Dietary Factors

A possible link among atherosclerosis, thrombotic events, and dietary factors has been explored in several epidemiologic studies. The first, referred to as the Seven Country Study (153), observed a correlation between total calories consumed as saturated fats and the occurrence of coronary heart disease-related death. The potential direct impact of dietary factors on cardiac events was investigated in the Lyon Diet Heart Study (154). Patients with a prior MI were given a diet previously shown...

Obstructive Sleep Apnea

It is increasingly recognized that many adults have sleep disordered breathing patterns characterized as obstructive sleep apnea and hypopnea. There appears to be a high prevalence of these abnormalities in patients with cardiovascular disease, in the range of 30-50 (148). There is evidence that the disorder may increase the relative risks of myocardial infarction (149,150), sudden death (151), and cardiovascular death (152). One small study of 40 patients admitted with acute myocardial...

STElevation Myocardial Infarction Thrombolytic Therapy

While aggressive reperfusion therapy with pharmacologic agents has been shown to reduce in-hospital mortality by as much as 25-30 , women are more likely to have a contraindication to thrombolysis and, therefore, not receive thrombolytic therapy (122). This observation was confirmed in a series of1059 patients who presented with an acute myocardial infarction, which revealed that women were less likely to receive throm-bolytic agents than men (126). Moreover, it has been shown that only 55 of...

Specific Activities as Potential Triggers of Acute Myocardial Infarction

Trigger Worksheets For Mental Health

Morning and awakening appears to trigger acute coronary syndromes. Other environmental changes, such as the transition from weekend to work week and changes in weather cycles, may also function as triggers. Many investigators have sought specific events identifiable by patients as triggers. Studies using interview techniques to determine the fraction of patients reporting a suspected triggering activity in the time period immediately preceding the onset of symptoms have found that 25 to > 50...

The Pathophysiology Of Cardiogenic Shock From Myocardial Infarction

A comprehensive understanding of the pathophysiologic characteristics and events of cardiogenic shock must be attained to impact the discouraging outcome of patients with this entity. The assiduous hemodynamic decline involves several interactive processes. Early initial 60 min in the course of infarction autonomic disturbances have a predominant influence on a patient's hemodynamic status. As reported by Webb et al. 8 sympathetic overactivity tachycardia and hypertension occurred in 36 of...

How To Reduce Your Chance of a Heart Attack

To find your risk for a heart attack, check the boxes that apply to you A family history of early heart disease Father or brother diagnosed before age 55 Mother or sister diagnosed before age 65 Age Men 45 years or older Women 55 years or older One or more previous heart attacks, angina, bypass surgery or angioplasty, stroke, or blockages in neck or leg arteries The more risk factors you have, the greater your risk for a heart attack Reduce Your Risk of a Heart Attack by Taking Steps To Prevent...

Allergy Hypotension Fever

SK and APSAC are antigenic and potentially allergenic although serious anaphylaxis and bronchoconstriction are rare incidence lt 0.2-0.5 96,103,104,110,118,160 . In ISIS-2, any allergic reaction was observed in 4.4 receiving SK compared to 0.9 receiving placebo, an absolute excess of 3.5 103 . In the comparative study ISIS-3 118 , any allergic-type reaction was reported after SK in 3.6 , APSAC in 5.1 , and tPA duteplase in 0.8 p lt 0.00001, SK vs tPA . Most of these reactions were minor only...

Anticoagulation Coagulation Cascade

Antithrombin Site Action

Thrombin is a glycosylated serine protease that plays a fundamental role in thrombosis 117 . Thrombin is generated from prothrombin by the prothrombinase complex, which includes factors Xa, Va, calcium, and phospholipids Fig. 7 . Its main action is to transform fibrinogen into fibrin. Thrombin is one of the most potent endogenous platelet activator 110-112 . The active catalytic site lies within a relatively narrow canyon on the molecule's surface Fig. 8 118 . Adjacent to this site is the...