• 근관절건강학회지
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• 제24권1호
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• pp.37-46
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• 2017

Purpose: The purpose of this study was to examine the effects of the program to improve on smoking patients' after acute coronary syndrome (ACS) smoking cessation rate, smoking cessation related self-efficacy, carbone monoxide (CO), nicotine dependence, and pain sense. Methods: This study used a non-equivalent control group pretest-posttest design. The participants of this study were 60 ACS patients: experimental group (30), control group (30), who received percutaneous coronary intervention. The study lasted from Aug 16, 2016 to Jan 13, 2017. Smoking cessation rate, smoking cessation related self-efficacy, CO, nicotine dependence, and pain sense were measured using the structured questionnaires and CO monitor Results: An examination of the effects of this program revealed the experimental group to have a significant increase in smoking cessation rate, smoking cessation related self-efficacy than the control group, and a significant decrease in CO, nicotine dependence and pain sense than in the control group. Conclusion: The findings indicate that this smoking cessation self-efficacy improvement program is effective for hospitalized patients after ACS.

• Annals of Clinical Neurophysiology
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• 제12권2호
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• pp.66-69
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• 2010

A 73-year-old man with progressive quadriparesis was diagnosed as Guillain-Barr$\acute{e}$ syndrome. On the 6th hospital day, the patient complained of sudden chest discomfort. The blood test and echocardiography suggested myocardial injury, and acute myocardial infarction was considered. However, coronary angiography displayed no vascular lesion, and the electrocardiography and echocardiogram showed marked improvement 14 days later. We concluded the patient had a reversible cardiomyopathy which is a rare complication of Guillain-Barr$\acute{e}$ syndrome.

• Journal of Chest Surgery
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• 제34권9호
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• pp.720-723
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• 2001

우관상동맥 폐쇄증을 동반한 Marfan 증후군환자를 보고한다. 환자는 45세 여자로 약 1년 전에 Marfan 증후군으로 진단받고, 최근 흉통을 주소로 내원하였다. 환자는 손가락과 발가락이 긴 지주증과 돌출흉이 있고 몸통에 비해 사지가 긴 전형적인 외형을 갖고 있었다. 시력이 매우 약하고 수정체의 아탈구가 있었다. 심초음파상 대동맥판막 폐쇄부전증은 경도로 있었고, 좌심실의 중등도 확장과 심박출율의 중등도 저하가 있었다. 수술시에 우관상동맥의 폐쇄증을 발견하였다. 대동맥판막 폐쇄부전증과 대동맥 확장증에 대해서 SJM 27mm composite graft를 이용하여 좌관상동맥에는 Bentall 술식과 우관상동맥에는 PTFE 6mm를 이용하여 변형된 Piehler 식 방법으로 수술을 하였다. 원래의 우관상동맥구로 추정되는 부분부터 우관상동맥 원위부의 혈류가 있는 곳까지의 결손부위는 약 4cm 가량 되었다. 관상동맥 폐색증과 Marfan 증후군의 조합은 매우 드문 질환으로 양측 관상동맥의 혈류 재건을 위하여 각기 다른 술식으로 수술하였다.

• 대한영상의학회지
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• 제83권1호
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• pp.70-83
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• 2022

급성 관동맥 증후군(acute coronary syndrome)은 대부분 죽상경화 관상동맥 질환(atherosclerotic coronary artery disease)에 의해 발생하지만, 비죽상경화 관상동맥 질환에서도 발생할 수 있다. 고식적 관상동맥 혈관조영술은 동맥 내강의 협착이나 확장 등의 형상에 대한 정보만을 제공하고, 동맥경화반이나 동맥벽에 대한 평가가 어려워 관상동맥 이상의 원인 질환의 진단에 낮은 특이도를 보인다. 반면, 관상동맥 전산화단층촬영 혈관조영술은 혈관경화반의 특징, 혈관벽의 조영증강뿐 아니라 연접한 대동맥이나 폐동맥의 변화 등도 함께 관찰할 수 있어, 비죽상경화 관상상동맥질환의 진단 및 다양한 원인 감별에 도움이 된다. 따라서 이종설에서는 다양한 비죽상경화 관상동맥 질환들을 소개하고, 이의 병태생리 및 대표적인 관상동맥 전산화단층촬영 혈관조영술의 영상 소견에 대해 설명하고자 한다.

• Journal of Chest Surgery
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• 제47권1호
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• pp.43-46
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• 2014

Phlegmasia cerulea dolens (PCD) is one of the most critical disorders of acute deep vein thrombosis in that it can cause permanent disability secondary to the compartment syndrome. Although several etiological factors have been proposed, PCD after coronary artery bypass surgery is extremely rare and its definitive pathophysiology is still under debate. We herein present a case of PCD that resulted in the compartment syndrome after coronary artery bypass surgery. Early recognition and decompression of PCD are crucial for saving the affected limbs.

• 대한임상독성학회지
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• 제17권1호
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• pp.32-37
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• 2019

Kounis syndrome is defined as the occurrence of acute coronary syndrome associated with vasoactive mediators, such as histamines in the setting of hypersensitivity and allergic reactions or anaphylactic insults. The condition can be caused by various drugs, foods, or environmental factors that cause allergic reactions. A 35-year-old male visited the emergency room with anaphylaxis accompanied by chest pain approximately 20 minutes after taking zaltoprofen, a nonsteroidal anti-inflammatory drug. After acute treatment for the anaphylaxis, the patient was stabilized and all symptoms disappeared, but the ischemic changes in the electrocardiogram and elevation of the cardiac enzymes were observed. The emergency cardiac angiography and echocardiography were all normal. The allergic reaction of this patient to zaltoprofen was believed to cause a temporary coronary arterial vasospasm, inducing Type 1 Kounis syndrome. Thus far, there have been case reports of Kounis syndrome caused by a range of nonsteroidal anti-inflammatory drugs, but there are no reports of the condition being caused by zaltoprofen. According to the pathophysiology, both cardiac and allergic symptoms must be solved simultaneously, so rapid treatment and diagnosis are needed. Doctors treating acute allergic reactions and anaphylaxis patients must check the cardiovascular symptoms thoroughly and consider the possibility of Kounis syndrome.

• International Journal of Arrhythmia
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• 제17권1호
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• pp.41-45
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• 2016

Atrial fibrillation (AF) can occur in acute coronary syndrome (ACS), which is a serious medical condition and may require the use of antiplatelet agents in addition to anticoagulants for stroke prevention. Recently, novel or non-vitamin K antagonist oral anticoagulants (NOACs) have been increasingly used for stroke prevention in patients with AF instead of traditional OACs. The duration of treatment or treatment with a stepwise approach (e.g. triple, double, or monotherapy) is determined depending on the clinical setting and the balance between the risks of ischemic stroke and bleeding. However, some concerns and controversies in the use of NOACs in patients with AF and ACS need to be addressed. Here, the current management for NOAC therapy in patients with ACS and AF will be reviewed based on recently published guidelines.

• 한국간호교육학회지
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• 제16권1호
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• pp.24-32
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• 2010

Purpose: This study was conducted to evaluate the results after implementing a simulation based critical care nursing education with $MicroSim^{(R)}$. Method: Simulation based education was used for a clinical scenario on a patient with chronic obstructive pulmonary disease(COPD) and acute coronary syndrome(ACS). Self-learning program was used for an acute asthma attack and acute myocardial infarction(AMI) in the $MicroSim^{(R)}$. A total of 97 nursing students were chosen. A pretest and posttest was conducted to evaluate learning achievement, clinical performance ability and self-directed learning. Result: Learning achievement and clinical performance ability significantly increased but self-directed learning did not. Conclusion: Simulation based education used with $MicroSim^{(R)}$ was useful for improving learning achievement and clinical performance ability of nursing students. Further studies are needed to compare the effects of simulation based education.

• Journal of Preventive Medicine and Public Health
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• 제51권2호
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• pp.71-82
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• 2018

Objectives: Areca nut is widely consumed in many parts of the world, especially in South and Southeast Asia, where cardiovascular disease (CVD) is also a huge burden. Among the forms of CVD, acute coronary syndrome (ACS) is a major cause of mortality and morbidity. Research has shown areca nut chewing to be associated with diabetes, hypertension, oropharyngeal and esophageal cancers, and CVD, but little is known about mortality and re-hospitalization secondary to ACS among areca nut users and non-users. Methods: A prospective cohort was studied to quantify the effect of areca nut chewing on patients with newly diagnosed ACS by categorizing the study population into exposed and non-exposed groups according to baseline chewing status. Cox proportional hazards models were used to examine the associations of areca nut chewing with the risk of re-hospitalization and 30-day mortality secondary to ACS. Results: Of the 384 ACS patients, 49.5% (n=190) were areca users. During 1-month of follow-up, 20.3% (n=78) deaths and 25.1% (n=96) re-hospitalizations occurred. A higher risk of re-hospitalization was found (adjusted hazard ratio [aHR], 2.05; 95% confidence interval [CI], 1.29 to 3.27; p=0.002) in areca users than in non-users. Moreover, patients with severe disease were at a significantly higher risk of 30-day mortality (aHR, 2.77; 95% CI, 1.67 to 4.59; p<0.001) and re-hospitalization (aHR, 2.72; 95% CI, 1.73 to 4.26; p<0.001). Conclusions: The 30-day re-hospitalization rate among ACS patients was found to be significantly higher in areca users and individuals with severe disease. These findings suggest that screening for a history of areca nut chewing may help to identify patients at a high risk for re-hospitalization due to secondary events.

• 대한약침학회지
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• 제24권4호
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• pp.196-205
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• 2021

Objectives: Bruising is an important side effect of enoxaparin injection. Comfrey (Symphytum officinale) is used to treat different types of wounds, bone fractures, and bruising in traditional medicine in many countries for centuries. This study aimed to determine the effects of the Comfrey ointment on the bruise size and color following enoxaparin injection. Methods: This double-blind randomized clinical trial was conducted on 80 patients with acute coronary syndrome (ACS). The participants were randomly divided into two groups of 40, namely Comfrey and Placebo. Changes in bruise size and color in both groups were assessed daily before and after the intervention. Results: The Comfrey and Placebo groups were homogeneous in demographic and clinical variables. A downward trend was observed in the bruise size in both groups throughout the study. However, the bruise size was smaller in the Comfrey group than the Placebo group on day 2-5 of the intervention. Moreover, there was a significant difference in bruise color between the groups, with a shorter healing course in the Comfrey group. Conclusion: The Comfrey ointment accelerated the healing process of enoxaparin injection-induced bruising in patients with ACS. It is recommended as a safe and simple approach for these patients.