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    Management of Acute Coronary Syndromes

    AvEli Gelfand,Christopher Cannon

    Inbunden, Engelska, 2009

    1 260 kr

    Beställningsvara. Skickas inom 5-8 vardagar. Fri frakt över 249 kr.

    Beskrivning

    Acute Coronary Syndrome covers the spectrum of clinical conditions ranging from unstable angina to non-ST elevation myocardial infarction and ST elevation myocardial infarction. These life-threatening disorders are a major cause of emergency medical care, hospitalization and mortality. Management of Acute Coronary Syndromes is designed to provide busy clinicians with a comprehensive guide to the investigation, diagnosis and treatment of these syndromes. It encompasses the latest technologies, including the use of biomarkers and non-invasive imaging procedures. For each condition, the reader is taken through all of the therapeutic options available; in each case the indications and contraindications are evaluated in the light of the latest clinical trials. Potential complications are dealt with in a similar fashion, permitting the reader to anticipate and manage problems as they arise. The authors also present evidence-based recommendations for long-term care of at-risk patients, encompassing pharmacologic therapies and lifestyle management.The book concludes with a comprehensive collection of appendices that include treatment algorithms, risk scores and a summary of the latest management guidelines.Management of Acute Coronary Syndromes is the most up to date and comprehensive evidence-based guide to managing acute coronary syndromes, in a compact and usable format.  It will be of interest to busy specialist physicians in cardiovascular medicine, cardiac and vascular surgery, and critical care, as well as primary care physicians and hospitalists who care for patients with these syndromes.

    Produktinformation

    • Utgivningsdatum:2009-04-17
    • Mått:137 x 218 x 18 mm
    • Vikt:408 g
    • Format:Inbunden
    • Språk:Engelska
    • Antal sidor:238
    • Förlag:John Wiley & Sons Inc
    • ISBN:9780470725573

    Utforska kategorier

    • Biokemisk teknik inom Naturvetenskap och teknik
    • Hjärt- och kärlsjukdomar inom Medicin

    Mer om författaren

    Dr. Eli Gelfand is a clinical cardiologist, who provides comprehensive care for patients with a full range of heart and vascular problems at the Beth Israel Deaconess Medical Center.He is the Director of the Vascular Diagnostic Laboratory, Harvard Medical School and is the , Harvard Medial School and is the Associate Cardiovascular Fellowship Director at Beth Israel Deaconess Medical Center. Dr. Christopher P. Cannon, is an Associate Professor of Medicine at Harvard Medical School and an Associate Physician in the Cardiovascular Division at Brigham and Women's Hospital in Boston, Massachusetts. He is a senior investigator of the Thrombolysis in Myocardial Infarction (TIMI) Study Group. Dr. Cannon has published more than 500 original articles, reviews, editorials, book chapters, and electronic publications in the field of acute coronary syndromes.Dr. Cannon has received numerous awards including the Alfred Steiner Research Award, Upjohn Achievement in Research Award, and Robert F. Loeb Award for Excellence in Clinical Medicine. He is a Fellow of the American Heart Association and of the American College of Cardiology.

    Innehållsförteckning

    • List of contributors xiiiForeword xvEugene BraunwaldChapter 1 Pathophysiology of acute coronary syndromes 1Alisa B. Rosen and Eli V. GelfandIntroduction 1Formation of atherosclerotic plaque 2Plaque instability and the development of ACS 5Myocardial ischemia 7Thrombus formation 7Platelets 7Secondary hemostasis 9Dynamic obstruction 10Progressive mechanical obstruction 10Inflammation 11Secondary unstable angina 11References 11Chapter 2 Diagnosis of acute coronary syndrome 13Eli V. Gelfand and Alisa B. RosenIntroduction 13Definition of myocardial infarction 13History 14Risk factors 17Physical examination 17Electrocardiography 19The pathophysiologic basis of ST segmentchanges during ischemia 19Electrocardiography in ST-elevation MI and identification of the infarct-related artery 20Electrocardiography in unstable angina and NSTEMI 26Cardiac biomarkers 26Noninvasive imaging 29Echocardiography 29Myocardial perfusion imaging 30Coronary computed tomography 30Cardiovascular magnetic resonance imaging 31Stress testing for diagnosis of ACS 32Overall diagnostic pathway for ACS 32References 34Chapter 3 Unstable angina and non-ST-elevation myocardial infarction 37Eli V. Gelfand and Christopher P. CannonIntroduction 37Causes of UA/NSTEMI 37Presentation of UA/NSTEMI 38General strategies in management of UA/NSTEMI 39Risk stratification of patients with UA/NSTEMI 40Initial management of UA/NSTEMI in the emergency department 42Pharmacologic treatment of ischemia in UA/NSTEMI 43Beta-blockers 44Nitrates 44Calcium channel blockers 45Angiotensin-converting enzyme inhibitors 45Morphine 46Oxygen 46Invasive versus conservative strategy 46Antiplatelet therapy in UA/NSTEMI 49Aspirin 54Clopidogrel 55Prasugrel 57Glycoprotein IIb/IIIa inhibitors 58Anticoagulant therapy in UA/NSTEMI 61Unfractionated heparin 61Enoxaparin 62Direct thrombin inhibitors 65Fondaparinux 66Oral anticoagulation in UA/NSTEMI 67Fibrinolysis in UA/NSTEMI 68Early lipid-lowering therapy in patients with UA/NSTEMI 68Predischarge noninvasive risk stratification after UA/NSTEMI 69Overall management of UA/NSTEMI 71References 71Chapter 4 ST-segment-elevation myocardial infarction 79Eli V. Gelfand and Christopher P. CannonIntroduction 79Global treatment goals in STEMI 79Prehospital management and triage 80Transport decisions 82Management prior to reperfusion 82Primary reperfusion therapy for STEMI 83Fibrinolysis 83Combination fibrinolysis 86Markers of fibrinolysis effectiveness 86Complications of fibrinolysis 88Primary percutaneous coronary intervention 88Comparison of PCI with fibrinolysis 90Timing of primary PCI 91PCI following fibrinolytic therapy 94Rescue PCI 94Facilitated PCI 94Routine PCI after successful fibrinolysis 96Overall reperfusion strategy 97Coronary artery bypass grafting for treatment of STEMI 98Adjunctive pharmacologic treatment of STEMI 98Antiplatelet agents 98Anticoagulation therapy 101Other adjunctive therapy 105Hospital care following successful reperfusion 110References 114Chapter 5 Special considerations in acute coronary syndromes 123Jason Ryan and Eli V. GelfandSecondary unstable angina 123Acute coronary syndrome in patients with diabetes mellitus 123General considerations 123Primary ACS therapy in diabetics 124Glycemic control in diabetics with ACS 125Coronary revascularization in diabetics 126Metabolic syndrome and ACS 127Chronic kidney disease in ACS 127Young patients with ACS 130ACS in the setting of cocaine use 130ACS in patients with normal coronary arteries or mild CAD 132Myocarditis 132Acute transient apical ballooning syndrome 133Postoperative ACS 134ACS in a pregnant woman 135Hyperthyroidism and ACS 136ACS in patients exposed to radiation 137Trauma and ACS 137References 137Chapter 6 Complications of acute coronary syndrome 141Jan M. Pattanayak and Eli V. GelfandIntroduction 141Pump failure 141General principle 141Clinical presentation 142Prognosis 144Treatment 144Right ventricular infarction 148Introduction 148Clinical presentation 148Diagnosis 149Management 150Prognosis 152Mechanical complications of ACS 152Introduction 152Left ventricular free wall rupture 152Ventricular septal rupture 153Acute mitral regurgitation 154Left ventricular aneurysm 155Left ventricular pseudoaneurysm 157Pericardial complications 157Arrhythmic complications of ACS 159Bradyarrhythmias 159Atrial fibrillation 163Ventricular tachycardia and fibrillation 163Complications involving bleeding 164Complications of percutaneous coronary intervention 165References 170Chapter 7 Post-hospitalization care of patients with acute coronary syndrome 173Jersey Chen and Eli V. GelfandIntroduction 173Pharmacologic measures 173Aspirin 173Clopidogrel 174Beta adrenergic blockade 177Renin–angiotensin–aldosterone inhibitors 179Lipid-lowering therapy 185Warfarin 189Influenza vaccination 192Medications of limited benefit to patients following ACS 192Vitamins/antioxidants 192Estrogen replacement therapy 192Nonsteroidal anti-inflammatory agents and related compounds 194Nonpharmacologic measures 195Antiarrhythmic devices 195Therapy of comorbidities following ACS 198Diabetes mellitus 198Hypertension 199Depression 199Lifestyle recommendations following ACS 200General physical activity and structured cardiac rehabilitation 200Sexual activity after ACS 201Smoking cessation 201Diet/nutrition and weight loss 202References 204Appendix 209Index 217