• Title/Summary/Keyword: acute myocardial infarction

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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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Association between periodontal disease and coronary heart disease (치주질환과 관상동맥질환의 관련성에 대한 임상적 연구)

  • Lee, Jun-Ho;Chung, Hyun-Ju;Kim, Ju-Han
    • Journal of Periodontal and Implant Science
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    • v.35 no.1
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    • pp.111-121
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    • 2005
  • Coronary heart disease is the leading cause of mortality in adult population. Whereas the association between periodontal disease and coronary heart disease (CHD) are controversial, recent studies reported the association between periodontal disease and acute myocardial infarction or prognosis of CHD. This study was aimed to investigate the relationship between periodontal disease and angiographically defined CHD, and acute myocardial infarction, and the prognosis of treated CHD. Patients under the age of 60 who had undergone the diagnostic coronary angiography were enrolled in this study, Subjects were classified as positive CHD (+CHD, n=37) with coronary artery stenosis more than 50% in at least one of major epicardial arteries, and negative CHD (-CHD, n=20) without stenosis. After recording the number of missing teeth, periodontal disease status was measured by means of plaque index (PI), gingival index (GI), bleeding on probing (BOP), probing depth (PD), and clinical attachment level (CAL), Positive CHD subjects were classified into acute myocardial infarction group (AMI), and non-AMI with angina pectoris and old myocardial infarction. Six months postoperatively, positive CHD subjects were followed and had undergone the coronary angiography again. Even though there was no significant difference in the periodontal parameters and status between positive CHD and negative CHD, some periodontal parameters, such as mean probing depth and proportion of sites with probing depth greater than 4mm or 6mm were significantly different between AMI and Non-AMI(p<0.05). There was no significant difference in the periodontal parameters according to in angiographically follow-up status. These results indicate that periodontal disease may be associated with the occurrence of acute myocardial infarction.

Clinical Characteristies and Findings of $^{99m}Tc$-MIBI Heart SPECT in Patients with Acute Myocardial Infarction with Normal Coronary Arteriography (정상 관동맥 조영상을 갖는 급성 심근경색증 환자의 임상적 특징 및 $^{99m}Tc$-MIBI심근 SPECT 소견)

  • Park, Myung-Jae;Choi, Tae-Youl;Kim, Deog-Yoon;Kang, Heung-Sun;Choue, Chung-Whee;Kim, Kwon-Sam;Kim, Kwang-Won;Kim, Myung-Shick;Song, Jung-Sang;Bae, Jong-Hoa
    • The Korean Journal of Nuclear Medicine
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    • v.27 no.1
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    • pp.65-70
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    • 1993
  • Among 64 patients with acute myocardial infarction who underwent coronary angiogrphy, 7 patients (10.9%) showed normal coronary artery. Six patients were men and 1 patient was female. The mean age of patients were $31.1{\pm}3.9$ years. Among the risk factors of coronary heart disease, smoking was most probable factor in patients with acute myocardial infarction with normal coronary angiography. $^{99m}Tc$-MIBI heart SPECT performed 5 of 7 patients and showed that it could be used in diagnosis, localization, extent of infarct area in patients with acute myocardial infarction with normal coronary angiograpy. But follow up $^{99m}Tc$-MIBI heart SPECT study will be needed to define the ability of myocardial viability in this patients.

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Factors associated with delay in reperfusion therapy in patients with acute myocardial infarction (급성심근경색 환자에서 재관류 치료 지연율과 그에 관련된 요인)

  • Kim, Yoon;Koh, Bong-Yeun
    • Health Policy and Management
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    • v.13 no.4
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    • pp.115-130
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    • 2003
  • Reperfusion delay in patients with acute myocardial infarction leads to increased morbidity and mortality. We sought to measure the rates of reperfusion delay and to identify factors associated with reperfusion delay after arrival to hospitals. We included 360 patients who had acute myocardial infarction with ST-elevation or left bundle branch block on electrocardiogram and received reperfusion therapy from the three participating academic medical centers from 1997 to 2000. Through retrospective chart review, we collected data about time to reperfusion therapy, patient and hospital factors potentially associated with reperfusion delay. Factors independently associated with reperfusion delay were determined by logistic regression analysis. Median door­to­needle time was 60.0 minutes, and median door­to­balloon time was 102.5 minutes. According to recommendation of the American College of Cardiology/American Heart Association Guidelines, 226 out of 264(85.6%) of thrombolytic patients and 43 out of 96(44.8%) percutaneous transluminal coronary angioplasty(PTCA) patients experienced reperfusion delay. The significant factors associated with delay were type of reperfusion therapy, patient factors including hypertension and delayed symptom onset to presentation(>4 hours), and hospital factors including nocturnal presentation(6pm∼8am), weekend, and an individual hospital. A significant proportion of patients experienced reperfusion delay. The identified predictors of reperfusion delay may help design a hospital system to reduce the delay in reperfusion therapy

Substance P and Neuropeptide Y as Potential Biomarkers for Diagnosis of Acute Myocardial Infarction in Korean Patients

  • Han, Hyojeong;Seo, Hong Seog;Jung, Byung Hwa;Woo, Kyoungja;Yoo, Young Sook;Kang, Min-Jung
    • Bulletin of the Korean Chemical Society
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    • v.35 no.1
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    • pp.158-164
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    • 2014
  • Substance P and neuropeptide Y were discovered as early diagnostic biomarkers of acute myocardial infarction in Korean patients and confirmed using enzyme-linked immunosorbent assay (ELISA). We screened 12 peptides from the sera of Korean acute myocardial infarction (AMI) patients and detected 3 peptides (neuropeptide Y, substance P, and N-terminal pro-B-type natriuretic peptide) to be elevated from patients' sera by liquid chromatography mass/mass spectrometry. The elevated concentration of 3 peptides was confirmed by ELISA. The screening results revealed the substance P, neuropeptide Y, and pro-B-type natriuretic peptide (47-76) concentrations were higher in patients' sera than in healthy controls. The sensitivity and specificity of substance P for AMI diagnostic marker were 80% and 83%, respectively, and those of neuropeptide Y were 87% and 90%, respectively compared to healthy controls. These results suggest that substance P and neuropeptide Y could be used as early diagnostic biomarkers in patients with AMI.

Effects of Relaxing Music on Stress Response of Patients with Acute Myocardial Infarction (이완음악이 급성 심근경색증 환자의 스트레스 반응에 미치는 효과)

  • 이혜란
    • Journal of Korean Academy of Nursing
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    • v.33 no.6
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    • pp.693-704
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    • 2003
  • Purpose: The purpose of this study was to determine whether a relaxing music was effective in reducing stress response of patients admitted to a coronary care unit with the diagnosis of acute myocardial infarction. Method: The research design was the chosen convenience sample of a randomized control group pre-posttest quasi-experimental design. Forty patients, 20 for an experimental group and another 20 for control group. The study was to provide the patients three different kinds of relaxing music. The experimental group listened to relaxing music for a 20-minute one time a day for 3days. The control group was just provided with a 20-minute period of rest. Test for hypothesis was done by repeated measured ANOV A. Result: The experimental group which received relaxing music showed a significantly lower level of electrodermal response, myocardial oxygen consumption and respiration rate, and a higher level of peripheral skin temperature than the control group. The experimental group which received relaxing music showed a significant reduction in state anxiety than the control group. Conclusion: The results showed that relaxing music is an effective nursing intervention for reducing physiologic and psychologic stress response of the patients with acute myocardial infarction in a critical intensive care unit.

Effect of Low-Intensity Cardiac Rehabilitation on Cardiac Function and Degree of Fibrosis in a White Rat Acute Myocardial Infarction Model

  • Ji, Sung Ha;Kim, Ki Jong
    • Journal of International Academy of Physical Therapy Research
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    • v.7 no.2
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    • pp.999-1005
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    • 2016
  • The purpose of this study was to investigate the effects of low-intensity cardiac rehabilitation exercise on the cardiac function and the degree of fibrosis in an older white rat model. This study used male Sprague-Dawley white rats that were 50 weeks old. After the acute myocardial infarction induction, Twenty of the rats were randomly allocated into an experimental group and a control group, and each of the groups consisted of 8 rats. In the experimental group, the exercise was conducted for six weeks, 30 minutes a day, five days a week, using a Rotarod treadmill for animals. The degree of myocardial fibrosis was significantly repressed in the experimental group($13.69{\pm}1.90%$) and in the control group($15.67{\pm}1.54%$)(p<0.05). However, fractional shortening and ejection fraction did not show a significant difference. The results of this study suggest that cardiac rehabilitation with low intensity treadmill exercise repress the myocardial fibrosis.

Rupture of Papillary Muscle -Report of a Case- (유두근 파열 수술 치험 1례)

  • 박국양
    • Journal of Chest Surgery
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    • v.28 no.1
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    • pp.69-72
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    • 1995
  • A 69-year-old patient with rupture of anterolateral papillary muscle following non-Q-wave myocardial infarction is described. Transesophageal echocardiography was useful in making the diagnosis. Mitral valve replacement was performed 22 days after the onset of acute myocardial infarction. The patient was discharged in his good condition and coronary angiography is scheduled.

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Left Side Otalgia Caused by Acute Myocardial Infarction (급성 심근경색에 의해 발생한 좌측 이통 1예)

  • Chung, Juyong;Park, Ji-Su;Choi, Jin Woong
    • Korean Journal of Otorhinolaryngology-Head and Neck Surgery
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    • v.60 no.6
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    • pp.322-325
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    • 2017
  • Otalgia consists of primary otalgia associated with disorders of the ear itself and referred otalgia due to disorders of organs that share the same innervation with the ear. Disorders of the oral cavity and laryngopharynx served by the glossopharyngeal and vagus nerves are common causes of referred otalgia. Chest pain from myocardial infarction spreads through the afferent pain pathway, especially through the sympathetic nerves in the cardiac plexus and the phrenic nerve, resulting in a typical chest pain or referred pain in the left upper extremity. However, pain spreading through the vagus nerve can theoretically cause referred otalgia. This association between the heart and ear has not been widely acknowledged, even though a referred otalgia can occasionally be the only symptom of the tragic disease, myocardial infarction, and should be taken seriously. We report a patient who complained of left otalgia as the only symptom of myocardial infarction.

A SELF-ADMINISTERED QUALITY-OF-LIFE QUESTIONNAIRE AFTER ACUTE MYOCARDIAL INFARCTION

  • Lim L. L-Y.;Valenti L.A.;Knapp J.C.;Dobson A.J.;Plotnikoff R.;Higginbotham N.;Heller R.F.
    • 대한예방의학회:학술대회논문집
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    • 1994.02b
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    • pp.180-187
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    • 1994
  • A slightly modified version of the Quality-of-Life after Myocardial Infarction (QLMI) questionnaire developed by Oldridge and colleagues was applied in a self-administered mode to patients with suspected acute myocardial infarction (AMI) in a randomized controlled trial of secondary prevention. Acceptability of the questionnaire was good, with 93% of responders answering all items. Factor analysis suggested three quality-of-life (QL) dimensions which we called 'emotional', 'physical' and 'social'. These differed somewhat from the dimensions proposed by Oldtidge and colleagues. However, a sensitivity analysis showed relative invariance of results to weighting schemes. Scores on our three dimensions were responsive to differences between the treatment groups, and demonstrated construct validity based on associations between the measured QL and variables expected to affect QL. We conclude that the QLMI questionnaire has good potential as an instrument for assessing QL in post-AMI patients and that it can be successfully self-administered.

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