A Brief Note On Coronary Intervention ( Pci )

According to the NICE guidelines (2013) as Mr Jones was presented with symptoms associated with a ST-segment-elevation myocardial infarction (STEMI) the recommended emergency treatment that is preferred is percutaneous

Coronary artery disease (CAD) is the commonest heart disease in the United States1. Approximately, 29% of patients with Myocardial Infarction ( MI ) present with ST- elevation Myocardial Infarction ( STEMI )2. STEMI is the result of complete occlusion of a major epicardial coronary artery due to thrombus formation. STEMI from a small coronary artery presenting as substantial EKG abnormalities similar to occlusion of a major artery and hemodynamic instability is a rare entity. The epidemiology, typical clinical presentation, outcomes, and optimal management in this group of patients are not sufficiently known.

This was a retrospective, descriptive, and correlational study. Data from the records of patients who had undergone a heart catheterization or PCI over the span of two years was retrieved from the Clinical Automated Office Solutions database. (Dumont, Keeling, Bourguignon,

Prior work has explored hospital-level variability (and risk factors) in HAIs after cardiac surgery. Shih used patient characteristics (age, body mass index, cardiovascular disease, smoking status, ejection fraction, dyslipidemia, hypertension, chronic lung disease, immunosuppressive therapy, peripheral arterial disease, diabetes mellitus, congestive heart failure, New York Heart Association class, cardiogenic shock, and anticoagulant usage ) to estimate each center’s predicted rate of HAI. While predicted risk of

Currently at Northeast Methodist Hospital (NEMH), the coordination of care of patients having outpatient coronary CTA is fragmented. At least one known patient experienced bleeding from the IV site and near syncopal episode within 10 minutes post discharge from the radiology department, which required a return to the facility for treatment. Inconsistencies in the current pre-, intra-, and post-procedure care of the patient, and risks associated, have been identified. The lack of an evidence based coronary CTA protocol within the facility contributes to the fragmented care.

Chest pain is a frequent cause of emergency department presentation. Many times, chest pain can be an indicator of myocardial infarction. Yearly, about 600,000 people die of heart disease in the United States, with a total of about 700,000 having a myocardial infarction. The leading source of death for both men and women is heart disease ("Heart disease facts," 2014). Managing the challenging clinical problems of those presenting with chest pain can be demanding. While clinical judgment is imperative in managing these patients, rapid treatment protocols to evaluate risk

In an article published in JACC: Cardiovascular Interventions, Doctors Madan, Halvorsen, Di Mario, Tan, Westerhout, Cantor, Le May, and Borgia explored whether patients experienced greater risk of undergoing angiography after the administration of fibrinolytic therapy. They concluded that there was not a serious risk of bleeding or death if they receive angiography within four hours of undergoing fibrinolytic therapy (Madan et al., 2015). They also suggest that the patient be moved a center that can perform PCI within 2 hours after fibrinolysis. This article suggests that although fibrinolysis can be success a patient should receive PCI treatment.

"In 2006, more than 690,000 open heart surgeries were performed in the United States. These included surgeries to correct and repair defective valves as well as coronary artery bypass surgery. As recently as 70 years ago, these surgeries would have been impossible. The heart lung machine had yet to be invented, allowing surgeons to temporarily stop and start the heart. Prior to its invention, the longest a heart could be stopped was 30 to 40 minutes---not enough time to complete extensive surgery" (Smith, 2009). Since then, a number of minimally invasive surgical procedures have been introduced that permit surgeons to perform a variety of surgeries, making smaller incisions that leave smaller scars, reduce the chance of infection, are less painful to the patient and necessitate shorter hospital stays. These include minimally invasive direct coronary artery bypass, off-pump coronary artery bypass, videoscopic surgery and robotic-assisted heart surgery.

Funny, but often when surgery &/or a lesser procedure is offered to a surgeon i.e. Dr. John Peters' situation, surgeons tend to go for the noninvasive route, even though they make their money by cutting into other people to get things done and usually done better and so be like Dr. Peters and who has had 2 angioplasties and no bypass(es), at least not yet. There was a cardiac surgeon on the west coast who actually went one step further than Peters, in that not only did he have angioplasties and not coronary bypass surgery done twice and both times the cardiologists and the cardiac surgeons had strongly recommended the bypass for a better fix for him, but he also continued to

The purpose of this paper is to discuss a new best practice, the necessary steps for implementing the new practice, and support this change in practice with current literature. Heart disease is the leading cause of death in the United States. Evidence-based clinical practice guidelines regarding patients with ST-segment elevation myocardial infarction (STEMI) seek to reduce variation in practice and improve outcomes for this patient population (O 'Gara et al., 2013). Current evidence-based practice includes immediate reperfusion therapy to the involved coronary artery in this patient population. However, it is often challenging for emergency department nurses to implement the initial steps of this evidence-based practice, which includes obtaining a 12-lead electrocardiogram within ten minutes of arrival, as some patients present with symptoms other than chest pain, or atypical symptoms. For instance, atypical presentations include shortness of breath, altered mental status, upper extremity pain, upper back pain, generalized weakness, and abdominal pain (Glickman et al., 2012). Ultimately, this results in delays of reperfusion therapy.

Providing care for post percutaneous coronary intervention (PCI) patients has evolved and the guidelines and protocols have been heavily influenced by research and evidence based practice (EBP). Unfortunately, coronary heart disease has become a major issue for the health status of Americans across the lifespan. According to the CDC, “About 610,000 people die of heart disease in the United States (U.S.) every year – that’s 1 in every 4 deaths.” In addition, treating coronary heart disease patients has negatively impacted the economic status of U.S. healthcare. Therefore, to manage

132); however, there is increasing interest in the use of transradial artery access (TRA) for coronary angiography and PCI. Several European countries and Asia use TRA as the primary mode of access (Mitchell et al., 2012), but TRA still accounts for only ten percent of the overall PCI procedures in the United States (Amoroso & Kiemeneij, 2010). A more recent report revealed one of six PCI’s in interventional practice was completed by the TRA approach (Feldman et al., 2013) which is suggestive of increasing adoption of TRA in the United States.

Mr. Harry Bright has undergone a procedure called percutaneous transluminal coronary intervention (PTCI) via femoral approach for the treatment of his progressive unstable angina. Femoral artery is the most common access site used for PCI because of its size and its direct passageway to the heart (Young, 2014 p.431; Cosman, Arthur, Bryant-Lukosius, Strachan, 2015 p.180). In this procedure, a cardiac catheter followed by a stent is inserted to the artery to dilate the occluded blood vessel and improve blood flow (Young, 2014 p.430). The occlusive atherosclerotic plaque are usually associated with Mr. Bright’s diabetes, hypetension and smoking history. Contrary to the positive effect of PTCI, bleeding and hematoma formation are the most typical

The purpose of the coronary artery bypass study was to analyze women’s experiences with surgery. Possible participants were chosen from a cardiac waiting list at two teaching hospitals in England and Wales between 2003 and 2006. The eligible criteria included, women who could read and understand English, and were eighteen years or older first-time coronary artery bypass graft surgery patients. Thirty Caucasian women were chosen to conduct the study over. Due to a lack in a diverse population, the study cannot be evidence for all women.

Coronary artery disease (CAD) is caused by fatty buildup in the arteries of the heart. Your arteries are made to carry oxygen infused blood to your heart and other parts of your body if it is filled up with plaque, which is the fatty substance that clogs and blocks up the arteries. If it gets clogged enough to where your heart is not receiving fresh oxygen, you could have a heart attack that could cause very serious damage to your body and could even kill you. When you are younger, you can begin to grow plaque in your blood vessels from not eating right and not exercising regularly. When your arteries are being filled up with plaque they become more narrow and harder for blood to get through as easily as it is supposed to be. When you have