CITY OF MANILA

UNIVERSIDAD DE MANILA
(FORMERLY CITY COLLEGE OF MANILA)
MEHAN GARDENS, MANILA
COLLEGE OF NURSING

IN PARTIAL FULFILLMENT OF THE REQUIREMENTS

IN RELATED LEARNING EXPERIENCE

(MEDICINE WARD)

SUBMITTED BY:

DACULA, JANE ALLYN D.

NR-31

SUBMITTED TO:

MR. TIRSO O. GONZALES, RN

DATE SUBMITTED:

MARCH 2 2011
 CITY OF MANILA
UNIVERSIDAD DE MANILA
(FORMERLY CITY COLLEGE OF MANILA)
MEHAN GARDENS, MANILA
COLLEGE OF NURSING

IN PARTIAL FULFILLMENT OF THE REQUIREMENTS

IN RELATED LEARNING EXPERIENCE
(MEDICINE WARD)

SUBMITTED BY:
BEJARE,JONALYN H.
NR-31

SUBMITTED TO:
MR. TIRSO O. GONZALES, RN

DATE SUBMITTED:
MARCH 2 2011
 Calcium Score: A New Risk Factor in Patients with
Possible Acute Coronary Syndromes?

Many patients now have access to screening electron beam tomography to determine
the amount of calcium in their coronary artery walls. The higher the amount of calcium
(and the score), the more likely it is that the patient has high-grade coronary lesions.
These authors followed a cohort of 98 asymptomatic patients with high ( 1000) calcium
scores who had no history of coronary artery disease or urgent cardiovascular testing.

During the 3-year follow-up period, there were 35 cardiac events: cardiac death in 12
patients and myocardial infarction in 23. The event rate per year was 25%. Calcium
scores were significantly higher in patients who experienced cardiac events than in
those who did not. The subset of patients with scores above 1500 had a higher death
rate than did the entire cohort (P=0.02).

This preliminary study is startling. The number of events was very high, even compared
with the historical rate in patients with abnormal perfusion scans. The added diagnostic
value of a high calcium score above that of other clinical predictors has not yet been
studied. However, until more is known, it would seem appropriate to consider patients
with high calcium scores to be at high risk for acute coronary syndrome.

Any patient with a coronary calcium score over 100 or greater than the 75th percentile
should be considered to have a substantial risk of coronary events and should reduce
their risk factors to secondary prevention targets

— James M. Christenson, MD, FRCPC

Published in Journal Watch Emergency Medicine March 13, 2002
 
REACTION:

THIS ARTICLE DISCUSSES ABOUT CALCIUM SCORE , A NEWLY

DISCOVERED RISK FACTOR FOR PATIENTS WITH POSSIBLE ACUTE CORONARY

SYNDROME . RECENT STUDIES SHOWS HOW CALCIUM SCORE WAS

CORRELATED AND HAS BEEN SEEN TO BE ASSOCIATED WITH THE TOTAL

PLAQUE BURDEN.

STUDY SHOWS THAT THE HIGHER THE AMOUNT OF CALCIUM AND , THE

MORE LIKELY IT IS THAT THE PATIENT HAS HIGH GRADE CORONARY

LESIONS THE CORONARY CALCIUM SCORE DETERMINED BY CT IMAGING

CAN PROVIDE AN ESTIMATE OF TOTAL CORONARY PLAQUE BURDEN. STUDIES

HAVE SHOWN THAT THE EXTENT OF CORONARY CALCIUM WITHIN PLAQUES

IS RELATED TO HEALED PLAQUE RUPTURES

I FIND THIS ARTICLE VERY HELPFUL SINCE CALCIUM SCORE APPEARS TO

BE AN EFFECTIVE INITIAL TOOL FOR RISK PATIENTS WITH POSSIBLE ACUTE

CORONARY SYNDROME,ALSO CORONARY CALCIUM SCORING SEEMS TO BE AN

INTERESTING TECHNIQUE FOR PREDICTING CARDIAC EVENTS, I THINK

KNOWLEDGE ABOUT THIS NEW TECHNIQUE COULD GIVE PATIENTS A HIGHER

CHANCE FOR SURVIVAL SINCE CALCIUM SCORING CAN INDICATE THE RISK

FOR FUTURE PLAQUE RUPTURE AND THROMBOTIC OBSTRUCTION .

THEREFORE, WE CAN IDENTIFY THE VULNERABLE PATIENT.

AREA

The area was always kept clean and quiet, it has the necessary equipments
needed by the patients. The environment was conducive for healing.

CLINICAL INSTRUCTOR

Our clinical instructor was very kind and he was very helpful, through his
guidance we were able to learn and gain a lot of new information and knowledge
especially in medications. he always encourage us to study, he was fair and
considerate.

STAFF

The staffs were very polite, kind and welcoming they were also helpful when we
ask questions and when borrowing the patient’s chart.

PATIENT

The patients even though they are in pain, still they are very cooperative and
kind, they don’t give us a hard time in taking vital signs and giving medications their
cases was new to me, it’s my first time to handle patients with Myocardial
infarction and so I was able to understand and got ideas on how to render care for
such patients. They tend to answer our questions honestly and they love to chat
and has a very positive outlook in life. .