital delay >3 hr in both younger and older patients. Low perceived health status was a significant independent predictor in older patients only. Conclusion: Health care providers should be concerned with different manifestations between younger and older adults, and educate people at risk for heart attack about symptoms and actions to get immediate help.

Role of Magnetocardiography in Emergency Room (응급실에서 심자도의 역할)

  • Kwon, H.;Kim, K.;Kim, J.M.;Lee, Y.H.;Kim, T.E.;Lim, H.K.;Park, Y.K.;Ko, Y.G.;Chung, N.
    • Progress in Superconductivity
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    • v.8 no.1
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    • pp.40-45
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    • 2006
  • In emergency rooms, patients with acute chest pain should be diagnosed as quickly as possible with higher diagnostic accuracy for an appropriate therapy to the patients with acute coronary syndrome or for avoiding unnecessary hospital admissions. At present, electrocardiography(ECG) and biochemical markers are generally used to detect myocardial infarction and coronary angiography is used as a gold standard to reveal the degree of narrowing of coronary artery. Magnetocardiography(MCG) has been proposed as a novel and non-invasive diagnostic tool fur the detection of cardiac electrical abnormality associated with myocardial ischemia. In this study, we examined whether the MCG can be used fur the detection of coronary artery disease(CAD) in patients, who were admitted to the emergency room with acute chest pain. MCG was recorded from 36 patients admitted to the emergency room with suspected acute coronary syndrome. The MCG recordings were obtained using a 64-channel SQUID MCG system in a magnetically shielded room. In result, presence of CAD could be found with a sensitivity of 88.2 % in patients with acute chest pain without 57 elevation in ECG, demonstrating a possible use in the emergency room to screen CAD patients.

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A Survey on Prehospital Emergency Medical Service for the Improvement of Acute Coronary Syndrome Assessments - Focus on the Jecheon.Danyans Area - (급성관상동맥증후군 환자의 병원 전 119구급의료서비스 실태 및 개선방안 -충북 제천.단양을 중심으로-)

  • Roh, Sang-Gyun
    • Fire Science and Engineering
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    • v.22 no.3
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    • pp.293-299
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    • 2008
  • From January, 2004 to July, 2007, 97 patients were diagnosed with Acute coronary syndrome(ACS) in Emergency Medical Center in Jecheon City in Korea. Among 97 patients, the prehospital assessment rates were as follows ; blood pressure check(27.80%, pulse rate check(33.0%), respiration check(23.7%). In hospital emergency care, oxygen supply was 52.6%, absolute bed rest was 12.4%, electrocardiogram(EKG) check was 4.1%, and nitroglycerin and intravenous fluid therapy was 0%. Therefore, ACS patients have not received sufficient prehospital cares till now. In order to improve the proficiency of the first aid emergency medical technicians(EMTs), it is necessary to provide the continuing On-the-job training(OJT) programs for prehospital emergency care.

A Comparative Study the USA, Europe and Korea Guidelines of Antiplatelet Therapy for Patients with Acute Coronary Syndrome (급성관상동맥 증후군 치료를 위한 국내·외 항혈소판제 약물요법 가이드라인 비교 연구)

  • Jung, Eun-Joo;Lee, Chae-Won;Baek, In-Hwan
    • Korean Journal of Clinical Pharmacy
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    • v.25 no.3
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    • pp.200-208
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    • 2015
  • Objective: Patients with acute coronary syndrome (ACS) are typically managed with dual antiplatelet therapy of acetylsalicylic acid (aspirin) and $P2Y_{12}$ receptor inhibitor. In this study, we discussed current and previous antiplatelet therapy guidelines and compared with guidelines of the USA (ACC/AHA), Europe (ESC) and Korea (KSC). Method: This study investigated from ACC/AHA Joint Guidelines (the USA), ESC Clinical Practice Guidelines (Europe) and Korea Society of Interventional Cardiology (Korea) web site, respectively. Results: It is significant that difference between the current and the previous guidelines was integration of terminology from clopidogrel to $P2Y_{12}$ receptor inhibitors since prasugrel and ticagrelor, new antiplatelet drugs, has been added. The other difference was all three guidelines has differences in dose of aspirin. The most notable difference was class of recommendation(COR) in $P2Y_{12}$ receptor inhibitors. ACC/AHA and Korean guidelines recommend clopidogrel, prasugrel, and ticagrelor with COR IB; whereas, ESC recommend prasugrel and ticagrelor with IB which is higher than clopidogrel with IC. Conclusion: This research addresses important movement to revise the Korean existing guideline recommendations. New Korean antiplatelet therapy guideline should be avoiding obvious differences in ACC/AHA and ESC guidelines and harmonizing international guidelines.

Return to Work after an Acute Coronary Syndrome: Patients' Perspective

  • Slebus, Frans G.;Jorstad, Harald T.;Peters, Ron J.G.;Kuijer, P. Paul F.M.;Willems, J. (Han) H.B.M.;Sluiter, Judith K.;Frings-Dresen, Monique H.W.
    • Safety and Health at Work
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    • v.3 no.2
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    • pp.117-122
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    • 2012
  • Objectives: To describe the time perspective of return to work and the factors that facilitate and hinder return to work in a group of survivors of acute coronary syndrome (ACS). Methods: Retrospective semi-structured telephone survey 2 to 3 years after hospitalization with 84 employed Dutch ACS-patients from one academic medical hospital. Results: Fifty-eight percent of patients returned to work within 3 months, whereas at least 88% returned to work once within 2 years. Two years after hospitalization, 12% of ACS patients had not returned to work at all, and 24% were working, but not at pre-ACS levels. For all ACS-patients, the most mentioned categories of facilitating factors to return to work were having no complaints and not having signs or symptoms of heart disease. Physical incapacity, co-morbidity, and mental incapacity were the top 3 categories of hindering factors against returning to work. Conclusion: Within 2 years, 36% of the patients had not returned to work at their pre-ACS levels. Disease factors, functional capacity, environmental factors, and personal factors were listed as affecting subjects' work ability level.

Review of the coronary artery disease in terms of insurance medicine (관상동맥질환의 보험의학적 이해)

  • Lee, Sinhyung
    • The Journal of the Korean life insurance medical association
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    • v.32 no.2
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    • pp.33-38
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    • 2013
  • Coronary artery diseases are very important agenda in the insurance medicine. Insurance medicine is defined as using medical knowledge for insurance administration such as underwriting, claims, and customer satisfaction. This review article contains review of coronary artery disease in terms of insurance medicine. Estimation of extra-risks for acute myocardial infarction are MR of 349% and EDR of 41‰. In medical underwriting, individual life applicants can be assessed by Framingham's CHD risk assessment model. In claims, medical claims review is a useful method of consulting for claims staffs. Several diagnostic criteria of acute myocardial infarction are introduced in time. The universal definition of myocardial infarction by ESC/ACCF/WHF was demonstrated the most valuable predictor of 10-year mortality. Contents for State-Of-The-Art of the coronary artery disease are current antithrombotics. There are many novel anti-thrombotic agents such as ticagrelol, dabigatran, rivaroxaban, and pegnivacogin.

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Metabolic Syndrome Risk Factors related to Severity of Coronary Artery Diseases in Patients with Acute Myocardial Infarction (한국인 급성 심근경색증 환자의 관상동맥 중증도에 영향을 미치는 대사증후군 위험요인)

  • Cho, Sook Hee;Choi, Myung Ja;Jeong, Myung Ho
    • Journal of Korean Clinical Nursing Research
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    • v.18 no.1
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    • pp.171-181
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    • 2012
  • Purpose: This study was conducted to identify the clinical characteristics and risk factors on the occurrence of metabolic syndrome (MS), and to examine factors affecting the severity of coronary artery diseases in patients with acute myocardial infarction (AMI). Methods: A total of 894 patients who had admitted C national university hospital from 2008 to 2010 participated in this study. Collected data were lipid profiles, abdominal circumference, blood pressure, fasting blood sugar (FBS) level, participants' demographic data and other risk factors by interview, measurement, and review of participants' medical records. MS was defined according to modified National Cholesterol Education Program Adult Treatment Panel III and Asia-Pacific Criteria. Results: The participants' mean age was 64.7 (${\pm}11.0$) years and 65% was male patients. The participants' with MS was 37.6% in men and 71.4% in women. According to binary logistic regression analysis, high FBS (95% CI 1.7-2.0) and lower high-density lipoprotein (HDL) cholesterol (95% CI 1.1-1.9) were independent predictors of severe coronary artery disease. Conclusion: These risk factors of severe coronary artery disease will be utilized as an important basic data in part of management, education, and countermeasure of patients with both MS and AMI.

Gender Differences in Cardiac Knowledge and Symptoms Recognition in Patients with Acute Coronary Syndromes (일 대학병원에 내원한 급성 관상동맥증후군 환자의 성별에 따른 질병지식 및 증상인지 비교)

  • Lee, Eun-Kyoung;Son, Youn-Jung
    • Journal of Korean Biological Nursing Science
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    • v.12 no.3
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    • pp.166-174
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    • 2010
  • Purpose: The purpose of this study was to compare the cardiac knowledge and symptoms recognition between men and women with acute coronary syndrome (ACS). Methods: Cross-sectional survey research design and convenience sampling were used in this study. 64 men and 42 women from a university medical center were participated in this study. Data collection were used with self reported questionnaires and medical records. Results: There was no difference in cardiac knowledge by gender. Women marked the higher score in symptoms recognition than men. Significant gender differences were observed in the reports of several symptoms (headache, nausea, palpitation, hand paresthesia, and leg numbness) and with ACS. There was significant correlation between cardiac knowledge and symptom recognition on both men and women. Conclusion: These findings suggest that health care professionals should pay attention to the differences in clinical symptoms between women and men. Furthermore, tailored information about possible symptoms of coronary artery disease according to the patient's gender is needed.