Thrombolytic use in the region around Amarillo, Texas, in patients with ST elevation myocardial infarction.

Thrombolytic use in the region around Amarillo, Texas, in patients with ST elevation myocardial infarction. Proc (Bayl Univ Med Cent). 2018 Jan;31(1):9-11 Authors: McMaster KS, Chatterjee T, McBrayer D, Brabham D Abstract Appropriate administration of thrombolytic therapy is particularly important for ST elevation myocardial infarction (STEMI) patients who are unable to access primary percutaneous coronary intervention (PCI) in a timely manner. We evaluated the current state of thrombolytic therapy in the Panhandle region of West Texas where access to primary PCI is poor. The medical records of 79 patients transferred from 20 outlying facilities to the two hospitals in Amarillo, Texas, for STEMI in 2016 were retrospectively evaluated for time of onset of chest pain, initial electrocardiogram findings, medication reconciliation, and any contraindications to thrombolytic therapy. Medical record review allowed the patients to be sorted into one of five predefined categories based on our findings. The most common error discovered was failure to deliver the appropriate accompanying medications with thrombolytic therapy, noted in 43% of patients. Other errors included failure to deliver thrombolytic therapy in patients who met no clear contraindications to thrombolytic therapy (21%) and administering thrombolytic therapy to patients who had not suffered STEMI (4%). Thirteen percent of patients were appropriately treated with thrombolytic therapy and 19% of pat...
Source: Baylor University Medical Center Proceedings - Category: Universities & Medical Training Authors: Tags: Proc (Bayl Univ Med Cent) Source Type: research

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Conclusion: This represents the largest study of patients with VPR and angiographically-proven ACO. The MSC were highly sensitive and specific for the diagnosis of ACO in patients presenting to the ED with VPR and symptoms of acute coronary syndrome.===================================MY Comment by KEN GRAUER, MD (10/4/2020):===================================Today ’s case provides a superb example of how acute OMI can sometimes be definitively recognized even in the presence ofpacing. Unfortunately, this was not recognized by the cardiology team despite...
Source: Dr. Smith's ECG Blog - Category: Cardiology Authors: Source Type: blogs
ConclusionsWhile we found that cemented hemiarthroplasty results in less postoperative pain than uncemented hemiarthroplasty in older patients with femoral neck fracture, the lack of significant differences in functional hip scores, mortality, and complications was surprising. Further high-level research is needed.
Source: HSS Journal - Category: Orthopaedics Source Type: research
This case was sent by an excellent medic:A 50-something yo male started to chop wood when he experienced a short syncopal episode followed by 8/10 chest pain.  Ground EMS arrived, administered ASA and sublingual nitro to which he passed out again.Flight crew was called to transport for signs of shock/syncopal episodes, not ACS.Ground crew had recorded this prehospital ECG:Sinus rhythm with one PVC (first complex)And anything else?These are hyperacute T-waves diagnostic of LAD occlusion.  They begin at V3, and there is no inferior ST depression, so this is probably a mid-LAD occlusion.  The hyperacute T-waves...
Source: Dr. Smith's ECG Blog - Category: Cardiology Authors: Source Type: blogs
ConclusionsVenous thromboembolism risk in rheumatoid arthritis is stated as being less recognized as an arterial complication. This is borne out by this patient ’s clinical journey, wherein his youth, fitness, athletic appearance, and onset of symptoms during exercise were said to suggest a diagnosis of a calf strain at a minor injuries unit. Ultrasonography at a different accident and emergency unit later that day ultimately was used to diagnose deep vei n thrombosis.
Source: Journal of Medical Case Reports - Category: General Medicine Source Type: research
Abstract Peripheral artery disease is a common disorder and a major cause of morbidity and mortality worldwide. Therapy is directed at reducing the risk of major adverse cardiovascular events and at ameliorating symptoms. Medical therapy is effective at reducing the incidence of myocardial infarction and stroke to which these patients are prone but is inadequate in relieving limb-related symptoms, such as intermittent claudication, rest pain, and ischemic ulceration. Limb-related morbidity is best addressed with surgical and endovascular interventions that restore perfusion. Current medical therapies have only mod...
Source: Arteriosclerosis, Thrombosis and Vascular Biology - Category: Cardiology Authors: Tags: Arterioscler Thromb Vasc Biol Source Type: research
A 25-year-old man presented with new-onset substernal chest pain. The pain was dull, and radiated to his neck and left jaw. ECG showed diffuse ST elevation without reciprocal changes (Figure 1A). Troponin level was 4.76 ng/mL (normal: 0 – 0.09). He was started on colchicine and aspirin for the treatment of suspected pericarditis. Repeat troponin level in six hours was greater than 50 ng/mL. Contrast echocardiography showed left ventricular (LV) ejection fraction of 45% and akinesis of all apical segments without left ventricular thrombus.
Source: The American Journal of Medicine - Category: General Medicine Authors: Tags: Clinical Communication to the Editor Source Type: research
Abstract Coronavirus disease 2019 (COVID-19) is a recently recognised pandemic spreading rapidly from Wuhan, Hubei, to other provinces in China and to many countries around the world. The number of COVID-19-related deaths is steadily increasing. Acute ST-segment elevation myocardial infarction (STEMI) is a disease with high morbidity and mortality rates, and primary percutaneous coronary intervention is usually recommended for the treatment. A patient with diabetes mellitus and hypertension for five years was admitted to the emergency unit with symptoms of fever, cough and dyspnoea. These symptoms were consistent ...
Source: Cardiovascular Journal of Africa - Category: Cardiology Authors: Tags: Cardiovasc J Afr Source Type: research
Rationale: Patent foramen ovale (PFO) is not considered to be the main cause of stroke and is classified as the infarction of undetermined cause. The relationship between PFO and cerebral embolism is still unclear and cerebral embolism accompanied with coronary artery embolization in PFO patient is rare. In this case, we reported a patient with PFO suffered acute cerebral and myocardial infarction simultaneously, and analyzed the source of emboli and potential pathogenesis. Patient concerns: A 53-year-old female presented with chief complaints of intermittent palpitations and chest tightness for 6 years, aggravated fo...
Source: Medicine - Category: Internal Medicine Tags: Research Article: Clinical Case Report Source Type: research
Abstract Prostanoids are a group of bioactive lipids that are synthesized de novo from membrane phospholipid-released arachidonic acid and have diverse functions in normal physiology and disease. NSAIDs, which are among the most commonly used medications, ameliorate pain, fever, and inflammation by inhibiting COX (cyclooxygenase), which is the rate-limiting enzyme in the biosynthetic cascade of prostanoids. The use of NSAIDs selective for COX-2 inhibition increases the risk of a thrombotic event (eg, myocardial infarction and stroke). All NSAIDs are associated with an increased risk of heart failure. Substantial v...
Source: Arteriosclerosis, Thrombosis and Vascular Biology - Category: Cardiology Authors: Tags: Arterioscler Thromb Vasc Biol Source Type: research
Authors: Shao C, Wang J, Tian J, Tang YD Abstract In most developed countries, coronary artery disease (CAD), mostly caused by atherosclerosis of coronary arteries, is one of the primary causes of death. From 1990s to 2000s, mortality caused by acute MI declined up to 50%. The incidence of CAD is related with age, gender, economic, etc. Atherosclerosis contains some highly correlative processes such as lipid disturbances, thrombosis, inflammation, vascular smooth cell activation, remodeling, platelet activation, endothelial dysfunction, oxidative stress, altered matrix metabolism, and genetic factors. Risk factors ...
Source: Advances in Experimental Medicine and Biology - Category: Research Tags: Adv Exp Med Biol Source Type: research
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