• 제목/요약/키워드: myocardial infarction patients

검색결과 391건 처리시간 0.024초

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

  • 이혜란
    • 대한간호학회지
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    • 제33권6호
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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.

Impact of Regional Cardiocerebrovascular Centers on Myocardial Infarction Patients in Korea: A Fixed-effects Model

  • Cho, Sang Guen;Kim, Youngsoo;Choi, Youngeun;Chung, Wankyo
    • Journal of Preventive Medicine and Public Health
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    • 제52권1호
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    • pp.21-29
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    • 2019
  • Objectives: The Regional Cardiocerebrovascular Center (RCCVC) Project designated local teaching hospitals as RCCVCs, in order to improve patient outcomes of acute cardiocerebrovascular emergencies by founding a regional system that can adequately transfer and manage patients within 3 hours. We investigated the effects of RCCVC establishment on treatment volume and 30-day mortality. Methods: We constructed a panel dataset by extracting all acute myocardial infarction cases that occurred from 2007 to 2016 from the Health Insurance Review and Assessment Service claims data, a national and representative source. We then used a panel fixed-effect model to estimate the impacts of RCCVC establishment on patient outcomes. Results: We found that the number of cases of acute myocardial infarction that were treated increased chronologically, but when the time effect and other related covariates were controlled for, RCCVCs only significantly increased the number of treatment cases of female in large catchment areas. There was no statistically significant impact on 30-day mortality. Conclusions: The establishment of RCCVCs increased the number of treatment cases of female, without increasing the mortality rate. Therefore, the RCCVCs might have prevented potential untreated deaths by increasing the preparedness and capacity of hospitals to treat acute myocardial infarction patients.

실신으로 내원한 후벽 단독 심근경색 환자에서 발생한 심장눌림증 1례 (Case Report: Cardiac tamponade in a patient with isolated posterior myocardial infarction presenting with syncope)

  • 강민성;오성범;김지원
    • 한국응급구조학회지
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    • 제25권1호
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    • pp.235-241
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    • 2021
  • Cardiogenic syncope occurs due to arrhythmia (bradycardia and tachycardia) or decreased cardiac output, and if proper treatment is not provided, it can lead to acute sudden death. A detailed medical history and physical examinations are required to determine the cause of syncope, and clinical approaches, including 12-lead ECG, are important. The 12-lead ECG does not have a chest lead in the posterior wall of the left ventricle; therefore, ECG of the isolated posterior wall myocardial infarction caused by left circumflex artery occlusion is not observed with ST elevation. Therefore, the significantly higher appearance of ST depression and R waves than S waves from V1 to V3 of the chest lead must be interpreted meaningfully. Isolated posterior wall myocardial infarction is small in the area of myocardial necrosis, and tension is increased in the necrotic area due to the contraction of the normal myocardial muscle, which can cause ventricular wall rupture. Therefore, it is necessary to additionally check Beck's triad, such as jugular venous distension and decreased heart sound, in patients with low blood pressure with an isolated posterior wall myocardial infarction on 12-lead ECG in patients with syncope.

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

  • 김윤;고봉련
    • 보건행정학회지
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    • 제13권4호
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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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    • 제35권1호
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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.

심장판막질환과 동반된 관상동맥질환의 수술 (Cardiac Valve Replacement and Simultaneous Myocardial Revascularization)

  • Reiner, Korfer;Jee, Heng-Ok
    • Journal of Chest Surgery
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    • 제21권1호
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    • pp.164-168
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    • 1988
  • Between November, 1984, and May, 1986, 93 patients underwent combined valvular and coronary artery operation. They were 70 male and 23 female, the age ranging from 29 to 82. From this population 89 patients underwent single valve replacement and 4 patients underwent double valve replacement. Patients with mitral valve disease were in the majority present in the age group between 50 till 70, where as in the group after 60 years, patients with aortic valve disease were dominant. The main indication for aortic valve replacement was aortic stenosis and the indication for mitral valve replacement was equal between mitral stenosis and mitral incompetence, the later was due to papillary dysfunction after myocardial infarction. Dyspnea was a very frequent symptom and it was found in nearly all patients. 28 patients had a previous myocardial infarction and severe left ventricular dysfunction. The grafts were placed prior to valve replacement and periods of myocardial ischemia were kept at a minimum by maintaining coronary perfusion throughout the operation. It is our opinion that simultaneous valve replacement and myocardial revascularization does not increase the risk of cardiac valve replacement substantially.

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급성심근경색증 환자에서 응급으로 시행한 Tc-99m Sestamibi 심근관류 SPECT와 심전도의 비교 (Comparison of Emergency Tc-99m Sestamibi Myocardial Perfusion SPECT and ECG in the Diagnosis of Acute Myocardial Infarction)

  • 조인호;이형우;박종선;원규장;도준영;신동구;윤경우;김영조;심봉섭;이현우
    • 대한핵의학회지
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    • 제30권1호
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    • pp.104-111
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    • 1996
  • 저자들은 금성심근경색증으로 진단된 36명에서 응급실 도착후에 시행한 Tc-99m seataMIBl 심근 SPECT를 심전도검사와 비교하여 다음의 결과를 얻었다. 1) 좌전하행관동맥과 우관동맥의 폐쇄로 인한 심근 경색증환자 24명 모두가 안정기 Tc-99m sestamibi 심근 SPECT에서 관류결손을 나타냈고, 심전도상에서는 Q파 혹은 ST절의 상승이 관찰되었다. 2) 좌회선관동맥의 폐쇄로 인한 심근경색증환자 7명 모두 안정기 Tc-99m sestamibi 심근 SPECT에서 측벽에 관류결손이 나타났으나, 이상 Q파는 1명에서만 관찰되었고, 6명에서 ST절의 변화가 보였으며, 1명에서는 정상심전도소견을 보였다. 3) 심혈관촬영술을 시행하지 않은 3예중 2예에서는 심전도상 경색의 위치와 심근 SPECT에서의 관류결손부위가 일치하였으나, 나머지 1예에서는 심전도상 LBBB가 보였고 심근SPECT에서는 하벽에 관류결손이 관찰되 었다. 4) 극성지도를 이용하여 구한 손상된 심근의 면적을 전체심근에 대한 백분율로 표시하면 좌전하행관동맥 : $31.17{\pm}18.21%$, 우관동맥 : $31.17{\pm}13.24%$, 좌회선관동맥 : $24.71{\pm}5.94%$ 이었다. 5) 정성적인 분석에서 심근경색의 진단적 예민도는 100%였고, 관동맥 조영술을 시행하여 경색 관련 관동맥을 진단할 수 있었던 31명의 모든 예에서 심근관류 SPECT로 국소화가 가능하였다. 이상의 결과에서 응급으로 시행한 심근관류 SPECT가 심근경색의 진단에 유용하며, 특히 심전도에서 심근경색증의 판단이 어려운 측벽경색이나 좌각차단이 있는 경우에 유용한 방법으로 생각된다.

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Cardiac arrest due to an unexpected acute myocardial infarction during head and neck surgery: A case report

  • Kim, Jimin;So, Eunsun;Kim, Hyun Jeong;Seo, Kwang-Suk;Karm, Myong-Hwan
    • Journal of Dental Anesthesia and Pain Medicine
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    • 제18권1호
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    • pp.57-64
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    • 2018
  • Major cardiac complication such as acute myocardial infarction can occur unexpectedly in patients without risk factors. We experienced cardiac arrest due to an unexpected acute myocardial infarction in a patient without any risk factors during head and neck reconstructive surgery. The patient was diagnosed with acute myocardial infarction after return of spontaneous circulation. With immediate percutaneous coronary intervention, the patient recovered without complications.

심혈관질환수술에 대한 임상적 고찰 -2094례 보고- (Clinical Analysis of Cardiovascular Surgery -Report of 2094 Cases-)

  • 김병열
    • Journal of Chest Surgery
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    • 제21권6호
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    • pp.1030-1039
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    • 1988
  • From 1985 through Oct. 1988, we have experienced 5 cases of Aorto-Coronary Bypass Surgery [ACBS] and 3 cases of Percutaneous Transluminal Coronary Anogioplasty [PTCA]under the diagnosis of unstable angina. There were 6 males and 2 females who ranged from 48 to 70 years old. Almost all patients had a evidence of hypertension & hyperlipidemia. Two patients showed old myocardial infarction and remaining patients showed myocardial ischemia on resting state. The patterns of involvement of coronary artery disease were single vessel disease [4 cases], double vessel disease [3 cases], Triple vessel disease [1 case]. Among 5 cases of ACBS, double bypass graft was in 3 cases and single bypass graft was in 2 cases. Mode of anastomosis were all individual anastomosis, using Saphenous vein graft. Postoperative complications were perioperative myocardial infarction [2 cases], postoperative bleeding [1 case], leg wound disruption [1 case]. Perioperative myocardial infarction cases didn*t survive. In cases of PTCA, there were no complications. Follow up periods were ranged from 1 month to 25 months. All survived cases were asymptomatic except one case, who showed Functional Class II.

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Alteration in Magnesium Level in Acute Myocardial Infarction

  • T. Angeline;K. Ramadevi;Aruna, Rita-Mary;G. Mohan;Nirmala Jeyaraj
    • Animal cells and systems
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    • 제7권2호
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    • pp.169-171
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    • 2003
  • Sodium, potassium, calcium, zinc and magnesium levels in the serum of 31 patients diagnosed as acute myocardial infarction were analyzed on admission (within 24 Hours) and after 48 hours. The results were compared with those of 26 age matched controls. No significant difference was observed in the mean sodium, potassium, calcium and zinc levels between the cases and controls. Compared to the controls, however, the variation in the level of magnesium is highly significant at the time of admission as well as after 48 hours. When the risk factors like diabetes mellitus, hypertension, smoking and alcohol were considered, it is found that there is no significant difference between the risk groups as well as between the patients. The alteration in magnesium level in acute myocardial infarction is independent of these risk factors. Within the first 24 hours, the significant decrease in serum magnesium (35-51% fall when compared with the control group), correlates with its entry into the cell following ischemia. From this hypomagnesemic state, it rises to 9-22 times after 48 hours. This hyper-magnesemia after 45 hours is probably due to the shift of magnesuim from the intracellular fluid compartment to the extracellular fluid compartment that follows cellular recovery. Therefore, including magnesium in the immediate management of acute myocardial infarction will be beneficial in the early recovery.