scholarly journals Evaluation of applying chest pain guidelines in coronary care patients on their health outcome

2017 ◽  
Vol 6 (2) ◽  
pp. 99
Author(s):  
Eman Shahin ◽  
Mona Hasan
Keyword(s):  
Health Outcome ◽  
Acute Coronary Syndrome ◽  
Chest Pain ◽  
Nursing Care ◽  
University Hospital ◽  
Respiratory Pattern ◽  
P Value ◽  
Coronary Syndrome ◽  
Study Results ◽  
Coronary Care

Background: the National Heart, Lung, and blood Institute estimate that each year approximately 785,000 Americans will have a new coronary attack and approximately 470,000 will have a recurrent attack. Chest pain is one of the most common symptoms   of coronary artery disease or acute coronary syndrome. Objectives: this study aims to compare between routine nursing care of chest pain and chest pain guidelines in patients with acute coronary syndrome and assess health outcome after application of chest pain guidelines in acute coronary syndrome patients. Method: Quasi experimental research design was used in the current study. The study was conducted at the coronary care unit of Suez canal University Hospital. Sample; consecutive of 70 patients was included in the study.  Four tools were used for study data collection that named the chest pain guidelines evidence based nursing care in patients with angina pectoris, visual analog scale to assess chest pain, dyspnea scale to assess breathing pattern and fourth one was lab investigation to assess patient health prognosis. Results: The study results revealed an improvement of patients’ health outcome represented in a significant reduction in complain of chest pain, blood pressure and insufficient sleeping with P-value of 0.000 after applying guidelines of care regarding chest pain. Additionally, the respiratory pattern and respiratory rate improved significantly with P-value of 0.000. Moreover, lab investigation showed significantly decrease in LHD level with P-value of 0.000. Conclusion: The current study concluded that application of chest pain guidelines intervention could be improved patients health outcomes.        

scholarly journals ACUTE CORONARY SYNDROME;

2017 ◽  
Vol 24 (03) ◽  
pp. 409-413
Author(s):  
Naveed Aslam Lashari ◽  
Nadia Irum Lakho ◽  
Sarfaraz Ahmed Memon ◽  
Ayaz Ahmed ◽  
Muhammad Fahad Waseem
Keyword(s):  
Acute Coronary Syndrome ◽  
Chest Pain ◽  
Cross Sectional Study ◽  
P Value ◽  
Cross Sectional ◽  
Coronary Syndrome ◽  
Study Results ◽  
Artery Obstruction ◽  
Conventional Risk Factors ◽  
Typical Chest Pain

Introduction: ACS is defined as the cluster of symptoms arising due to the rapiddrop of blood flow to the heart because of coronary artery obstruction. It is stated that worldwidearound 17 million people die due to cardiovascular diseases of which half of the deaths arereported due to ACS. Chest pain is known to be the most leading factor associated with ACS.Objectives: To determine the frequency of acute coronary syndrome, its types and commoncontributing factors in patients presenting with typical chest pain in a secondary care hospital.Study Design: Cross sectional study. Setting: Medical Unit, PAF Hospital Mushaf Sargodha.Period: October 2013 to March 2014. Methodology: A total of 280 patients of either gender,aged 20 to 80 years presented with typical chest pain with or without conventional risk factorswere included in the study. Results: Majority (68.9%) was males and 31.1% were female. Acutecoronary syndrome was observed in 131(46.8%) patients. Out of these 131 patients, 55% hadNSTEMI, 28.2% had unstable angina and 16.8% had STEMI. A higher proportion of femaleswere found to have ACS as compared to males (75.9% vs 33.7%, P-value<0.0001). Out of131 patients, 40.5% were diabetic, 29.8% were hypertensive 16% were hyperlipidemic, while13.7% were smokers. Conventional risk factors except smoking were observed more in femalesas compared to males. Conclusion: Majority of patients with acute coronary syndrome werefemales and diabetic. NSTEMI was the most common type of ACS. Prevalence of conventionalrisk factors was found more in females with ACS.

Transitioning from a coronary to a critical cardiovascular care unit: trends over the past three decades

2020 ◽  
pp. 204887262093603
Author(s):  
Marc Ferrer ◽  
Cosme García-García ◽  
Nabil El Ouaddi ◽  
Ferran Rueda ◽  
Jordi Serra ◽  
...  
Keyword(s):  
Heart Failure ◽  
Acute Coronary Syndrome ◽  
Coronary Care Unit ◽  
University Hospital ◽  
Main Diagnosis ◽  
Coronary Syndrome ◽  
The Past ◽  
Coronary Care ◽  
Cardiovascular Care ◽  
Malignant Arrhythmias

Background: Coronary care units were established in the 1960s to reduce acute-phase mortality in acute coronary syndrome. In the 21st century, the original coronary care unit concept has evolved into an intensive cardiovascular care unit. The aim of this study was to analyse trend changes in characteristics and mortality of patients admitted to a coronary care unit over the past three decades. Method: Between February 1989 and December 2017, a total of 18,334 patients was consecutively admitted to the coronary care unit of a university hospital in Barcelona. Data were analysed in five time frames: 1989–1994, 1995–1999, 2000–2004, 2005–2009 and 2010–2017. We analysed demographic profile, diagnoses at admission and trend changes in mortality across periods. Results: During the periods, the patients’ ages and comorbidities increased. Diagnoses at admission have evolved. Acute coronary syndrome cases declined from the first to the last period (72.6% vs. 62.8%) while heart failure (6.0% vs. 8.6%) and malignant arrhythmias (0.8% vs. 4.0%) increased significantly. Overall, coronary care unit mortality decreased 34% from the first to the last period (6.8% vs. 4.5%, P<0.001). Furthermore, the cause of death has changed, those due to acute coronary syndrome declining (66.7% vs. 45.5%), and death from malignant arrhythmias increasing (1.9% vs. 16.2%) from the first to the last period. Conclusions: Although acute coronary syndrome remained the main diagnosis, heart failure and arrhythmias have increased. Despite the aging and comorbidities, overall mortality in the coronary care unit decreased by 34% in the past three decades. Deaths due to acute coronary syndrome have declined, whereas those due to malignant arrhythmias have increased.

scholarly journals Acute Coronary Syndrome and patient behavior factors in overcoming the event of chest pain in pre hospital phase

2020 ◽  
Author(s):  
Cipto Susilo ◽  
Mochammad Bagus Qomaruddin ◽  
Mellani Puji Fahrera
Keyword(s):  
Acute Coronary Syndrome ◽  
Chest Pain ◽  
Complex Disease ◽  
Sampling Technique ◽  
P Value ◽  
Behavioral Factors ◽  
Cross Sectional ◽  
Over The Counter ◽  
Coronary Syndrome ◽  
Design And Methods

Background: Acute coronary syndrome (ACS) is a complex disease induced by thrombosis, which causes unstable angina (UA), acute myocardial infarction (AMI) or sudden cardiac death. It is important to rapidly detect the presence of chest pain to conduct the pre-hospital phase. This study aims to analyze the behavioral factors of patients suffering from ACS in overcoming the incidence of chest pain in the prehospital phase. Design and Methods: The consecutive sampling technique and cross-sectional method were used to obtain data from a sample of 110 outpatient respondents at the Community- Integrated Health Center.Results: After the logistic regression test, a significant relationship was found between the occurrence of chest pain (Pvalue = 0.040), with compressive behavior factors, buying over the counter drugs (P-value = 0.001), massaging and rubbing with oil (P-value = 0.046). Conclusions: In conclusion, the significant behavioral factors associated with ACS sufferers in dealing with the occurrence of chest pain in the pre-hospital phase are due to the act of buying OTC drugs and the habit of massaging or rubbing with oil.

scholarly journals Ticagrelor in patients with acute coronary syndrome without ST elevation and a conservative treatment strategy

2016 ◽  
Vol 7 (1) ◽  
pp. 51-55
Author(s):  
A. D Erlikh
Keyword(s):  
Acute Coronary Syndrome ◽  
Conservative Treatment ◽  
Adverse Events ◽  
Treatment Strategy ◽  
Coronary Intervention ◽  
Cardiovascular Death ◽  
P Value ◽  
Correct Treatment ◽  
Coronary Syndrome ◽  
Study Results

The article provides an overview of the relevance of the use of dual antiplatelet therapy (DAT) in patients with acute coronary syndrome (ACS) without lifting ST (ACSwl ST ) receiving conservative treatment. Compared with those patients with ACSwl ST who underwent percutaneous coronary intervention, conservative treatment, patients traditionally have more comorbidities, risk factors and prognosis is worse. It is in this subgroup of patients to improve outcomes most important to carry out the most correct treatment of ACS, most strictly corresponding to current clinical guidelines. In particular this applies to that therapy, with which you can try to influence the mechanism of development of ACS, namely antirombocit therapy. The results of a clinical study PLATO showed that the use as a DAT combination with acetylsalicylic acid (ASA) and ticagrelor due to a decrease in the incidence of cardiovascular death, heart attack or stroke (primary adverse events) as compared to the combination of ASA and clopidogrel. The results of further analysis of PLATO study showed that when comparing the groups of patients with ACSwl ST treatment of invasive and conservative, noted a similar proportional reduction in the incidence of primary adverse events when using ticagrelor compared to clopidogrel group (hazard ratio of 0.86 compared with 0.85; p-value for interaction 0.89), which is consistent with the overall results of the study. Among patients with ACSwl ST treated conservatively, receiving ticagrelor as compared with clopidogrel was associated with a significantly smaller number of all deaths (relative risk, 0.73; 95 CI 0.57-0.93). The frequency of the "big" bleeding among patients treated conservatively with ACSwl ST treated with ticagrelor and clopidogrel did not differ significantly. PLATO study results identified the mandatory use of ticagrelor as DAT in patients with ACSwl ST regardless of the chosen treatment strategy.

scholarly journals Prognosis and follow-up of young patients admitted to a critical coronary care unit with acute coronary syndrome

2021 ◽  
Vol 10 (Supplement_1) ◽  
Author(s):  
DF Arroyo Monino ◽  
C Barea Gonzalez ◽  
MP Ruiz Garcia ◽  
T Seoane Garcia ◽  
JC Garcia Rubira
Keyword(s):  
Acute Coronary Syndrome ◽  
Chest Pain ◽  
Coronary Artery ◽  
Hospital Mortality ◽  
Coronary Care Unit ◽  
Young Patients ◽  
St Segment Elevation ◽  
Coronary Syndrome ◽  
Coronary Care

Abstract Funding Acknowledgements Type of funding sources: None. Introduction The presence of young patients admitted to a Critical Coronary Care Unit (CCCU) with the diagnosis of Acute Coronary Syndrome (ACS) is very common nowadays. The prognosis of these patients seems to be better than the elderly ones, although there are few records that endorse this statement. Objective Our aim is to carry out a follow-up of this population and study their prognosis during the index hospitalization and the follo-up. Methods Retrospective, descriptive, unicentric and observational registry of young patients (&lt;45 years old) admitted to one CCCU with the diagnosis of ACS between January 2.010 and November 2.020. The follow-up of these patients was performed using the electronic platform of Andalusian Health Security System. Results A total number of 252 patients were included in the registry, with a mean age of 40 years old, being male 206 (81,7%). The main reason of the admission was ACS with persistent ST segment elevation (STEMI) (177 patients – 70,2%). The most prevalent risk factor in this population was active smoking (198 patients – 78,6%). The main underlying mechanism of the ACS was the rupture of an atherosclerotic plaque (194 patients – 77%) and in most cases, there was only 1 coronary artery affected (153 patients – 60,7%). Intra-hospital mortality was low (2 patients died of cardiovascular cause – 0,8%, and 1 died of non-cardiovascular cause – 0,4%). Left ventricle ejection fraction (LVEF) at the discharge was preserved in 166 patients (65,9% - mean 58%), and reduced (&lt;40%) in 37 patients (14,7%). The median of the follow-up was 77 months (minimum 1 month and maximum 132 months). A total number of 5 patients died during this follow-up (2%, 3 during the first year), 3 of them of cardiovascular cause; these 3 patients had reduced LVEF at the discharge. During this follow-up, 64 (25,4%) patients were re-admitted to the hospital due to cardiovascular causes, most of them (30 – 11,9%) with the diagnosis of chest pain and 20 of them (7,9%) with the diagnosis of a new ACS. Conclusions Young patients admitted to our CCCU with the diagnosis of ACS presented most frequently with STEMI, affecting predominantly one coronary artery. Most of them had preserved LVEF at the discharge. The prognosis of this group of patients is good, with a low intra-hospital mortality and during the follow-up, with clear relation with the presence of reduced LVEF at the discharge. Re-admission was relatively frequent, mostly due to chest pain.

scholarly journals PERAN PERAWAT DALAM IDENTIFIKASI DINI DAN PENATALAKSANAAN PADA ACUTE CORONARY SYNDROME

2018 ◽  
Vol 8 (2) ◽  
Author(s):  
Nur Ainiyah
Keyword(s):  
Acute Coronary Syndrome ◽  
Chest Pain ◽  
Nursing Care ◽  
Early Identification ◽  
Literature Search ◽  
Ecg Changes ◽  
Knowledge And Skills ◽  
Coronary Syndrome

The role of nurses in the early identification and treatment on Acute Coronary Syndrome. Introduction : Acute Coronary Syndrome ( ACS ) is an emergency in the coronary arteries . Nurses are very necessary to provide treatment of acute coronary syndrome accurately and precisely both prehospital and intrahospital . Methods: The literature search from April 2006 through April 2016 in MEDLINE, NCBI, CINAHL using key words : Acute Coronary Syndrome, treatment and does not restrict the research sampling. Results: Based on the literature review 10 obtained the enforcement of early diagnosis of ACS should be done immediately, which can be done by looking of three criteria: chest pain, ECG changes and sign biochemical (biomarker serum). Discussion: The nursing care must have role in the management of ACS. Therefore the quality of care given depends on the knowledge and skills of nurses both prehospital and intrahospital

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