imported>Chunbum Park |
imported>John Stephenson |
| (87 intermediate revisions by 5 users not shown) |
| Line 1: |
Line 1: |
| == '''[[Acute coronary syndrome]]''' ==
| | {{:{{FeaturedArticleTitle}}}} |
| ----
| | <small> |
| In [[medicine]] and [[cardiology]], '''acute coronary syndrome''' (ACS) is a collection of [[sign (medical)|signs]] and [[symptom]]s due to inadequate oxygenation of the heart muscle, the [[myocardium]], usually due to [[coronary artery disease]].<ref>{{MeSH}}</ref> ACS includes [[myocardial infarction]] ("heart attack") and [[angina]].
| | ==Footnotes== |
| | |
| Pain relief and proper oxygenation is the core of ACS treatment. When the root causie is angina, the temporary cause of ischemia should be reversed. For myocardial infarction, more vigorous interventions are appropriate if they can prevent damage to myocardium.
| |
| | |
| ===Etiology/causes===
| |
| ====Atheroclerotic obstruction====
| |
| ACS is usually caused by obstruction in an epicardial coronary artery.<ref name="pmid18687244">{{cite journal |author=Ong P, Athanasiadis A, Hill S, Vogelsberg H, Voehringer M, Sechtem U |title=Coronary artery spasm as a frequent cause of acute coronary syndrome: The CASPAR (Coronary Artery Spasm in Patients With Acute Coronary Syndrome) Study |journal=J. Am. Coll. Cardiol. |volume=52 |issue=7 |pages=523–7 |year=2008 |month=August |pmid=18687244 |doi=10.1016/j.jacc.2008.04.050 |url=http://linkinghub.elsevier.com/retrieve/pii/S0735-1097(08)01872-X |issn=}}</ref> The obstruction may be due to a thrombus at the site of a ruptured atherosclerotic plaque.<ref name="pmid1728732">{{cite journal |author=Mizuno K, Satomura K, Miyamoto A, ''et al'' |title=Angioscopic evaluation of coronary-artery thrombi in acute coronary syndromes |journal=N. Engl. J. Med. |volume=326 |issue=5 |pages=287–91 |year=1992 |month=January |pmid=1728732 |doi= |url= |issn=}}</ref>
| |
| | |
| Rupture seems more likely to occur during the morning hours.<ref name="pmid2865677">{{cite journal |author=Muller JE, Stone PH, Turi ZG, ''et al'' |title=Circadian variation in the frequency of onset of acute myocardial infarction |journal=N. Engl. J. Med. |volume=313 |issue=21 |pages=1315–22 |year=1985 |month=November |pmid=2865677 |doi= |url= |issn=}}</ref> Rupture may be precipited by inflammation from non-cardiac infections.<ref name="pmid18293142">{{cite journal |author=Harskamp RE, van Ginkel MW |title=Acute respiratory tract infections: a potential trigger for the acute coronary syndrome |journal=Ann. Med. |volume=40 |issue=2 |pages=121–8 |year=2008 |pmid=18293142 |doi=10.1080/07853890701753672 |url=http://www.informaworld.com/openurl?genre=article&doi=10.1080/07853890701753672&magic=pubmed||1B69BA326FFE69C3F0A8F227DF8201D0 |issn=}}</ref> Rupture may be triggered by vigorous exercise among individuals who do not ordinarily do vigorous exercise.<ref name="pmid6472399">{{cite journal |author=Siscovick DS, Weiss NS, Fletcher RH, Lasky T |title=The incidence of primary cardiac arrest during vigorous exercise |journal=N. Engl. J. Med. |volume=311 |issue=14 |pages=874–7 |year=1984 |month=October |pmid=6472399 |doi= |url= |issn=}}</ref>
| |
| | |
| ====Coronary vasospasm====
| |
| Approximately 15% of NSTEMI and 2% of STEMI patients have no obstruction of coronary vessels and in about half of these patients, spasm can be induced of a coronary artery.<ref name="pmid18687244"/>
| |
| | |
| ''[[Acute coronary syndrome|.... (read more)]]''
| |
| | |
| {| class="wikitable collapsible collapsed" style="width: 90%; float: center; margin: 0.5em 1em 0.8em 0px;"
| |
| |-
| |
| ! style="text-align: center;" | [[Acute coronary syndrome#References|notes]]
| |
| |-
| |
| |
| |
| {{reflist|2}} | | {{reflist|2}} |
| |}
| | </small> |
Latest revision as of 10:19, 11 September 2020
Napoleon (Napoleon Bonaparte or, after 1804, Napoleon I, Emperor of the French) was a world historic figure and dictator of France from 1799 to 1814. He was the greatest general of his age--perhaps any age, with a sure command of battlefield tactics and campaign strategies, As a civil leader he played a major role in the French Revolution, then ended it when he became dictator in 1799 and Emperor of France in 1804 He modernized the French military, fiscal, political legal and religious systems. He fought an unending series of wars against Britain with a complex, ever-changing coalition of European nations on both sides. Refusing to compromise after his immense defeat in Russia in 1812, he was overwhelmed by a coalition of enemies and abdicated in 1814. In 1815 he returned from exile, took control of France, built a new army, and in 100 days almost succeeded--but was defeated at Waterloo and exiled to a remote island. His image and memory are central to French national identity, but he is despised by the British and Russians and is a controversial figure in Germany and elsewhere in Europe.
Rise to Power
Once the Revolution had begun, so many of the aristocratic officers turned against the Revolutionary government, or were exiled or executed, that a vacuum of senior leadership resulted. Promotions came very quickly now, and loyalty to the Revolution was as important as technical skill; Napoleon had both. His demerits were overlooked as he was twice reinstated, promoted, and allowed to collect his back pay. Paris knew him as an intellectual soldier deeply involved in politics. His first test of military genius came at Toulon in 1793, where the British had seized this key port. Napoleon, an acting Lieutenant-Colonel, used his artillery to force the British to abandon the city. He was immediately promoted by the Jacobin radicals under Robespierre to brigadier-general, joining the ranks of several brilliant young generals. He played a major role in defending Paris itself from counter-revolutionaries, and became the operational planner for the Army of Italy and planned two successful attacks in April 1794. He married Josephine (Rose de Beauharnais) in 1796, after falling violently in love with the older aristocratic widow.[1]
- ↑ Englund pp 63-73, 91-2, 97-8
