The Canadian journal of cardiology
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Observational Study
Prognosis Impact of Frailty Assessed by the Edmonton Frail Scale in the Setting of Acute Coronary Syndrome in the Elderly.
Elderly patients represent a large proportion of patients admitted for acute coronary syndrome (ACS). Whether frailty-defined as a biological syndrome that reflects a state of decreased physiological reserve and vulnerability to stressors-may impact the clinical outcomes in this population remains unclear. We aimed to determine the prevalence of frailty and its impact on mortality in patients aged ≥ 80 years admitted for ACS. ⋯ Frailty is a strong and independent prognostic factor for midterm all-cause mortality in elderly patients presenting with ACS.
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Consensus regarding the management of massive pulmonary embolism (PE) and persistent shock after thrombolysis is lacking. A 30-year-old man collapsed with massive PE 3 days after an exploratory laparotomy for penetrating trauma, and he remained hypoxic and hypotensive despite thrombolytic therapy. ⋯ After 48 hours, the RVAD was removed, and the patient survived to discharge. ECMO and temporary RVAD to support surgical embolectomy are lifesaving therapeutic considerations.