Acute Coronary Syndrome Ecab

Acute coronary syndrome (ACS) is the term for the clinical signs and symptoms of myocardial ischemia: unstable angina, non–ST-segment elevation myocardial infarction (NSTEMI), and ST-segment elevation myocardial infarction (STEMI). Unstable angina and NSTEMI normally result from a partially or intermittently occluded coronary artery, whereas STEMI results from a fully occluded coronary artery. The patients present with a wide arena of signs and symptoms like chest pain, nausea/vomiting, exertional pain, palpitation, shortness of breath, fatigue, etc. Angina, or chest pain, continues to be recognized as the classic symptom of ACS. In unstable angina, chest pain normally occurs either at rest or with exertion and results in limited activity. Chest pain associated with NSTEMI is usually longer in duration and more severe than chest pain associated with unstable angina. The diagnosis of ACS is based on triad of clinical presentation, electrocardiography and cardiac biomarkers. Electrocardiography is the most important initial diagnostic procedure when doctors suspect an acute coronary syndrome. Findings on a 12-lead ECG help the practitioner to differentiate between myocardial ischemia, injury, and infarction, locate the affected area and assess related conduction abnormalities. But at the same front, the definition of unstable angina, NSTEMI and STEMI is based on the levels of cardiac biomarkers too. Acute coronary syndromes are medical emergencies that need prompt action. Half of deaths due to a heart attack occur in the first 3–4 hours after symptoms begin. The sooner treatment begins, the better the chances of survival. Anyone having symptoms that might indicate an acute coronary syndrome should obtain prompt medical attention. Management of ACS involves a spectrum of interventions. It encompasses cardiac monitoring, thrombolysis, antiplatelet therapy, anticoagulant therapy, reperfusion therapy and invasive investigation and revascularization therapy. Reperfusion therapy (percutaneous coronary intervention) mainly holds for the ST-elevation myocardial infarction. Prognosis of the ACS patients depends on the post-myocardial risk stratification. The main highlights of risk stratification are risk stratification scores, assessment of cardiac function and stress testing, and management.

ECAB Cardiorenal Syndrome - E-Book

Diabetes is one of the most important non-communicable lifestyle diseases. Diabetes is a multifaceted disorder which possibly influences and impacts body pathophysiology by different mechanisms and in varied ways. Diabetes has a very distinguished impact on cardiovascular system and plays a detrimental role in development of cardiovascular disorders. Metabolic memory is used to describe the impact of exposure to glucotoxicity, lipotoxicity and other metabolic disturbances, either as an adverse or a beneficial cell response which determines the later development of vascular complications. Terms such as metabolic imprint, legacy effect, glycemic memory or latent hyperglycemic damage are also used. Diabetes has significant impact on different facets of life. Diabetes has a distinguished but significant impact on development of various cancers. Diabetes has a positive, negative and even neutral impact on pathogenesis and progression of cancer depending upon the tumor site. On the contrary, cancer also has a significant effect on diabetes development and management. These facets tend to get overlooked in the study of diabetes development and management. All these aspects are being thoroughly covered in this project so as to facilitate better management of diabetics.

Cardiometabolic disease is the leading cause of death in many parts of the world. There are many potentially modifiable and non-modifiable risk factors associated with the same. Although with the recent advances in management and preventive strategies the mortality rates have reduced, but no patient actually achieves an adequate control of the CVD risk factors with the declining quality of life. In addition, growing obesity and DM in younger age groups has further undermined the improvements achieved in CVD. Diabetes and CVD share a "common soil" in their etiology and the causative factors for these diseases are termed as "cardiometabolic risk factors." Cardiometabolic risk (CMR) is the global risk of developing type 2 diabetes and CVD. CMR factors include overweight or obesity, high blood glucose, HTN, dyslipidemia, inflammation and hypercoagulation, physical inactivity, smoking, age, race and ethnicity, gender, and family history. Among these, age, race/ethnicity, gender, and family history are non-modifiable risk factors. The remaining are modifiable risk factors and closely interrelated. Recently, systematic prospective studies have shown evidences that moderate lifestyle modifications help in reducing the metabolic risk factors. The major principles include cessation of smoking, enhanced physical activity, and reduction of excess weight. Healthy diet also has a major role in controlling overweight and maintaining ideal weight. Each of the risk factors poses a danger to good health; the propensity increases with multiple risk factors. It is also shown that the CMR factors tend to cluster as the metabolic syndrome. This book is designed to address such questions with supportive typical clinical scenarios, with which all readers will be able to identify. Thus it provides an excellent opportunity to widen one’s perspective in this area.

India in particular and South-Asia in general have witnessed a rapid increase in the prevalence and incidence of cardiovascular disease over the past 25 years. Lifestyles changes, unhealthy diet, lack of regular physical exercise, and obesity have all led to rising prevalence of metabolic syndrome. It is of no wonder that metabolic syndrome is being increasingly recognized as a clinical entity which is believed to be associated with increased risk of cardiovascular disease beyond individual risk factors, though this is at times debated. This monograph addresses the total nuance of metabolic syndrome in its entirety and answers questions frequently asked on this subject. The authors are internationally respected investigators in their own right having made major contributions in the particular field and are revered teachers as well. The book itself has clear sections which makes it very user friendly and divided into two volumes. The first volume has the evaluation of metabolic syndrome and the vastness of the problem and how it leads to smouldering dysfunctional endothelium making such a patient vulnerable to vascular disease. It purely deals with clinical issues we face daily in metabolic syndrome and patients. It is fairly broad-based to answer most of the queries which arise in a busy clinician’s head while dealing with metabolic syndrome on a day-to-day basis. Of special interest are chapters on metabolic syndrome in children, non-alcoholic fatty liver disease and hypogonadism.

Dealing with Depression in Medically-ill Patients - ECAB

Coronary artery disease or CAD is the end result of the process of accumulation of atheromatous plaques within the walls of the arteries supplying the myocardium. Atherosclerosis is a chronic systemic disease process, affecting all the vascular beds in body and many factors responsible for its evolution have been identified. A rising incidence of this disease among people of Indian origin and an emerging role of genetic factors leading to atherosclerosis necessitates modifications in ourstrategies to handle it. The importance of the risk factors in causation of the disease need to be emphasized even more and masses need to be educated about the role of lifestyle modifications in its management. Further, early detection of preclinical or sub-clinical disease would add another dimension to the overall preventive strategy for this condition. This book is designed to update the readers on the evergrowing list of risk factors for CAD and the increasing significance of lifestyle modifications in prevention of the disease. Besides these, the therapeutic approach towards this chronic disease and methods of early detection has also been discussed. Typical supportive case scenarios are also included to exemplify and highlight the various points discussed. Thus, it provides an excellent opportunity to widen one’s perspective in this area.