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SARS-CoV-2 and COVID-19
Published in Patricia G. Melloy, Viruses and Society, 2023
Cardiovascular complications have been associated with COVID-19. These patients may have a range of symptoms including myocarditis (inflammation of the muscle of the heart), shortness of breath, chest pain, irregular heartbeat, or even a sudden heart attack. It is not known why the cardiovascular system specifically would be affected, but it may be due to viral infection of cardiac cells or a side effect of cytokine storm. Physicians have noted that COVID-19 may make the diagnosis of other disease conditions difficult because it may “mask” these other conditions (Giyanani et al. 2021; Wright 2021).
Coronary Artery Disease
Published in Jahangir Moini, Matthew Adams, Anthony LoGalbo, Complications of Diabetes Mellitus, 2022
Jahangir Moini, Matthew Adams, Anthony LoGalbo
Diagnosis of CAD is based on medical history, physical examination, and routine blood tests. Other diagnostic tests include ECG, echocardiogram, an exercise stress test, a nuclear stress test, cardiac catheterization, and cardiac CT scan. Electrocardiogram can reveal evidence of a previous heart attack or even one that is currently happening. Echocardiogram allows for examination of all parts of the heart wall, revealing signs of CAD. An exercise stress test involves walking on a treadmill or riding a stationary bicycle as an ECG is being performed, and sometimes an echocardiogram is done as well. For some patients, a medication is used to stimulate the heart instead of exercise. A nuclear stress test is similar to an exercise stress test, but provides images as well as ECG recordings, measuring blood flow to the heart muscle during stress and at rest via specialized cameras. In cardiac catheterization, a catheter is inserted into a groin, neck, or arm artery or vein and carefully pushed to the heart, guided by the use of various imaging techniques. Dye may be injected to improve imaging of the blood vessels and any blockages. A cardiac CT helps visualize calcium deposits in the arteries that can narrow them, indicating likely CAD. Also, in a CT coronary angiogram, a contrast dye is injected intravenously to produce detailed images of the coronary arteries (see Figure 9.1).
Cardiovascular disease
Published in Sally Robinson, Priorities for Health Promotion and Public Health, 2021
A heart attack, also called a myocardial infarction, occurs because the blood supply to the heart muscle, travelling in the coronary arteries, has been cut off, causing some heart tissue to die. The symptoms of a heart attack are discomfort or pain in the chest that does not go awaymild to severe pain that spreads to the arms, neck, jaw, stomach or backnausea, sweating, feeling short of breath and light-headednone or only some of the above
Risk factors for a broken heart: understanding drug-induced causes for Takotsubo syndrome and pharmacological treatment options
Published in Expert Review of Clinical Pharmacology, 2022
Gao Jing Ong, Thanh Ha Nguyen, Sven Y Surikow, John D Horowitz
On patient discharge, a detailed communication should be established with the patient’s usual medical practitioner, and arrangements made to review the patient after 3 months or less. It should be explained to the patient that:- This was not a ‘heart attack’, and has nothing to do with blocked coronary arteries: nor are either aspirin or statins indicated for its treatmentAlthough there will be rapid improvement in echocardiographic appearances, the patient is likely to take at least 3 months to feel better, and there is a chance that some scarring will occur within the heart, resulting in a degree of permanent exercise limitation.There is a small risk of recurrence in future.
Researchers’ perspectives on return of individual genetics results to research participants: a qualitative study
Published in Global Bioethics, 2021
Erisa Sabakaki Mwaka, Deborah Ekusai Sebatta, Joseph Ochieng, Ian Guyton Munabi, Godfrey Bagenda, Deborah Ainembabazi, David Kaawa-Mafigiri
Whereas the majority of interviewees felt that it was the investigator's obligation to convey research results to study participants, some advised caution when handling genetic results. They pointed out that a lot of the genetic and genomic results are not validated and are of unknown utility and as such, should not be communicated to research participants. I will tell you that there are many variants we are [currently] identifying in the DNA that diverge from the normal and we call them variants of unknown significance (VUS) because we don’t know what they are associated with. Are they associated with risk to heart attack? Who would want to know a variant of unknown origin? (R12, Male)
Point-of-Care Troponin Testing during Ambulance Transport to Detect Acute Myocardial Infarction
Published in Prehospital Emergency Care, 2020
Jason P. Stopyra, Anna C. Snavely, James F. Scheidler, Lane M. Smith, Robert D. Nelson, James E. Winslow, Gregory J. Pomper, Nicklaus P. Ashburn, Nella W. Hendley, Robert F. Riley, Lauren E. Koehler, Chadwick D. Miller, Simon A. Mahler
Patients experiencing chest pain commonly call 911 for assistance due to fear they are having a heart attack (1). In fact, many patients that seek care in the Emergency Department (ED) for symptoms concerning for acute coronary syndrome arrive by ambulance (2). Despite frequent chest pain encounters, current Emergency Medical Services (EMS) risk stratification protocols are limited to electrocardiogram (ECG) screening for an ST-segment elevation myocardial Infarction (STEMI). Thus in the prehospital setting, patients at high risk for non-ST-segment elevation myocardial infarction (NSTEMI) are not differentiated from patients with benign chest pain etiologies. Furthermore, patients with NSTEMI may be transported to hospitals, which lack interventional coronary catheterization capabilities, leading to eventual transfer to another facility, which inefficiently uses limited EMS resources, increases cost, and delays definitive care.