Study of Hs Troponin I & uric acid in patients of myocardial infarction

We aimed to provide Correlation of Hs Troponin I & Uric Acid in patients of Myocardial Infarction.: 100 patients who came to cardiac emergency in Shri Mahant Indresh Hospital. Serum samples taken for Hs Troponin I and Uric Acid for patients of Myocardial Infarction and run on VITROS 5600/7600 which is based on dry chemistry. : With 100 patients of more than 40 years of age 61 were males & 39 were females. For both males & females age mean & SD was 59.8±10.77.In our study we took 100 random patients coming to cardiac emergency out of which 50 patients had raised trop I and 45 patients had raised uric acid levels. Out of those 50 patients with raised HS Trop I 25 patients had raised values for uric acid. For Hs Trop I males – 21.88±48.8 & females 1676±57.58. For uric acid for males-6.545±3.75 & for females- 6.315±1.86.Therefore Hs Trop I & uric acid were both significant when compared with age T value was 2.7001 and P value was 0.0075. Whereas when compared with sex that is male and female to both Hs Trop I and uric acid then Hs Trop I was more significant with P value 0.0001.Uric acid is an economical marker that is readily, quickly and reliably obtainable & can be one of the predictable prognostic indicator in acute Myocardial Infarction.

URGENT 1.5: diagnostic accuracy of the modified HEART score, with fingerstick point-of-care troponin testing, in ruling out acute coronary syndrome

Background The HEART score is a validated risk stratification tool for chest pain patients presenting to the emergency department and was recently investigated for implementation in a pre-hospital setting. Fingerstick (capillary blood) point-of-care (POC) troponin testing enables quick measurements outside the hospital and seems easier to implement than the current venous blood sampling techniques. This study investigates the diagnostic accuracy of the modified HEART score, integrating fingerstick POC troponin testing, in ruling out acute coronary syndrome (ACS). Methods The data of 96 patients with chest pain, included in a study investigating a novel POC troponin device under development at the cardiac emergency department, were analysed retrospectively. Based on the patients’ admission data and capillary POC high-sensitivity troponin I (hs-cTnI) results, the modified HEART score was determined. The outcome measure, for evaluating the diagnostic accuracy of the modified HEART score, was the occurrence of ACS. Results Of the total study population, 33 patients (34%) were diagnosed with ACS. Seventeen patients (18%) were classified as low risk (0–3 points) and one patient (6%) in this group was diagnosed with ACS. The sensitivity and negative predictive value of the modified HEART score was 97.0 and 97.6%, respectively. Conclusion The modified HEART score, integrating capillary POC hs-cTnI results, is a promising tool for ruling out ACS in patients with chest pain presenting to the cardiac emergency department. These results encourage prospective investigation into the integration of fingerstick POC troponin testing in the modified HEART score in a pre-hospital setting.

Successful Treatment of a Patient with Cardiac Arrest Due to Hyperkalemia by Prolonged Cardiopulmonary Resuscitation along with Hemodialysis: A Case Report and Review of the Literature

Severe hyperkalemia is a potentially life threatening cardiac emergency, especially in patients with renal failure, and can lead to fatal arrhythmias such as ventricular fibrillation or asystole, leading to cardiac arrest. We report a case of a 39-year-old woman who developed sudden cardiac arrest secondary to hyperkalemia (9.95 mEq/L) with renal insufficiency. Despite 20 min of cardiopulmonary resuscitation (CPR) and conventional treatment for hyperkalemia, the cardiac arrest persisted. Hemodialysis was then initiated via the right femoral vein during CPR, and the patient restored spontaneous heartbeat 40 min later. Hemodialysis should be considered in the course of CPR in severe hyperkalemia induced cardiac arrest if conventional therapies fail.

Assessment of Risk and Emergency Knowledge Level - Cardiovascular Emergencies in Rural Communities Sungai Nagara, Margasari Village, Tapin, South Kalimantan

Background Cardiovascular disease contributes to a massive mortality rate in the world and also in Indonesia. Assessment of the risk and level of knowledge of cardiac emergency symptoms needs to be carried out, especially in rural areas where access to cardiovascular treatment is far.Purposes This study aims to assess risk stratification and the level of knowledge. The method of measuring risk and level of knowledge was carried out on 100 Margasari Ilir respondent who were over 40 years old and carried out using the stratified random sampling method during September 2020—measuring risk using the instrument Framingham Risk Score and the level of knowledge using the ACS Response Index.Result The average age of respondents was 54.98 years, 30 men (30%) and 70 women (70%), 22 smokers (22%), seven diabetes mellitus (7%), 11 people ( 11%) had high cholesterol, 41 people (41%) had hypertension, and 33 people (33%) had low HDL levels. The number of people who have a high risk of emergency - cardiovascular emergency is seven people (7%), 24 people are at moderate risk (24%), and 69 people are at low risk (69%). The level of knowledge about cardiac emergencies is in the low category of 80 people (80%), 19 people (19%), and one high (1%).Conclusion It is necessary to increase public knowledge about cardiovascular emergencies.

SARS-CoV-2 Infection in Asymptomatic Patients Hospitalized for Cardiac Emergencies: Implications for Patient Management

Background: The coronavirus disease (COVID-19) pandemic imposed diverse challenges on the health care system. Morbidity and mortality of non-COVID-19 emergencies might also have changed because hospitals may not be able to provide optimal care due to restructured resources and uncertainties how to deal with potentially infected patients. It has been recommended to stratify treatment of cardiovascular emergencies according to cardiovascular risk. However, data on the prevalence of asymptomatic SARS-CoV-2 infection in patients presenting with cardiac emergencies remain scarce.Methods: We retrospectively analyzed patients' data from a tertiary cardiology department between April 15 and May 31, 2020. All patients were screened on admission for COVID-19 symptoms using a questionnaire and body temperature measurements. All hospitalized patients were routinely screened using nasopharyngeal swab testing.Results: In total, we counted 710 urgent and emergency admissions. Nasopharyngeal swab tests were available in 689 (97%) patients, 409 and 280 of which presented as urgent and emergency admissions, respectively. Among 280 emergency admissions, none tested positive for SARS-CoV-2.Conclusion: In cardiac emergency patients which were screened negative for COVID-19 symptoms, the prevalence of SARS-CoV-2 infection in regions with a modest overall prevalence is low. This finding might be helpful to better determine timing of emergency procedures and reasonable usage of protective equipment during the COVID-19 crisis and the future.

SURF: identifying and allocating resources during Out-of-Hospital Cardiac Arrest

Background When an Out-of-Hospital Cardiac Arrest (OHCA) incident is reported to emergency services, the 911 agent dispatches Emergency Medical Services to the location and activates responder network system (RNS), if the option is available. The RNS notifies all the registered users in the vicinity of the cardiac arrest patient by sending alerts to their mobile devices, which contains the location of the emergency. The main objective of this research is to find the best match between the user who could support the OHCA patient. Methods For performing matching among the user and the AEDs, we used Bipartite Matching and Integer Linear Programming. However, these approaches take a longer processing time; therefore, a new method Preprocessed Integer Linear Programming is proposed that solves the problem faster than the other two techniques. Results The average processing time for the experimentation data was 1850 s using Bipartite matching, 32 s using the Integer Linear Programming and 2 s when using the Preprocessed Integer Linear Programming method. The proposed algorithm performs matching among users and AEDs faster than the existing matching algorithm and thus allowing it to be used in the real world. Conclusion: This research proposes an efficient algorithm that will allow matching of users with AED in real-time during cardiac emergency. Implementation of this system can help in reducing the time to resuscitate the patient.