scholarly journals Delayed Presentation of Acute Coronary Syndrome: A Challenge in its Early Management

2009 ◽  
Vol 48 (173) ◽  
Author(s):  
Pramod Acharya ◽  
RR Adhikari ◽  
J Bhattarai ◽  
NR Shrestha
Keyword(s):  
Acute Coronary Syndrome ◽  
Chest Pain ◽  
Care Center ◽  
Tertiary Care ◽  
Late Presentation ◽  
Delayed Presentation ◽  
Tertiary Care Center ◽  
Early Management ◽  
Coronary Syndrome ◽  
District Hospitals

INTRODUCTION:The time of presentation of acute coronary syndrome from the onset of chest pain determines the treatment modality and prognosis. Delayed presentation is associated with a poor outcome. In the present study, we tried to find out the causes of late presentation of ACS in a tertiary care center in the eastern part of Nepal.METHODS:It was a cross-sectional descriptive study that included 100 consecutive patients with ACS presenting to our institute over a period of 8 months. They were studied for their demographic profile, delay in presentation, the management done at the local centers and their final diagnosis.RESULTS:We found that patients living within Dharan City reached BPKIHS within 20 hours of the onset of chest pain while those from outside the city who came directly reached within 63 hours. Other patients reached their respective local centers (health posts, district hospitals and private clinics) within 39 hours. The commonest cause of delay was vehicular problem followed by unnecessary delay at the local centers. The work up for chest pain was inadequate in these centers. Late presentation to our institute significantly affected the optimal management.CONCLUSIONS: We found that significant number of patients with ACS from eastern Nepal presented late in our tertiary care center. In order to improve ACS outcome in this region, we advise equipping the local centers with electrocardiogram machines, improvement in ambulance services and a greater emphasis on coronary artery disease awareness programs as well as initiating preventive measures.KEY WORDS:acute coronary syndrome, chest pain, delayed presentation, electrocardiogram

scholarly journals Prevalence of Vitamin D Deficiency among Patients of Acute Coronary Syndrome in a Tertiary Care Center of Eastern Nepal

2021 ◽  
Vol 59 (235) ◽  
Author(s):  
Richa Nepal ◽  
Prahlad Karki ◽  
Surendra Uraw ◽  
Madhab Lamsal
Keyword(s):  
Vitamin D ◽  
Acute Coronary Syndrome ◽  
Confidence Interval ◽  
Vitamin D Deficiency ◽  
Care Center ◽  
Tertiary Care ◽  
Care Hospital ◽  
Tertiary Care Center ◽  
Hypertensive Patients ◽  
Coronary Syndrome

Introduction: Vitamin D deficiency is an emerging risk factor for cardiovascular diseases. Very few studies have been done to find out vitamin D deficiency status among cardiovascular patients in Nepalese setup. This research aims to find out the prevalence of vitamin D deficiency among patients of acute coronary syndrome admitted in a tertiary care center of eastern Nepal. Methods: This was a descriptive cross-sectional study conducted among patients of acute coronary syndrome admitted in a tertiary care hospital from 1st February 2018 to 31st July 2018. Ethical clearence was taken from Institutional Review Committee of B.P. Koirala Institute of Health Sciences (Reference number: 259/074/075-IRC). Convenience sampling method was used. Data was entered in Microsoft Excel and analyzed using Statistical Package for the Social Sciences version 25. Point estimate at 95% Confidence Interval was calculated along with frequency and proportion for binary data. Results: A total of 33 (64.7%) at 95% Confidence Interval (51.58-77.82) patients of acute coronary syndrome had vitamin D deficiency in our study with 19 (37.3%) having mild deficiency and 14 (27.4%) having moderate deficiency. None of the patients had severe vitamin D deficiency in our study. The mean vitamin D levels were lower in diabetics (23.57±9.28ng/ml) as compared to non-diabetics (31.91±12.50ng/ml), in hypertensive patients (24.36±7.67ng/ml) as compared to non-hypertensive patients (30.97±13.72ng/ml), and in patients with dyslipidemia (22.86±6.44ng/ml) as compared to those without dyslipidemia (37.68±13.15ng/ml). Conclusions: Prevalence of vitamin D deficiency among patients of acute coronary syndrome in our study was comparable to various other homologous international studies.

Frequency of Intensive Statin Therapy in Patients With Acute Coronary Syndrome Admitted to a Tertiary Care Center

2012 ◽  
Vol 109 (1) ◽  
pp. 1-5 ◽  
Author(s):  
Jennifer R. Shiu ◽  
Glen J. Pearson ◽  
Theresa L. Charrois ◽  
Gabor Gyenes ◽  
Sheri L. Koshman
Keyword(s):  
Acute Coronary Syndrome ◽  
Statin Therapy ◽  
Care Center ◽  
Tertiary Care ◽  
Tertiary Care Center ◽  
Coronary Syndrome ◽  
Intensive Statin Therapy

scholarly journals Predictors of Long-Term Survival of Individuals with Acute Coronary Syndrome Aged 90 and Older Admitted to a Tertiary Care Center

2015 ◽  
Vol 63 (11) ◽  
pp. 2410-2412
Author(s):  
Nicolas W. Shammas ◽  
Gail A. Shammas ◽  
Michael Jerin ◽  
Carolyn Shanks ◽  
Amanda Dvorak ◽  
...  
Keyword(s):  
Acute Coronary Syndrome ◽  
Care Center ◽  
Tertiary Care ◽  
Tertiary Care Center ◽  
Term Survival ◽  
Long Term Survival ◽  
Coronary Syndrome

scholarly journals SYNDROME X IN ACUTE CORONARY SYNDROME PATIENTS - A TERTIARY CARE CENTER STUDY

2015 ◽  
Vol 4 (102) ◽  
pp. 16796-16800
Author(s):  
Yogendra Malhotra ◽  
Harendra Kumar Shukla ◽  
Aniketh Prabhakar
Keyword(s):  
Acute Coronary Syndrome ◽  
Care Center ◽  
Tertiary Care ◽  
Syndrome X ◽  
Tertiary Care Center ◽  
Coronary Syndrome ◽  
Center Study

scholarly journals COMPARATIVE ANALYSIS OF VARIOUS RISK ASSESSMENT SCORES FOR LOW RISK ACUTE CORONARY SYNDROME IN AN INDIAN SCENARIO – AN ED BASED OBSERVATIONAL STUDY.

2019 ◽  
Vol 3 (11) ◽  
Author(s):  
Zahid Shaikh ◽  
V. S. Shinde ◽  
Sumalya Tripathi ◽  
Dhiraj Jadhav ◽  
Ishan Lamba ◽  
...  
Keyword(s):  
Acute Coronary Syndrome ◽  
Chest Pain ◽  
Tertiary Care ◽  
Acute Chest Pain ◽  
Industrial Area ◽  
Low Risk ◽  
Cardiac Biomarkers ◽  
Assessment Scores ◽  
Heart Score ◽  
Coronary Syndrome

Chest pain is one of the most common presentation to emergency department (ED). The misdiagnosis or over-diagnosis of patients with acute chest pain can be associated with serious clinical events or is time-consuming and this places a heavy burden on overcrowded and resource constraint ED. To help overcome this issue various scores are formed to rule out acute coronary syndrome (ACS) in these patients. Those who do not meet the criteria of high risk ACS like raised cardiac biomarkers, ECG changes, etc are labeled as low risk ACS. These patients form the majority of patients. A multitude of risk score have been formulated to predict the outcome and risk stratify patients with chest pain. Our objective was to evaluate the utility of these score in Indian setting in low risk ACS patients. We studied the various risk prediction score of 100 patients presenting to the ED of tertiary care teaching institute in an urban industrial area with low risk ACS. The scores that were calculated included HEART, TIMI, ADAPT, GRACE, NACPR and EDACS. Of all the scores only the HEART score correlated well with identifying those who required further testing. Taking a score of less than 3 as a marker of low risk ACS we get a sensitivity of 95.83% (95CI - 89.67% to 98.85%) and specificity of 100%. The PPV is 100% and accuracy of 96%. All other scores were either not specific enough or had limited utility. Keywords: Low risk ACS, ACS, HEART, TIMI, ADAPT, GRACE, NACPR, EDACS

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