Giornale italiano di cardiologia : organo ufficiale della Federazione italiana di cardiologia : organo ufficiale della Società italiana di chirurgia cardiaca
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Stroke Unit admission together with reperfusion strategies (intravenous thrombolysis and mechanical thrombectomy) are the main treatment options for acute ischemic stroke. The last 15 years have seen a revolution in the treatment of ischemic stroke: intravenous thrombolysis with recombinant tissue-type plasminogen activator is indicated within 4.5 h of symptom onset regardless of age or severity, whereas mechanical thrombectomy is indicated within 6 h of anterior circulation intracranial occlusion. In case of favorable mismatch, advanced neuroimaging allows wake-up or non-datable strokes or with late onset time windows to be treated with thrombolysis and/or thrombectomy (within 9 h for thrombolysis and 24 h for thrombectomy).
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G Ital Cardiol (Rome) · May 2019
[ANMCO/FADOI/SIAARTI/SIC/SIMG/SIMI/SIMEU consensus document: The clinical care pathway of acute heart failure patients from symptom onset to discharge from the emergency department].
Acute heart failure (AHF) represents a relevant burden for emergency departments worldwide. AHF patients have markedly worse long-term outcomes than patients with other acute cardiac diseases (e.g. acute coronary syndromes); mortality or readmissions rates at 3 months approximate 33%, whereas 1-year mortality from index discharge ranges from 25% to 50%. The multiplicity of healthcare professionals acting across the care pathway of AHF patients represents a critical factor, which generates the need for integrating the different expertise and competence of general practitioners, emergency physicians, cardiologists, internists, and intensive care physicians to focus on care goals able to improve clinical outcomes. ⋯ The increasing care burden and complex problems generated by AHF are unlikely to be solved without an integrated multidisciplinary approach. Efficient networking among emergency departments, intensive care units, ordinary wards and primary care settings is crucial to achieve better outcomes. Thanks to the joint effort of qualified scientific societies, this document aims to achieve this goal through an integrated, shared and applicable pathway that will contribute to a homogeneous care management of AHF patients across the country.