scholarly journals Lived Experiences of Patients with Coronary Artery Disease: A Qualitative Study from a Cardiac Center of a Regional Hospital in Mauritius

2021 ◽  
Vol 16 ◽  
pp. 11
Author(s):  
Ananya Shukla ◽  
Satvik Jain ◽  
Nihal Mohammed ◽  
Tasneem Hussain ◽  
Indrajit Banerjee
Keyword(s):  
Coronary Artery Disease ◽  
Heart Disease ◽  
Coronary Artery ◽  
Qualitative Study ◽  
Qualitative Interviews ◽  
Improve Patient Care ◽  
Cardiac Patients ◽  
Atherosclerotic Cardiovascular Disease ◽  
Lifestyle Modifications ◽  
Artery Disease

Objectives: Coronary artery disease (CAD), also known as ischemic heart disease or atherosclerotic cardiovascular disease (CVD), is one of the major causes of morbidity and mortality globally and has contributed to about 80% of sudden deaths. There have been advancements in the diagnosis and treatment of CAD, some of which are still going on to improve patient care, however, there is a dearth of information regarding the various challenges the patients go through after being diagnosed with CAD and so a qualitative study was conducted on cardiac patients in Mauritius to shine a light on the various aspects of life affected by CAD. This is the first qualitative study conducted on cardiac patients in Mauritius. Material and Methods: A phenomenological qualitative study was performed on 12 patients who were diagnosed with CAD, at the Cardiac Unit of Victoria Hospital, Mauritius. By the use of NVivo 12 (Windows) Plus software, after it was transcribed, codes/nodes and themes were generated. Results: Twenty-five different codes were inferred from the study done and from the respective codes, eight main themes were established. The main themes drawn from the study were as follows: Emotional factors, risk factors, optimistic factors, support, awareness of your health, consequences, lifestyle modifications, and the healthcare system. Conclusion: An event of CAD is an experience with multifaceted influences on innumerable aspects of the patient’s life. The study illuminated the immense sufferings and emotional bearings of those patients who were living with heart disease. They expressed their overbearing, insecurities, and a loss of control over various aspects of their lives. This study provided various thought-provoking themes that emerged after transcribing the qualitative interviews. It also highlighted the various challenges faced by patients and how the beliefs of patients with CAD were vital to sustaining them. Family support is a vital aspect in keeping the patient both motivated to follow their treatment and emotionally grounded.

Elevated level of circulatory sTLT1 induces inflammation through SYK/MEK/ERK signalling in coronary artery disease

2019 ◽  
Vol 133 (22) ◽  
pp. 2283-2299
Author(s):  
Apabrita Ayan Das ◽  
Devasmita Chakravarty ◽  
Debmalya Bhunia ◽  
Surajit Ghosh ◽  
Prakash C. Mandal ◽  
...  
Keyword(s):  
Risk Factors ◽  
Coronary Artery Disease ◽  
Coronary Artery ◽  
Chronic Inflammation ◽  
Ex Vivo ◽  
Human Subjects ◽  
Critical Role ◽  
Atherosclerotic Cardiovascular Disease ◽  
Tnf Α ◽  
Artery Disease

Abstract The role of inflammation in all phases of atherosclerotic process is well established and soluble TREM-like transcript 1 (sTLT1) is reported to be associated with chronic inflammation. Yet, no information is available about the involvement of sTLT1 in atherosclerotic cardiovascular disease. Present study was undertaken to determine the pathophysiological significance of sTLT1 in atherosclerosis by employing an observational study on human subjects (n=117) followed by experiments in human macrophages and atherosclerotic apolipoprotein E (apoE)−/− mice. Plasma level of sTLT1 was found to be significantly (P<0.05) higher in clinical (2342 ± 184 pg/ml) and subclinical cases (1773 ± 118 pg/ml) than healthy controls (461 ± 57 pg/ml). Moreover, statistical analyses further indicated that sTLT1 was not only associated with common risk factors for Coronary Artery Disease (CAD) in both clinical and subclinical groups but also strongly correlated with disease severity. Ex vivo studies on macrophages showed that sTLT1 interacts with Fcɣ receptor I (FcɣRI) to activate spleen tyrosine kinase (SYK)-mediated downstream MAP kinase signalling cascade to activate nuclear factor-κ B (NF-kB). Activation of NF-kB induces secretion of tumour necrosis factor-α (TNF-α) from macrophage cells that plays pivotal role in governing the persistence of chronic inflammation. Atherosclerotic apoE−/− mice also showed high levels of sTLT1 and TNF-α in nearly occluded aortic stage indicating the contribution of sTLT1 in inflammation. Our results clearly demonstrate that sTLT1 is clinically related to the risk factors of CAD. We also showed that binding of sTLT1 with macrophage membrane receptor, FcɣR1 initiates inflammatory signals in macrophages suggesting its critical role in thrombus development and atherosclerosis.

Gender Differences in Non-Obstructive Coronary Artery Disease

2020 ◽  
Vol 26 ◽  
Author(s):  
Maria Bergami ◽  
Marialuisa Scarpone ◽  
Edina Cenko ◽  
Elisa Varotti ◽  
Peter Louis Amaduzzi ◽  
...  
Keyword(s):  
Coronary Artery Disease ◽  
Gender Differences ◽  
Heart Disease ◽  
Coronary Artery ◽  
Ischemic Heart Disease ◽  
Coronary Arteries ◽  
Obstructive Coronary Artery Disease ◽  
Ischemic Heart ◽  
Current Evidence ◽  
Artery Disease

: Subjects affected by ischemic heart disease with non-obstructive coronary arteries constitute a population that has received increasing attention over the past two decades. Since the first studies with coronary angiography, female patients have been reported to have non-obstructive coronary artery disease more frequently than their male counterparts, both in stable and acute clinical settings. Although traditionally considered a relatively infrequent and low-risk form of myocardial ischemia, its impact on clinical practice is undeniable, especially when it comes to infarction, where the prognosis is not as benign as previously assumed. Unfortunately, despite increasing awareness, there are still several questions left unanswered regarding diagnosis, risk stratification and treatment. The purpose of this review is to provide a state of the art and an update on current evidence available on gender differences in clinical characteristics, management and prognosis of ischemic heart disease with non-obstructive coronary arteries, both in the acute and stable clinical setting.

Prevalence of Coronary Artery Disease Risk Factors and Metabolic Syndrome in Children with Heart Disease

2017 ◽  
Vol 39 (2) ◽  
pp. 261-267 ◽  
Author(s):  
Adam L. Ware ◽  
Paul C. Young ◽  
Cindy Weng ◽  
Angela P. Presson ◽  
L. LuAnn Minich ◽  
...  
Keyword(s):  
Risk Factors ◽  
Coronary Artery Disease ◽  
Metabolic Syndrome ◽  
Heart Disease ◽  
Coronary Artery ◽  
Disease Risk ◽  
Coronary Artery Disease Risk ◽  
Artery Disease

Are Retinal Microvascular Caliber Changes Associated with Severity of Coronary Artery Disease in Symptomatic Cardiac Patients?

2009 ◽  
Vol 16 (2) ◽  
pp. 177-181 ◽  
Author(s):  
Andreas Josef Kreis ◽  
Thanh Tan Nguyen ◽  
Jie Jin Wang ◽  
Sophie Rogers ◽  
Ali Al-Fiadh ◽  
...  
Keyword(s):  
Coronary Artery Disease ◽  
Coronary Artery ◽  
Cardiac Patients ◽  
Artery Disease

Prediction of atherosclerosis in children and the possibility of early prevention of coronary heart disease

1999 ◽  
Vol 80 (4) ◽  
pp. 296-297
Author(s):  
O. I. Pikuza ◽  
V. N. Oslopov ◽  
H. M. Vakhitov ◽  
A. A. Babushkina ◽  
S. E. Nikolsky
Keyword(s):  
Coronary Artery Disease ◽  
Coronary Heart Disease ◽  
Heart Disease ◽  
Coronary Artery ◽  
Cardiovascular Diseases ◽  
Childhood And Adolescence ◽  
Early Prevention ◽  
Cerebrovascular Pathology ◽  
Artery Disease

Cardiovascular diseases caused by atherosclerosis (coronary artery disease, cerebrovascular pathology, etc.) are responsible for 40-50% of all deaths in adults. Of particular concern to clinicians is the emerging unfavorable tendency to "rejuvenate" these diseases. Currently, the fact that atherosclerosis (AS) begins to form in childhood and adolescence is indisputable.

Errors during the exercise test for the diagnosis of Coronary heart disease: negative result in the presence of three-vessel coronary artery disease

2021 ◽  
pp. 30-33
Author(s):  
L. A. Popova ◽  
N. L. Karpina ◽  
M. I. Chushkin ◽  
S. Y. Mandrykin ◽  
V. M. Janus ◽  
...  
Keyword(s):  
Coronary Artery Disease ◽  
Coronary Heart Disease ◽  
Heart Disease ◽  
Coronary Artery ◽  
Clinical Case ◽  
Multivessel Coronary Artery Disease ◽  
First Choice ◽  
Exercise Ecg ◽  
Artery Disease ◽  
Vessel Coronary Artery

The exercise ECG test is traditionally the first choice in patients with suspected CHD, as the most accessible, despite the fact that its sensitivity and specificity are 68 % and 77 %, respectively. Description of a clinical case of multivessel coronary artery disease in a patient with a negative result of exercise ECG test is presented.

OBSTRUCTIVE SLEEP APNEA / HYPOPNEA SYNDROME IN RAILWAY WORKERS WITH RISK FACTORS FOR CORONARY HEART DISEASE

2021 ◽  
Author(s):  
S. Gorokhova ◽  
◽  
N. Belozerova ◽  
M. Buniatyan ◽  
Keyword(s):  
Risk Factors ◽  
Coronary Artery Disease ◽  
Coronary Heart Disease ◽  
Heart Disease ◽  
Coronary Artery ◽  
Obstructive Sleep ◽  
Railway Workers ◽  
Artery Disease ◽  
Step Algorithm ◽  
Hypopnea Syndrome

Abstract: Obstructive sleep apnea/hypopnea syndrome (OSA) is a common condition that may lead to excessive daytime sleepiness, cognitive disturbance, and a decreased concentration that are associated with the risk of workplace accidents and injuries. It is difficult to diagnose OSA due to low severity and specificity of its symptoms and special requirements in respect of medical resources. We assumed that it would be more effective and cost-efficient to diagnose OSA in railway workers with such risk factors f coronary heart disease as arterial hypertension and metabolic disorders since this group receives comprehensive medical attention. However, no studies on the prevalence of OSA in railway workers specifically considered the risk factors for coronary artery disease. The aim of the study was to assess the prevalence of OSA in railway workers with confirmed cardiovascular and metabolic disorders that did not disqualify them from their job. Material and methods. The study included 967 railway workers (locomotive drivers and their assistants). On Stage 1, a group of participants suspected OSA was selected; and on Stage 2, a group of participants with confirmed OSA was formed. Polysomnography or cardiorespiratory monitoring were used to diagnose OSA. Results. We developed a two-step algorithm of OSA diagnosis that included a preliminary assessment of the probability of OSA. 236 (24.4%) participants with a probability of OSA were selected among the initial 967 persons with risk factors for coronary artery disease. Further assessment confirmed OSA in 141 (60%) participants in this group. The analysis of distribution of risk factors for coronary artery disease and OSA showed that 125 (53.0%) of patients with BMI ≥ 30 kg/m², 115 (48.7%) of patients with AH, and 26 (11.0%) of patients with type 2 diabetes had OSA; most of them had some combination of these risk factors. Conclusions: OSA is prevalent in the group of professionally active locomotive drivers and their assistants with risk factors for coronary heart disease; every second worker in a target group with BMI ≥ 30 kg/m², AH or with both risk factors was diagnosed with OSA. The proposed two-step algorithm with a pre-test assessment of OSA probability and subsequent instrumental examination (cardiorespiratory monitoring, polysomnography) allows to accurately diagnosis OSA and allocate medical resources in a cost-effective manner.

Abstract 342: Impact Of System And Physician Factors On The Diagnostic Yield Of Coronary Angiography In Stable Ischemic Heart Disease: A Population Based Study

2014 ◽  
Vol 7 (suppl_1) ◽  
Author(s):  
Harindra C Wijeysundera ◽  
Feng Qiu ◽  
Maria C Bennell ◽  
Madhu K Natarajan ◽  
Warren J Cantor ◽  
...  
Keyword(s):  
Coronary Artery Disease ◽  
Heart Disease ◽  
Coronary Artery ◽  
Coronary Angiography ◽  
Ischemic Heart Disease ◽  
Diagnostic Yield ◽  
Obstructive Coronary Artery Disease ◽  
Ischemic Heart ◽  
Patient Factors ◽  
Artery Disease

Background: Wide variation exists in the diagnostic yield of coronary angiography in stable ischemic heart disease (IHD). Previous work has primarily focused on patient factors for this variation. We sought to understand if system and physician factors, specifically hospital and physician type, as well as physician self-referral, have incremental impacts on the yield of coronary angiography, above and beyond that of patient factors alone. Methods: All patients who underwent a diagnostic coronary angiogram for possible stable IHD, at the 18 cardiac centers in Ontario, Canada were identified from October 1st, 2008 to September 30th, 2011. Obstructive coronary artery disease was defined as stenosis greater than 70% in the main coronary arteries or greater than 50% in the left main artery. Physicians were classified as either invasive or interventional. Hospitals were categorized into cath only, stand-alone PCI and full service centers. Multi-variable hierarchical logistic models were developed to identify system and physician level predictors of obstructive coronary artery disease, having adjusted for patient factors. Results: Our cohort consisted of 60,986 patients who underwent a diagnostic angiogram for possible stable IHD, of which 33,483 had obstructive coronary artery disease (54.9%), ranging from 41.0% to 70.2% across centers. Self-referral rates varied from 4.8% to 74.6%. Fewer self-referral patients (52.5%) had obstructive coronary artery disease compared to non-self-referral patients (56.5%), with an odds ratio (OR) of 0.89 (95% CI 0.85-0.93;p <0.001), after accounting for patient factors. Angiograms performed by interventional physicians had a higher likelihood of showing obstructive coronary artery disease (60.1% vs. 50.8%; OR 1.22; 95% CI 1.17-1.28; p<0.001). Fewer angiograms at cath only centers showed obstructive disease (45.0%) compared to full service centers (58.1%); this was of borderline significance (OR 0.59; 95% CI 0.34-1.00; p=0.05). Conclusion: Physician and system factors are important predictors of the diagnostic yield of coronary angiography in stable IHD, even after accounting for patient characteristics. Further study into the drivers of how these physician and system factors impact diagnostic yield is an important focus for quality improvement.

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