Case Study : Mi / Acs ( Acute Coronary Syndrome )

Mr. XXXX is a 44 years old Caucasian male, a general construction worker who works on a nearby highway for the bridge project, and checked in this urgent care center for complaining of chest pain and shortness of breath (SOB). The chest pain is constant dull and pressure like pain, and started 3 hours ago. The pain is located on the center of chest. He rates the pain 4 out of 10 on a pain scale 0 to 10 while resting. The pain gets worse and increases after eating. He experienced increased chest pain and SOB with simple walking from the parking lot to this office. The pain was not resolved with taking PO 365mg of Aspirin 2 hours ago and resting. He was diagnosed with hyperlipedemia 10 years ago. He is taking medication to manage his high cholesterol level. He denies past history of chest pain, hypertension, and coronary artery disease. He denies any history of heart surgery or cardio artery bypass surgery. He is anxious and fearful for his first chest and SOB. He smokes a half pack a day for past 20 years. He drinks one bottle of bear every evening with meals. He denies taking any herbal medication or illicit drugs. He has been a good appetite. He reported 20 lbs weight gain since his retirement from military. He has an irregular meal time and does not exercise as much as he used to do in the military.

Heart: Rhythm regular, no murmurs. Normal S1 and S2. No S3, S4 or murmurs. No peripheral edema, cyanosis or pallor. Extremities are warm and well perfused. No carotid bruits.

Fibrinolytic therapy uses drugs to break up blood clots. This therapy is used with heart attack patients to remove the blockage that caused the myocardial infarction. Another treatment option is percutaneous coronary intervention (PCI). PCI involves the placement of a catheter into the blocked artery to allow blood to flow. The purpose of this paper is to examine the outcomes of these two procedures and to suggest that percutaneous coronary intervention is superior to fibrinolytic therapy.

Enoxaparin is a low molecular weight heparin used to prevent thrombosis, particularly post surgery. Enoxaparin binds to antithrombin III which is responsible for inhibiting coagulation by acting on factor Xa. Enoxaparin accelerates the activity of antithrombin III therefore preventing clot formation (McKenna & Lim, 2014 p766). When a blood vessel is damaged, platelets in circulating blood stick to the site of injury and release chemicals that attract more platelets causing aggregation. There are both intrinsic and extrinsic pathways causing thrombi to form to maintain a closed cardiovascular system (Hollar, 2017). Immobility increases risk of thrombus formation as the blood becomes stagnant with gravity and decreased

A non-ST elevation acute coronary syndrome (NSTE-ACS) is a very common presentation to emergency departments everywhere, as well as primary care practices. Therefore, it is important that all providers be well informed on the effectivity of certain treatment regimens.

Heparin, also known as a blood thinner is given to people to help reduce and stop blood clots that have yet begun to form. It is one of the most common medications given to help thin blood by entering the thrombus and speeding up the activity of one of the body's natural anticoagulant by 2000 times. Heparin may also be given to people who about to undergo surgeries such as: open heart, heart transplant, lung

It is important to recognize ECG tracings, even if described and not visually seen. Much can be deciphered from this vignette to rule out the other answers. P waves are discernable (Choice A), the rate is > 120 beats/pmin (Choice B), and the QRS waves are normal—-meaning no evident delta waves (Choice E), and QRS waves are not wide (Choice D). For Step 2 purposes, knowing the diagnosis based on application of one’s basic knowledge to the clinical scenario would be enough. The next best step in this case would be synchronized cardioversion since he is tachycardic and hemodynamically unstable. If the QRS was > 0.12/second and the patient is still hemodynamically unstable, then one would consider an anti-arrhythmic antiarrhythmic drug; the choice depending on the actual morphology of the QRS (monomorphic vs. polymorphic). Based on the vignette’s ECG description: the tracing has distinguishing P waves, normal appearing QRS length and shape, and a heart rate greater than 120

In a hospital setting, anticoagulants and antiplatelets are widely prescribed by physicians because of their greater benefits in changing the physiological homeostasis of the cardiovascular system. Anticoagulants and antiplatelets play a fundamental role in the treatment of cardiovascular diseases as they are very effective at counteracting the different symptoms cardiovascular diseases present.

Each treatment should be treated case-by-case to ensure that the patient is receiving the best possible care. Suggested treatments consist of regular infusions of DDAVP and/or clotting factor, first aid for minor cuts, physical therapy, fibrin sealants and clot-preserving medications. For Hemophilia C, clotting factor XI is available only in Europe and in the United States bleeding episodes are treated through plasma infusions. Clotting factor XI is not available in the United States because Factor XI concentrates are blood products with a concentrated form of Factor XI. Meanwhile, available only in certain areas of Europe, these blood concentrates are made through a series combining thousands of different blood donors. Therefore, the United States only keeps frozen plasma instead. Fibrin sealants work by applying the medication directly to the site of the wound, from there the Fibrin promotes clotting and healing. Clot-preserving medications can also be applied directly to the wound. However, this time the medication preserves the clot from breaking down and assists in ending the

Representatives from Thrombolysis in Myocardial Infarction (TIMI), Duke Clinical Research Institute (DCRI), and Merck & Co., Inc.

Thromboembolic events and associated ischemic stroke are major AF related complications. Those thromboembolic events could occur at least once in 35% and the risk of stroke increases fivefold in patients with AF. Moreover, recurrent stroke in patients who had a stroke or transient ischemic events are widely common, with the incidence reaching up to 12%(8). AF related morbidity and mortality can be prevented by optimal use of antithrombotic medications. A range of national and international guidelines are developed to maximize uniform and efficient utilization of anticoagulants for prevention of stroke while minimizing the risk of bleeding. For the past 50 years, vitamin K antagonists notably of warfarin therapy was considered to be the gold standard for

Tranexamic acid is anti-fibrinolytic agent which prevents breakdown of fibrin clots. The mechanism of action of the drug is a complex one. The acid initially acts by hindering the binding of plasminogen and plasmin. Tranexamic acid has more potency and efficacy than aminocaproic acid. Tranexamic acid is used in multiple emergency medical conditions. The drug is used in prevention of postoperative bleeding disorders such as hemophilia. The drug proves to very useful in treating conditions such as menorrhagia, epistaxis, angioedema, and surface bleeding from tumors. In conditions such as DIC, tranexamic acid should not be used. The acid should not be used because it works against clots and hence activates

Most cases are mild, and you may need treatment only if you have surgery, tooth extraction, or any injury or trauma. The medicines are used to increase the amount of von Willebrand factor that is released into the bloodstream, prevent the breakdown of blood clots, and control heavy menstrual period bleeding in women. (Pollak, MD, 2014).

A 60-year-old male, 5 days post laparoscopic cholecystectomy, is getting ready to be discharged today and is going through the final assessment. When the assessment takes place, the nurse finds that patient has a pulse of a 110 beats per minute and irregular compared to his normal 86-90 beats per minute with a regular pulse that the patient has been having since post-surgery.

Anticoagulant and Anti Thrombolytic – It is used for Atrial Fibrillation (AF). It helps to prevent the ischemic stroke in AF patients (Shakib, 2010). While monitoring the sign and symptoms of hemorrhage and as well as INR and PT, Mrs. Audrey is more likely to commence a low molecular weight heparin. As such, empirical studies suggest that the rate of the venous thromboembolism is lowered with patient on heparin than those managed with warfarin (Colwell et al., 1999).