Primary Percutaneous Coronary Intervention And PCI Research Analysis

Cardiogenic shock, according to Werden et al. (2012), is the most common cause of death from an acute myocardial infarction (AMI) and has a chance of mortality from thirty percent to eighty percent. Infarction-related cardiogenic shock (ICS) complicates approximately five to ten percent of acute myocardial infarctions (AMI) and remains the leading cause of death in patients hospitalized from an AMI (Kolte et al., 2014). Kolte et al. (2014) also states that the incidence of cardiogenic shock is higher in patients over the age of seventy-five, and has higher prevalence in women, Caucasians, Asians, and Pacific islanders. This paper will discuss the pathophysiology, clinical manifestations, tools used to diagnose, and therapeutic management of cardiogenic shock.

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

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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.

Early recognition of signs and symptoms and taking the right steps to identify, distinguish, and manage subtypes (STEMI and NSTEMI/UA) will improve Mr James outcomes (Bradley E.H., 2006)Recognizing the signs and symptoms such as chest pain or shortness of breath suggestive of an MI and obtaining an ECG as soon as possible (goal of less than 10 minutes following presentation of a patient) should be the standard of practice to manage this patient It has been demonstrated that reperfusion of the infarct-related artery in the very first hour (golden hour) of MI reduces mortality rates (Ayrik et al. 2006, Van de Werf et al. 2008). fact, every 30 minutes of delay time, the 1-year mortality risk increases by (DeLuca et al. 2004).According to triage and first assessment guidelines (Wrightet. al. 2011) Patients who complain of chest pain , pressure , tightness or heaviness require immediate assessment by the triage nurse and should be referred for further evaluation.

The Surgeon General, after releasing this report should be ready for an open discussion on tobacco harm reductions. In these discussions, the SG should be open-minded and ready to accept research-based facts that indeed e-cigarettes have many benefits to adult smokers. We hope that the Surgeon General will consider the positive impacts of e-cigarettes and acknowledge that they are a healthier alternative to

With many decades worth of health data now available, it has never been clearer that smoking is one of the most dangerous habits a person can engage in. It is no wonder, then, that so many smokers are committed to quitting and improving their health.

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.

“Vasodilatation reduces cardiac preload and afterload and decreases the myocardial oxygen requirements needed for circulation. Vasodilatation of the coronary arteries improves blood flow through the partially obstructed vessels as well as through collateral vessels” (Bolooki and Askari, 2014). Nitrates, such as nitroglycerin reverse the vasoconstriction associated with thrombosis and coronary occlusion. Morphine is the analgesic opioid of choice for ischemic cardiac pain. Morphine has been shown in studies to decrease cardiac workload and decrease the anxiety and fear associated with chest pain. The heart is influenced by the needs of the body. Bed rest is important during the acute phase of a myocardial infarction because when a person is at rest, the organs, muscles and tissues will require a reduced amount of blood and oxygen (Peate and Jones, 2014). This results in a decrease workload of the heart and myocardial oxygen consumption, decreased blood pressure, and decreased heart rate. Vital signs should be closely monitored after a STEMI to monitor for any potential complications. Hypotension is a potential complication when using vasodilators such as nitroglycerin and in the use of opioids such as morphine sulfate to control pain associated with MI’s. Blood pressure also needs to be closely monitored because heart failure is a serious complication after a STEMI. Cardiac monitoring should be included for the first 24 hours after a STEMI for early detection

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.

Smoking is injurious to health and a preventable cause of premature death. In the U.S.; it is estimated that one in each five adults smoke currently and about 480,000 people die prematurely from diseases caused by smoking or secondhand smoke exposure. (CDC tobacco use). The economic burden of tobacco use is also significant. About $100 billion per year is spent in medical expenses and another $100 billion per year in lost productivity. There is no safe level of smoking

This study was completed to determine the effectiveness of the current guidelines for the treatment of a myocardial infarction. “Door-to-Balloon Time and Mortality among Patients Undergoing Primary PCI” is about the door-to-ballon time that has become a performance measure in the treatment of MI’s, the recommended door-to-ballon time is 90 minutes or less. This title clearly states what the article is about, the abstract is also broken down to include what is detailed in greater depth in the body of this article.

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

Percutaneous coronary intervention (PCI) is an emergency treatment option for a patient experiencing MI. PCI can be performed within 90 minutes of arriving to the hospital. “Emergency diagnostic coronary angiography should be performed to identify blocked coronary artery before PCI” (Urden et al., 2014, p. 365).

Dr. Ken Denson is a respected doctor in the medical community and well known for his invention of the INR system and Factor X. (The INR system is for out-patients monitoring their blood. Factor X is an enzyme involved in the coagulation of blood, and part of the INR system.) He is not funded by nor receives any money from tobacco companies, yet he is a strong supporter of smoking. He says “Smokers have the most atrocious lifestyles, but otherwise healthy smokers in my opinion live longer than non-smokers. What a terrible mistake the medical establishment has made.” He believes that the lifestyles led by smokers are much different than those of nonsmokers. Smokers tend not to eat balanced meals or exercise as frequently as nonsmokers do. He