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Introduction: Ischemic heart disease is the term associated with an inadequate blood supply to the myocardium due to obstruction of the epicardial coronary arteries, usually due to atherosclerosis. Patients may have chronic (stable) or acute (unstable) disease. Studies suggest that the risk of a patient over 40 years of age developing coronary heart disease is higher among men and incidence rates can reach up to 30% in both genders. Although the topic is controversial, there is evidence that associates the amount of alcohol consumed with the risk of developing coronary disease. Objectives: To investigate the correlation between alcohol consumption and the risk of developing acute coronary disease. Methodology: Prospective, cross-sectional, analytical, investigative and integrative study, with a quantitative approach, carried out in a large hospital in the North of Paraná. The AUDIT questionnaire was used to quantify the effect of alcohol consumption on individuals evaluated in an outpatient clinic 30 days after having a coronary event. Data were collected between the months of April and July 2023. Result: 52 patients were interviewed, 15 female and 37 male. Among these, 15 people did not drink alcoholic beverages. Among those who used it, around 50% used it harmfully or were likely dependent on alcohol, 30% reported having already caused injuries or harm to themselves or another person after drinking alcohol. 60% claimed that someone or a relative, friend or doctor, had already been concerned about their alcohol consumption or had suggested that they stop using alcohol, before the coronary event occurred. Discussion: The study found results in accordance with current scientific literature, relating harmful alcohol consumption to increased risks of developing coronary disease. Most individuals seem to be unaware of or ignore the harmful effects of alcohol on their health, not adopting changes or attempts to improve their lifestyle habits, such as ceasing alcohol consumption. Conclusion: The study suggests that people who consume alcoholic beverages in a harmful way have a risk of up to 17 times greater of developing an acute coronary event compared to those who do not consume the drink. [ABSTRACT FROM AUTHOR]

Background: Acute Myocardial Infarction (AMI) is a preventable pathology with modifiable factors, making it of interest in public health. Objective: To identifies the factors associated with AMI in patients with arterial hypertension. Material and Methods: This study employed a cross-sectional design with correlational phase, analyzing 130 medical records from the Friends of the Heart program at Hospital San Rafael of Tunja, Boyacá, Colombia, for the year 2016. The sample was selected using the simple random sampling technique. Results: Non-modifiable factors revealed a mean age of 70 years and a weight of 65 kg. Of the participants, 54.6% were male, and 40.8% belonged to the lower-middle class. Concerning modifiable factors, 30.8% reported alcohol consumption, 60% were smokers, and 94.6% were sedentary. 84.6% had high-normal blood pressure, 44.6% reported overweight, 53.1% consumed drugs, with 29.2% receiving insulin and 33.1% antidepressants, 46.2% presented moderate cardiovascular risk. Additionally, 92.3% had normal cholesterol levels, 32.3% were diagnosed with type II diabetes, and 43.8% had AMI. Evidence suggests an association between AMI and the insulin administration (p=0.003), antidepressants (p=0.021), and the comorbidity of Type II Diabetes (p=0.001). Conclusions: Modifiable risk factors associated with AMI were identified, with insulin administration standing out as a protective factor. [ABSTRACT FROM AUTHOR]

The study reports the case of a patient with multiple aneurysms and ectasias of the coronary arteries whose first manifestation was acute coronary syndrome. This is a 42-year-old male patient who was diagnosed with acute myocardial infarction without ST segment elevation. Cineangiocoronariography showed a three-vessel lesion with aneurysmatic and ectatic coronary dilations. Myocardial revascularization surgery was chosen, but he refused to undergo surgical treatment. He was discharged with optimized clinical treatment with outpatient follow-up. Months after diagnosis, the patient died and was being followed up in another service. Coronary artery aneurysm is a rare entity. The ideal management is still not well established, with doubts and disagreements about surgical and interventional treatment and when to indicate them. [ABSTRACT FROM AUTHOR]

Acute coronary syndrome (ACS) is the main cause of mortality around the world; therefore, it is essential to recognize the clinical characteristics that increase its diagnostic suspicion. Traditionally, it has been defined as a so-called typical condition, consisting of retrosternal chest pain or pain in the left region of the thorax. It is described as a feeling of pressure or heaviness, lasting more than 20 minutes, which can radiate to the left or right upper limb, neck or jaw, and can be associated with diaphoresis and nausea. Various groups of patients such as women, diabetics, the elderly, and those with a history of heart failure or cerebrovascular accident, have so-called atypical clinical sets of symptoms, which in a large proportion may not present chest pain. Various studies suggest that there are not sufficiently sensitive and specific symptoms to be considered typical in the context of ACS, thus, the approach must include the electrocardiogram, risk factors and biomarkers in addition to the clinical evaluation. The use of risk scores such as the HEART has proven very useful in this scenario. [ABSTRACT FROM AUTHOR]

The psychological variables have a special relevance in the coronary affectations. The aim of the present work was to study the evolution of different psychological variables, of quality of life and of adjustment psychosocial, in patients who have suffered an acute coronary syndrome (ACS) and attended a cardiac rehabilitation program, which included, among other, a module of physical activity. The measurements were made when the ACS debuted and 3 months after the cardiac event in a total of 146 men (57.86 years of age (dt = 9.45)) who had undergone a diagnostic catheterization with therapeutic intent within 3 days. The study design was of the quasi-experimental, prospective and longitudinal type. The results at 3 months after suffering the cardiac event show lower levels of anxiety (Cohen's d = .61; p < .01), depression (Cohen's d = .33; p < .05), psychological distress (Cohen's d =. 72; p < .01) and anger (Cohen's d = .34; p < .01), and higher personal strength scores (Cohen's d = .37; p < .01) or life appreciation (Cohen's d =. 35, p < .01). In the ACS, knowing the psychosocial evolution of the patient is considered fundamental next to the usual medical control. [ABSTRACT FROM AUTHOR]

OBJECTIVE: To clinically validate the nursing diagnosis, disturbed sleep pattern (00198), in patients with acute coronary syndrome. DATA COLLECTION: A clinical validation study using the patient history, Visual Analog Sleep scale, and diagnostic inference. Accuracy techniques were performed. SYNTHESIS OF DATA: There were 75 patients: 76.00% were men, and 82.66% had a myocardial infarction. The defining characteristic, changes in sleep pattern, presented a sensitivity of 0.900 and specificity of 0.9714. CONCLUSION: Changes in sleep pattern was a predictor of the nursing diagnosis. IMPLICATIONS FOR PRACTICE: Results will contribute to the identification of sleep disturbances, by nurses, emphasizing the importance of improving sleep during hospitalization. OBJETIVO: Validar clinicamente o Diagnóstico de Enfermagem Padrão de Sono Prejudicado (00198) em pacientes com Síndrome Coronariana Aguda. MÉTODOS: Estudo de validação clínica, utilizando Histórico de Enfermagem, Escalas Visuais Análogas do Sono e inferência diagnóstica. Realizada medidas de acurácia. RESULTADOS: 75 pacientes, 76,00% homens e 82,66% com Infarto do Miocárdio. A característica definidora Alteração do Padrão de Sono teve 0,900 de Sensibilidade e 0,9714 de Especificidade. CONCLUSÕES: Alteração do padrão de sono foi preditora do diagnóstico de enfermagem. IMPLICAÇÕES PARA A PRÁTICA: Contribuirá na identificação de distúrbios do sono, pelos enfermeiros, ressaltando a importância da melhoria do sono durante a internação. [ABSTRACT FROM AUTHOR]

Kounis syndrome, while an acute coronary syndrome, occurs in the context of a hypersensitivity reaction, allergies, or anaphylaxis and is subdivided into three types: coronary spasm in normal arteries, instability of plaques in atherosclerotic coronary arteries, and thrombosis of coronary stents. Herein, the case of a 73-year-old patient who, after administration of amoxicillin/clavulanic acid, went into cardiorespiratory arrest with evidence of ST-T segment elevation on electrocardiogram is reported. Coronarography revealed no obstructive lesions, and spontaneous resolution of electrocardiographic abnormalities was observed. A review of anamnesis with the family revealed a previous allergy to penicillin. The tryptase dosage was strongly positive. Kounis syndrome type 2 was diagnosed, and the clinical outcome was good. [ABSTRACT FROM AUTHOR]

Coronary subclavian steal (CSS) is a rare phenomenon that occurs in patients undergoing coronary artery bypass graft surgery using the left internal thoracic artery (LITA) causing stenosis of the ipsilateral subclavian artery proximal to the origin of the LITA. We report the case of a 65-year-old male patient who presented with atypical CSS syndrome, manifesting as acute coronary syndrome after vascular surgery. [ABSTRACT FROM AUTHOR]

Introduction: Nursing plays a crucial role during the different stages of care of people with acute coronary syndrome, including hospital discharge. Providing care to these patients, according to their needs, requires the identification of the main nursing diagnoses. Objective: To determine the prevalence of nursing diagnoses of people with Acute Coronary Syndrome at the time of hospital discharge. Methodology: This is a cross-sectional study of 196 hospitalized people for this event; a focused assessment instrument was used to evaluate the defining characteristics of the nursing diagnoses: anxiety, ineffective coping of the problem, willingness to improve religiosity, readiness to improve knowledge, and intolerance to activity. These characteristics were identified as priorities according to the scientific literature and by the consensus of experts. A definition analysis and defining characteristics of the problem were performed to determine the prevalence of the diagnoses. Results: The main problem of the population studied was evidenced a deficient knowledge about the problem, followed by intolerance to activity and anxiety. Likewise, it was possible to identify some positive diagnoses such as the willingness to improve their knowledge about the problem and religiosity. Conclusions: The current study allowed identifying real needs and recognizing protective factors at the time of hospital discharge in people who have experienced an acute coronary event, which is a starting point for the design of care plans and the implementation of interventions that lead to improve the health situation of this group of people. [Padilla-García CI, Bonilla-Marciales AP, Romero-Guevara SL, Camargo-Figuera FA. Nursing Diagnoses to Hospital Discharge in People with Acute Coronary Syndrome. [ABSTRACT FROM AUTHOR]

The diagnosis of myocarditis has increased mainly due to greater availability of methods such as cardiac magnetic resonance (CMR). Its clinical presentation varies, usually following respiratory or gastrointestinal tract infection, in patients presenting with acute coronary syndrome (ACS), acute or chronic heart failure, cardiac arrhythmias, or even unexplained cardiogenic shock. Case reports of patients with myocarditis following urinary tract infection (UTI) are scarce. This is a case report of a 24-year-old male patient with myocarditis with symptoms of ACS following UTI. [ABSTRACT FROM AUTHOR]

Objective: To investigate the prevalence of anxiety and depression in patients admitted for acute coronary syndrome to a university hospital and to examine associations with use of psychotropic drugs. Methods: Ninety-one patients who had had an acute coronary event were enrolled on this cross-sectional prevalence study. Characteristics of the study population and the prevalence rates of depression and anxiety in the sample were assessed using the Hospital São Lucas da Pontifícia Universidade Católica do Rio Grande do Sul (PUCRS) psychiatric consultation protocol, which includes clinical and sociodemographic data, and the Hospital Anxiety and Depression Scale (HADS). Results: The prevalence of symptoms of anxiety was 48.4% (44 patients) and the prevalence of depressive symptoms was 26.4% (24 patients). Of these, 19 patients (20.9% of the whole sample) had scores indicative of both types of symptoms concomitantly. Considering the whole sample, just 17 patients (18.7%) were receiving treatment for anxiety or depression with benzodiazepines and/or antidepressants. Conclusions: Anxiety and depression are disorders that are more prevalent among patients with acute coronary syndrome than in the general population, but they are generally under-diagnosed and under-treated. Patients with anxiety and depression simultaneously had higher scores on the HADS for anxiety and depression and therefore require more intensive care. [ABSTRACT FROM AUTHOR]

Objective: To compare patients without previously diagnosed cardiovascular risk factors) and patients with one or more risk factors admitted with acute coronary syndrome. Methods: This was a retrospective analysis of patients admitted with first episode of acute coronary syndrome without previous heart disease, who were included in a national acute coronary syndrome registry. The patients were divided according to the number of risk factors, as follows: 0 risk factor (G0), 1 or 2 risk factors (G1 - 2) and 3 or more risk factors (G ≥ 3). Comparative analysis was performed between the three groups, and independent predictors of cardiac arrest and death were studied. Results: A total of 5,518 patients were studied, of which 72.2% were male and the mean age was 64 ± 14 years. G0 had a greater incidence of ST-segment elevation myocardial infarction, with the left anterior descending artery being the most frequently involved vessel, and a lower prevalence of multivessel disease. Even though G0 had a lower Killip class (96% in Killip I; p < 0.001) and higher ejection fraction (G0 56 ± 10% versus G1 - 2 and G ≥ 3 53 ± 12%; p = 0.024) on admission, there was a significant higher incidence of cardiac arrest. Multivariate analysis identified the absence of risk factors as an independent predictor of cardiac arrest (OR 2.78; p = 0.019). Hospital mortality was slightly higher in G0, although this difference was not significant. By Cox regression analysis, the number of risk factors was found not to be associated with mortality. Predictors of death at 1 year follow up included age (OR 1.05; p < 0.001), ST-segment elevation myocardial infarction (OR 1.94; p = 0.003) and ejection fraction < 50% (OR 2.34; p < 0.001). Conclusion: Even though the group without risk factors was composed of younger patients with fewer comorbidities, better left ventricular function and less extensive coronary disease, the absence of risk factors was an independent predictor of cardiac arrest. [ABSTRACT FROM AUTHOR]

Objective: In Brazil, there are few descriptions in the literature on the angiographic pattern and clinical characteristics of young patients with acute coronary syndrome, despite the evident number of cases in the population. The objective of this study was to evaluate which clinical characteristics are most closely related to the acute coronary syndrome in young patients, and what long-term outcomes are in this population. Methods: This is a prospective observational study with 268 patients aged under 55 years with acute coronary syndrome, carried out between May 2010 and May 2013. Data were obtained on demographics, laboratory test and angiography results, and the coronary treatment adopted. Statistical analysis was presented as percentages and absolute values. Results: Approximately 57% were men and the median age was 50 years (30 to 55). The main risk factors were arterial hypertension (68%), smoking (67%), and dyslipidemia (43%). Typical pain was present in 90% of patients. In young individuals, 25.7% showed ST segment elevation. Approximately 56.5% of patients presented with a single-vessel angiographic pattern. About 7.1% were submitted to coronary bypass surgery, and 42.1% to percutaneous coronary angioplasty. Intrahospital mortality was 1.5%, and the combined event rate (cerebrovascular accident/stroke, cardiogenic shock, reinfarction, and arrhythmias) was 13.8%. After a mean follow-up of 10 months, mortality was 9.8%, while 25.4% of the patients had new ischemic events, and 37.3% required readmission to hospital. Conclusion: In the short-term, young patients presented with mortality rates below what was expected when compared to the rates noted in other studies. However, there was a significant increase in the number of events in the 10-month follow-up. [ABSTRACT FROM AUTHOR]

Objective: To demonstrate the prevalence of stress hyperglycemia in a cohort of patients with acute coronary syndrome and to determine the correlation of stress hyperglycemia with death, heart failure and/or left ventricular systolic dysfunction during the intrahospital phase. Methods: A prospective initial cohort study of hospitalized patients with acute coronary syndrome with or without ST segment elevation. The groups were compared to demonstrate the correlation between stress hyperglycemia and cardiovascular events. The chi-square test or Fisher's exact test and student's t-test were used to compare the groups with and without stress hyperglycemia. The variables with p<0.20 in the univariate analysis were submitted to logistic regression. Results: In total, 363 patients with an average age of 12.45 ± 62.06 were studied. There was a predominance of males (64.2%). In total, 96 patients (26.4%) presented with stress hyperglycemia. There were no differences between the groups with or without stress hyperglycemia. The area under the ROC curve was 0.67 for the relationship between stress hyperglycemia and the composite outcome heart failure, left ventricular systolic dysfunction or death at the end of the hospital admission. The ROC curve proved that stress hyperglycemia was the predictor of the composite outcome (death, heart failure and/or ventricular dysfunction). The multivariate analysis did not indicate age, stress hyperglycemia or admission heart rate as risk factors. Conclusion: Stress hyperglycemia was common in the studied sample. In the univariate analysis, the presence of stress hyperglycemia was associated with such events as death, heart failure and/or intrahospital ventricular dysfunction in patients with acute coronary syndrome. [ABSTRACT FROM AUTHOR]

Aim: to assess the clinical evolution of patients hospitalized due to the first episode of Acute Coronary Syndrome (ACS) according to its clinical manifestation. Methods: data were collected from 234 patients, hospitalized between May 2006 and July 2009 due to the first episode of an ACS, by consulting their medical records. Results: 234 patients were hospitalized, 140 (59.8%) due to Acute Myocardial Infarction (AMI). In the group with AMI, 19.3% presented complications, against 12.8% in the group with Unstable Angina (UA) (p=0.19). Angioplasty levels were higher among patients with AMI than with UA (p=0.02) and coronary artery bypass graft surgery was more frequent among UA patients (p=0.03). The majority (227; 97%) survived after the coronary event. Among the seven patients who died during the hospitalization, four had AMI (2.9%) and three UA (3.2%). Conclusions: A larger number of complications were found among infarction victims and the accomplishment of coronary artery bypass graft surgery differed between the groups. [ABSTRACT FROM AUTHOR]

This study aimed to investigate health-related quality of life based on the four weeks antecedent to first admission for acute coronary syndrome and describe potential associations between quality of life, gender and prior treatment for any other cardiovascular condition. An exploratory, descriptive and cross-sectional study was conducted in two public hospitals in an inner state city of the State of São Paulo. Of 253 participants studied, 69.2% were male, 69.6% were married or living with a partner, and 58.1% were professionally active before the current hospital admission. Mean age was 57.9 years old. Higher scores were seen in the Social Functioning (x=86.1) domain, while the domain perceived as more compromised was Role Physical (x=57.7). Female participants and those who had previously been treated for any other cardiovascular condition had lower quality of life, and these differences were all statistically significant (p<0.05). [ABSTRACT FROM AUTHOR]

Objective: To trace an epidemiological profile, to verify presence of depressive symptoms in patients with previous diagnosis of acute coronary syndrome and to identify factors that contribute to maintenance of depressive symptoms in the sample. Methods: A cross-section study carried out at the Cardiology Outpatients Clinics of Universidade Federal de São Paulo. An instrument prepared by the authors was used, which was based on similar studies with patient identification data, questions related to the psychological follow-up, relationship with family members and friends, in addition to use of the Beck Depression Inventory. Results: A total of 200 patients were interviewed, 127 (63.5%) were male. The mean age was 60.19 years with a standard deviation of 9.38, minimum age of 36 years and maximum of 81 years; 164 (82%) denied any follow-up with a psychologist or psychiatrist in the phase after acute coronary syndrome diagnosis and treatment. In the utilization of Beck Depression Inventory, 67 (33.5%) presented scores between 0 and 4, indicating mild depressive symptoms; 72 (36%) had scores between 5 and 9, indicating mild to moderate depressive symptoms, and 61 (30.5%) presented scores greater than 9, which point out moderate to severe depressive symptoms. Conclusion: The evaluation and multiprofessional follow-up can help patients cope with the illness in addition to providing greater compliance to drug therapy and beginning changes in life habits. [ABSTRACT FROM AUTHOR]

SCA is characterized by the acute onset of myocardial ischemia, which may progress to necrosis if diagnostic tests and definitive interventions are not performed. The nursing diagnosis is essential for the development of the care plan, in order to treat, disease control and reduced hospital mortality by assessing how the needs, making it a challenge, despite its high prevalence in ICU. This is a systematic review of the literature. The nursing interventions should advocate pain relief in order to decrease the chest discomfort due to decreased oxygen delivery to the myocardium, promoting physical comfort and individualized care. The reduction of coronary events of complications occurs when the SCA is treated in accordance with the proposed measures that improve the quality of care in this critical patient. Systematic diagnostic strategies are essential in this type of care in order to obtain a high accuracy on the tour. To comfort this pain interventions should be performed, minimizing cardiac stress as: maintain absolute bed rest, oxygen administration and drug therapy. Early recognition of the clinical manifestations of SCA more complex is one of the nursing responsibilities, intervening appropriately, aiming to improve prognosis and reducing the rates of complications syndrome, pain relief and clinical, developing a care plan can guide conduct of his team before the evolutionary picture of the patient. The onset time of symptoms to the provision of assistance is directly proportional to clinically relevant event occurrences. [ABSTRACT FROM AUTHOR]