Management of patients undergoing percutaneous coronary revascularization
Article Abstract:
While performance of percutaneous coronary intervention (PCI) remains the domain of specialized cardiologists, patients undergoing PCI are cared for by noninvasive cardiologists, internists, and primary care physicians. Therefore, patient care is optimized when the entire patient care team understands procedural risks and complications as well as optimum patient management before, during, and after PCI. Before PCI, patients with contrast dye allergies should be identified and pretreated with steroids and an H(sub 1)-blocker. Hydration should be initiated and maintained before and after the procedure to minimize the risks for contrast nephropathy. Periprocedure, patients should be monitored clinically for evidence of ischemia. In patients with significant groin, flank, abdominal, or back pain, as well as those with decrease in hematocrit or unexplained hypotension, the diagnosis of groin or retroperitoneal hematoma should be considered and promptly evaluated. Groin tenderness, pulsatile mass, or bruit should prompt evaluation for possible femoral pseudoaneurysm or arteriovenous fistulae. After the procedure, all patients treated with coronary stents should receive aspirin plus clopidogrel. Patients who develop typical anginal symptoms between the 1st and 6th to 8th months after PCI are likely to have restenosis and can be evaluated by an imaging study or repeated catheterization.
Publication Name: Annals of Internal Medicine
Subject: Health
ISSN: 0003-4819
Year: 2003
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The effect of estrogen replacement therapy on plasma nitric oxide and endothelin-1 levels in postmenopausal women
Article Abstract:
Estrogen replacement therapy (ERT) appears to increase blood levels of nitric oxide, which could explain why estrogen lowers a woman's risk of heart disease. Nitric oxide occurs naturally in the body, where it dilates and relaxes blood vessels and inhibits one step in the formation of blood clots. Researchers measured nitric oxide levels and endothelin-1 levels in blood samples from 15 postmenopausal women on ERT. Endothelin-1 opposes the action of nitric oxide, causing blood vessels to constrict. After 6 months of ERT, nitric oxide levels were higher than at the start of ERT and endothelin-1 levels were lower.
Publication Name: Annals of Internal Medicine
Subject: Health
ISSN: 0003-4819
Year: 1998
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Management of patients undergoing percutaneous coronary interventions
Article Abstract:
The care of patients before and after they receive percutaneous coronary interventions is briefly reviewed. Percutaneous coronary interventions are treatments to open blocked coronary arteries. They include angioplasty, atherectomy, and stents. These procedures all have potential complications that can be treated.
Publication Name: Annals of Internal Medicine
Subject: Health
ISSN: 0003-4819
Year: 2003
User Contributions:
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