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Shooting the messenger
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For the 2006 British television film, see Shoot the Messenger (film).
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"Shooting the messenger" is a metaphoric phrase used to describe the act of blaming the bearer of bad news.
Until the advent of modern telecommunication, messages were usually delivered by human envoys. For example, in war, a messenger would be sent from one camp to another. If the message was unfitting, the receiver might blame the messenger for such bad news and take their anger out on them.
"Shooting the messenger" is a subdivision of the ad hominem logical fallacy.[1]
Contents
[hide]
1 History
2 Freud and defense
3 Current application
4 Similar phrases
5 See also
6 References
7 External links
History[edit]
An analogy of the phrase can come from the breaching of an unwritten code of conduct in war, in which a commanding officer was expected to receive and send back emissaries or diplomatic envoys sent by the enemy unharmed. During the early Warring States period of China, the concept of chivalry and virtue prevented the executions of messengers sent by opposing sides.
An early literary citing of "shooting the messenger" is in Plutarch's Lives states: "The first messenger, that gave notice of Lucullus' coming was so far from pleasing Tigranes that, he had his head cut off for his pains; and no man dared to bring further information. Without any intelligence at all, Tigranes sat while war was already blazing around him, giving ear only to those who flattered him".[2]
A related sentiment was expressed in Antigone by Sophocles as "no one loves the messenger who brings bad news" or "no man delights in the bearer of bad news" (Greek: στέργει γὰρ οὐδεὶς ἄγγελον κακῶν ἐπῶν).[3]
The sentiment that one should not shoot the messenger was expressed by Shakespeare in Henry IV, Part 2 (1598)[4] and in Antony and Cleopatra: Cleopatra threatens to treat the messenger's eyes as balls when told Antony has married another, eliciting the response "Gracious madam, I that do bring the news made not the match."[5]
The term also applied to a town crier, an officer of the court who made public pronouncements in the name of the ruling monarch, and often including bad news. Harming a town crier was considered treason.[6]
Freud and defense[edit]
Sigmund Freud considered shooting the messenger a "marginal case of this kind of defense...of fending off what is distressing or unbearable", citing the example of "the famous lament of the Spanish Moors Ay de mi Alhama, which tells how King Boabdil received the news of the fall of his city of Alhama. He feels that this loss means the end of his rule. But he will not 'let it be true....He threw the letters in the fire and killed the messenger'".[7]
Freud added that "a further determinant of this behaviour of the king was his need to combat a feeling of powerlessness. By burning the letters and having the messenger killed he was still trying to show his absolute power."[8]
Carl G. Jung, a peer of Freud’s, describes the shadow in the individual as part of the unconscious mind, which is largely negative. “Everyone carries a shadow", Jung wrote, "and the less it is embodied in the individual’s conscious life, the blacker and denser it is". It may be in part one’s links to more primitive animal instincts, which are superseded in early childhood by the conscious mind. V.G. Hufnagel, a bioethics expert wrote, “the shadow of the institution protects its own fraternity".[9] The fraternity members form a collective and share a collective consciousness with a predatory instinctive animal in nature and hold the fears of childhood. These fears stimulate actions to destroy any message that may harm them. There is no cognitive process in these actions. These are forced on death of an individual and of an idea through human sacrifice. There are religious aspects to these actions. The fraternity of authority believes it holds a right to exterminate those who could harm them.[10][10] The shadow is a part of the "psychology of institutions". Institutions have enormous funds to use unlike an individual whistleblower. Institutions also have massive communication systems and a loyal population that supports the institution.
Current application[edit]
A modern version of "shooting the messenger" can be perceived when someone blames the media for presenting bad news about a favored cause, person, organization, etc. "Shooting the messenger" may be a time-honored emotional response to unwanted news, but it is not a very effective method of remaining well-informed."[11]
Getting rid of the messenger may be a tactical move, but danger found in nondisclosure may result in either hostile responses or negative feedback from others. "People learn very quickly where this is the case, and will studiously avoid giving any negative feedback; thus the 'Emperor' continues with the self-delusion....Obviously this is not a recipe for success".[12] Barbara Ehrenreich in Bright-sided/Smile or Die argued that a culture of "thinking positive" so as to "purge 'negative people' from the ranks...[fed into] the bubble-itis"[13] of the 2000s.
Reactions to the whistleblowing organization WikiLeaks led to calls not to shoot the messenger.[14]
Similar phrases[edit]
A syntactically similar expression "Please do not shoot the pianist. He is doing his best". It originated around 1860 in the Wild West of the United States when Oscar Wilde, during his 1883 tour of the United States, saw this saying on a notice in a Leadville, Colorado, saloon.[15] This phrase is sometimes attributed to Mark Twain, but neither Wilde nor Twain ever claimed authorship.
Alternative expressions:
"Killing the messenger"
"Attacking the messenger"
"Blaming the bearer of bad tidings"
See also[edit]
Egodystonic
Guilt by association
Kick the cat
Own goal
Scapegoating
References[edit]
Jump up ^ J. Rothwell, In Mixed Company: Communicating in Small Groups. 2015. Page 421
Jump up ^ Plutarch's Life of Lucullus (Dryden transl.), paragraph 25; a slightly different account (the messenger was hanged) is in Appian's Mithradatic Wars, paragraph 84
Jump up ^ Sophocles (1891). "Line 277". The Antigone of Sophocles. Edited with introduction and notes by Sir Richard Jebb. Cambridge University Press. At the Perseus Project.
Jump up ^ Act I, scene 1, lines 95-103; "Thou shakest thy head and hold'st it fear or sin to speak a truth. ... Yet the first bringer of unwelcome news hath but a losing office, and his tongue sounds ever after as a sullen bell, remember'd tolling a departed friend."
Jump up ^ II, 5; cf. I, 2 : "The nature of bad news infects the teller."
Jump up ^ "Top town crier to be crowned as Hebden Bridge hits 500". BBC. 2010-08-20.
Jump up ^ Sigmund Freud, On Metapsychology (PFL 11) p. 454-5
Jump up ^ Freud, On Metapsychology p. 455
Jump up ^ Hufnagel,V.G. (2014) “The Truth Hurts”, Introduction :Kill the Messinger, Kill the Message.
^ Jump up to: a b Jung, C.G. (1938). "Psychology and Religion." In CW 11: Psychology and Religion: West and East. P.131
Jump up ^ Bruce W. Sanford, Don't Shoot the Messenger (2001) p. 10
Jump up ^ Mike Robson/Ciaran Beary, Facilitating (1995) p. 135
Jump up ^ Barbar Ehrenreich, Smile or Die (London 2009) p. 188-9
Jump up ^ "Julian Assange: 'Don't Shoot the Messenger'". London: The Independent. 7 December 2010. Retrieved 7 January 2011.
Jump up ^ "Oscar Wilde in Leadville". Retrieved 23 February 2015.
External links[edit]
Look up shoot the messenger, don't shoot the messenger, or kill the messenger in Wiktionary, the free dictionary.
The dictionary definition of don't shoot the messenger at Wiktionary
Retrieved from "https://en.wikipedia.org/w/index.php?title=Shooting_the_messenger&oldid=826949520"
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Acute coronary syndrome
From Wikipedia, the free encyclopedia
Jump to: navigation, search
Acute coronary syndrome
Blockage of a coronary artery
Specialty
Cardiology
Acute coronary syndrome (ACS) is a syndrome (set of signs and symptoms) due to decreased blood flow in the coronary arteries such that part of the heart muscle is unable to function properly or dies.[1] The most common symptom is chest pain, often radiating to the left shoulder[2] or angle of the jaw, crushing, central and associated with nausea and sweating. Many people with acute coronary syndromes present with symptoms other than chest pain, particularly, women, older patients, and patients with diabetes mellitus.[3]
Acute coronary syndrome is commonly associated with three clinical manifestations: ST elevation myocardial infarction (STEMI, 30%), non ST elevation myocardial infarction (NSTEMI, 25%), or unstable angina (38%).[4] These types are named according to the appearance of the electrocardiogram (ECG) as non-ST segment elevation myocardial infarction and ST segment elevation myocardial infarction.[5] There can be some variation as to which forms of myocardial infarction (MI) are classified under acute coronary syndrome.[6]
ACS should be distinguished from stable angina, which develops during physical activity or stress and resolves at rest. In contrast with stable angina, unstable angina occurs suddenly, often at rest or with minimal exertion, or at lesser degrees of exertion than the individual's previous angina ("crescendo angina"). New-onset angina is also considered unstable angina, since it suggests a new problem in a coronary artery.
Contents
[hide]
1 Signs and symptoms
2 Diagnosis
2.1 Electrocardiogram
2.2 Imaging and blood tests
2.3 Prediction scores
3 Prevention
4 Treatment
4.1 STEMI
4.2 NSTEMI and NSTE-ACS
5 Prognosis
5.1 TIMI score
5.2 Global Registry of Acute Coronary Events (GRACE) score[15]
5.3 Killip class[29]
5.4 Biomarkers for diagnosis
5.5 Biomarkers for risk determination
5.6 Day of admission
6 See also
7 References
8 External links
Signs and symptoms[edit]
The cardinal symptom of critically decreased blood flow to the heart is chest pain, experienced as tightness around or over the chest and (often, but not always) radiating to the left arm and the left angle of the jaw. This may be associated with diaphoresis (sweating), nausea and vomiting, as well as shortness of breath. In many cases, the sensation is "atypical", with pain experienced in different ways or even being completely absent (which is more likely in female patients and those with diabetes). Some may report palpitations, anxiety or a sense of impending doom (angor animi) and a feeling of being acutely ill. The description of the chest discomfort as a pressure has little utility in aiding a diagnosis as it is not specific for ACS.[7]
Though ACS is usually associated with coronary thrombosis, it can also be associated with cocaine use.[8] Chest pain with features characteric of cardiac origin (angina) can also be precipitated by profound anemia, brady- or tachycardia (excessively slow or rapid heart rate), low or high blood pressure, severe aortic valve stenosis (narrowing of the valve at the beginning of the aorta), pulmonary artery hypertension and a number of other conditions.[citation needed]
Diagnosis[edit]
Classification of acute coronary syndromes.[9]
Electrocardiogram[edit]
In the setting of acute chest pain, the electrocardiogram is the investigation that most reliably distinguishes between various causes.[10] The ECG should be done as early as practicable, including in the ambulance if possible.[11] If this indicates acute heart damage (elevation in the ST segment, new left bundle branch block), treatment for a heart attack in the form of angioplasty or thrombolysis is indicated immediately (see below). In the absence of such changes, it is not possible to immediately distinguish between unstable angina and NSTEMI.
Imaging and blood tests[edit]
As it is only one of the many potential causes of chest pain, the patient usually has a number of tests in the emergency department, such as a chest X-ray, blood tests (including myocardial markers such as troponin I or T, and H-FABP and/or a D-dimer if a pulmonary embolism is suspected), and telemetry (monitoring of the heart rhythm).
Prediction scores[edit]
The ACI-TIPI score can be used to aid diagnosis; using seven variables from the admission record, this score predicts crudely which patients are likely to have myocardial ischemia.[12] For example, according to a randomized controlled trial, males having chest pain with normal or non diagnostic ECG are at higher risk for having acute coronary syndrome than women.[13] In this study, the sensitivity was 65.2% and specificity was 44%. This particular study had an 8.4% prevalence of acute coronary syndrome, which means the positive predictive value of being a male with chest pain and having coronary syndrome is 9.6% and negative predictive value is 93.2% ( click here[permanent dead link] to adjust these results for patients at higher or lower risk of acute coronary syndrome).
In a second cohort study, exercise electrocardiography was similarly found to be a poor predictor of acute coronary syndrome at follow-up.[14] Of the patients who had a coronary event at 6 years of follow up, 47% had a negative ECG at the start of the study. With an average follow up of 2.21 years the receiver operating characteristic curves gave resting ECG a score of 0.72 and exercise ECG a score of 0.74.
There are not only prediction scores for diagnosis of ACS, but also prognosis. Most notably, the GRACE ACS Risk and Mortality score helps diagnose, and based upon that score predicts mortality rate of a given patient. It takes into account both clinical (blood pressure, heart rate, EKG findings) and medical history in its scoring system.[15]
Prevention[edit]
Acute coronary syndrome often reflects a degree of damage to the coronaries by atherosclerosis. Primary prevention of atherosclerosis is controlling the risk factors: healthy eating, exercise, treatment for hypertension and diabetes, avoiding smoking and controlling cholesterol levels; in patients with significant risk factors, aspirin has been shown to reduce the risk of cardiovascular events. Secondary prevention is discussed in myocardial infarction.
After a ban on smoking in all enclosed public places was introduced in Scotland in March 2006, there was a 17% reduction in hospital admissions for acute coronary syndrome. 67% of the decrease occurred in non-smokers.[16]
Treatment[edit]
Main article: Management of acute coronary syndrome
People with presumed ACS are typically treated with aspirin, clopidogrel or ticagrelor, nitroglycerin, and if the chest discomfort persists morphine.[17] Other analgesics such as nitrous oxide are of unknown benefit.[17] Angiography is recommended in those who have either new ST elevation or a new left bundle branch block on their ECG.[1] Unless the person has low oxygen levels additional oxygen does not appear to be useful.[18]
STEMI[edit]
If the ECG confirms changes suggestive of myocardial infarction (ST elevations in specific leads, a new left bundle branch block or a true posterior MI pattern), thrombolytics may be administered or primary coronary angioplasty may be performed. In the former, medication is injected that stimulates fibrinolysis, destroying blood clots obstructing the coronary arteries. In the latter, a flexible catheter is passed via the femoral or radial arteries and advanced to the heart to identify blockages in the coronaries. When occlusions are found, they can be intervened upon mechanically with angioplasty and usually stent deployment if a lesion, termed the culprit lesion, is thought to be causing myocardial damage. Data suggest that rapid triage, transfer and treatment is essential.[19] The time frame for door-to-needle thrombolytic administration according to American College of Cardiology (ACC) guidelines should be within 30 minutes, whereas the door-to-balloon Percutaneous Coronary Intervention (PCI) time should be less than 90 minutes. It was found that thrombolysis is more likely to be delivered within the established ACC guidelines among patients with STEMI as compared to PCI according to a case control study.[20]
NSTEMI and NSTE-ACS[edit]
If the ECG does not show typical changes, the term "non-ST segment elevation ACS" is applied. The patient may still have suffered a "non-ST elevation MI" (NSTEMI). The accepted management of unstable angina and acute coronary syndrome is therefore empirical treatment with aspirin, a second platelet inhibitor such as clopidogrel, prasugrel or ticagrelor, and heparin (usually a low-molecular weight heparin), with intravenous nitroglycerin and opioids if the pain persists. The heparin-like drug known as fondaparinux appears to be better than enoxaparin.[21]
A blood test is generally performed for cardiac troponins twelve hours after onset of the pain. If this is positive, coronary angiography is typically performed on an urgent basis, as this is highly predictive of a heart attack in the near-future. If the troponin is negative, a treadmill exercise test or a thallium scintigram may be requested.
If there is no evidence of ST segment elevation on the electrocardiogram, delaying urgent angioplasty until the next morning is not inferior to doing so immediately.[22] Using statins in the first 14 days after ACS reduces the risk of further ACS.[23]
In a cohort study comparing NSTEMI and STEMI, people with NSTEMI had a similar risk of death at one year after PCI as compared to people with STEMI (3.4% vs 4.4%).[24] However, NSTEMI had significantly more "major cardiac events" (death, myocardial infarction, disabling stroke, or requiring revascularization) at one year (24.0% vs 16.6%).
Cocaine associated ACS should be managed in a manner similar to other patients with acute coronary syndrome except beta blockers should not be used and benzodiazepines should be administered early.[25]
Prognosis[edit]
TIMI score[edit]
The TIMI risk score can identify high risk patients in non-ST segment elevation MI ACS[26] and has been independently validated.[27][28]
Global Registry of Acute Coronary Events (GRACE) score[15][edit]
Based on a global registry of 102,341 patients, the GRACE score estimates in-hospital, 6 months, 1 year, and 3 year mortality risk after a heart attack. GRACE Score 2.0 Calculator..
Killip class[29][edit]
The Killip classification consists of 4 classes based on clinical symptoms. It predicts 30-day mortality after myocardial infarction.[29]
Biomarkers for diagnosis[edit]
The aim of diagnostic markers is to identify patients with ACS even when there is no evidence of heart muscle damage.
Ischemia-Modified Albumin (IMA) – In cases of Ischemia – Albumin undergoes a conformational change and loses its ability to bind transitional metals (copper or cobalt). IMA can be used to assess the proportion of modified albumin in ischemia. Its use is limited to ruling out ischemia rather than a diagnostic test for the occurrence of ischemia.
Myeloperoxidase (MPO) – The levels of circulating MPO, a leukocyte enzyme, elevate early after ACS and can be used as an early marker for the condition.
Glycogen Phosphorylase Isoenzyme BB-(GPBB) is an early marker of cardiac ischemia and is one of three isoenzyme of Glycogen Phosphorylase.
Troponin is a late cardiac marker of ACS
Biomarkers for risk determination[edit]
The aim of prognostic markers is to reflect different components of pathophysiology of ACS. For example:
Natriuretic peptide – Both B-type natriuretic peptide (BNP) and N-terminal Pro BNP can be applied to predict the risk of death and heart failure following ACS.
Monocyte chemo attractive protein (MCP)-1 – has been shown in a number of studies to identify patients with a higher risk of adverse outcomes after ACS.
Day of admission[edit]
Studies have shown that for ACS patients, weekend admission is associated with higher mortality and lower utilization of invasive cardiac procedures, and those who did undergo these interventions had higher rates of mortality and complications than their weekday counterparts. This data leads to the possible conclusion that access to diagnostic/interventional procedures may be contingent upon the day of admission, which may impact mortality.[30][31] This phenomenon is described as weekend effect.
See also[edit]
Allergic acute coronary syndrome (Kounis syndrome)
References[edit]
^ Jump up to: a b Amsterdam, E. A.; Wenger, N. K.; Brindis, R. G.; Casey, D. E.; Ganiats, T. G.; Holmes, D. R.; Jaffe, A. S.; Jneid, H.; Kelly, R. F.; Kontos, M. C.; Levine, G. N.; Liebson, P. R.; Mukherjee, D.; Peterson, E. D.; Sabatine, M. S.; Smalling, R. W.; Zieman, S. J. (23 September 2014). "2014 AHA/ACC Guideline for the Management of Patients With Non-ST-Elevation Acute Coronary Syndromes: A Report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines". Circulation. 130 (25): e344–e426. doi:10.1161/CIR.0000000000000134. PMID 25249585.
Jump up ^ Goodacre S, Pett P, Arnold J, Chawla A, Hollingsworth J, Roe D, Crowder S, Mann C, Pitcher D, Brett C (November 2009). "Clinical diagnosis of acute coronary syndrome in patients with chest pain and a normal or non-diagnostic electrocardiogram". Emergency Medicine Journal. 26 (12): 866–870. doi:10.1136/emj.2008.064428. PMID 19934131. Archived from the original on 2017-04-05.
Jump up ^ Canto JG, Shlipak MG, Rogers WJ (June 2000). "Prevalence, Clinical Characteristics, and Mortality among Patients with Acute Myocardial Infarction Presenting Without Chest Pain". JAMA. 283 (24): 3223–3229, vi. doi:10.1001/jama.283.24.3223. PMID 10866870.
Jump up ^ Torres M, Moayedi S (May 2007). "Evaluation of the acutely dyspneic elderly patient". Clin. Geriatr. Med. 23 (2): 307–25, vi. doi:10.1016/j.cger.2007.01.007. PMID 17462519.
Jump up ^ Grech ED, Ramsdale DR (June 2003). "Acute coronary syndrome: unstable angina and non-ST segment elevation myocardial infarction". BMJ. 326 (7401): 1259–61. doi:10.1136/bmj.326.7401.1259. PMC 1126130  . PMID 12791748.
Jump up ^ "Dorlands Medical Dictionary:acute coronary syndrome". Archived from the original on 2009-09-07.
Jump up ^ Woo KM, Schneider JI (November 2009). "High-risk chief complaints I: chest pain--the big three". Emerg. Med. Clin. North Am. 27 (4): 685–712, x. doi:10.1016/j.emc.2009.07.007. PMID 19932401.
Jump up ^ Achar SA, Kundu S, Norcross WA (2005). "Diagnosis of acute coronary syndrome". Am Fam Physician. 72 (1): 119–26. PMID 16035692. Archived from the original on 2007-10-09.
Jump up ^ Alpert JS, Thygesen K, Antman E, Bassand JP (2000). "Myocardial infarction redefined--a consensus document of The Joint European Society of Cardiology/American College of Cardiology Committee for the redefinition of myocardial infarction". J Am Coll Cardiol. 36 (3): 959–69. doi:10.1016/S0735-1097(00)00804-4. PMID 10987628.
Jump up ^ Chun AA, McGee SR (2004). "Bedside diagnosis of coronary artery disease: a systematic review". Am. J. Med. 117 (5): 334–43. doi:10.1016/j.amjmed.2004.03.021. PMID 15336583.
Jump up ^ Neumar, RW; Shuster, M; Callaway, CW; Gent, LM; Atkins, DL; Bhanji, F; Brooks, SC; de Caen, AR; Donnino, MW; Ferrer, JM; Kleinman, ME; Kronick, SL; Lavonas, EJ; Link, MS; Mancini, ME; Morrison, LJ; O'Connor, RE; Samson, RA; Schexnayder, SM; Singletary, EM; Sinz, EH; Travers, AH; Wyckoff, MH; Hazinski, MF (3 November 2015). "Part 1: Executive Summary: 2015 American Heart Association Guidelines Update for Cardiopulmonary Resuscitation and Emergency Cardiovascular Care". Circulation. 132 (18 Suppl 2): S315–67. doi:10.1161/cir.0000000000000252. PMID 26472989.
Jump up ^ Selker HP, Griffith JL, D'Agostino RB (1991). "A tool for judging coronary care unit admission appropriateness, valid for both real-time and retrospective use. A time-insensitive predictive instrument (TIPI) for acute cardiac ischemia: a multicenter study". Medical care. 29 (7): 610–27. doi:10.1097/00005650-199107000-00002. PMID 2072767.
Jump up ^ Goodacre, S; Pett, P; Arnold, J; Chawla, A; Hollingsworth, J; Roe, D; Crowder, S; Mann, C; Pitcher, D; Brett, C (2009). "Clinical diagnosis of acute coronary syndrome in patients with chest pain and a normal or non-diagnostic electrocardiogram". Emergency medicine journal : EMJ. 26 (12): 866–70. doi:10.1136/emj.2008.064428. PMID 19934131.
Jump up ^ Sekhri, N; Feder, GS; Junghans, C; Eldridge, S; Umaipalan, A; Madhu, R; Hemingway, H; Timmis, AD (2008). "Incremental prognostic value of the exercise electrocardiogram in the initial assessment of patients with suspected angina: cohort study". BMJ (Clinical research ed.). 337: a2240. doi:10.1136/bmj.a2240. PMC 2583389  . PMID 19008264.
^ Jump up to: a b Fox KA, Dabbous OH, Goldberg RJ, Pieper KS, Eagle KA, Van de Werf F, Avezum A, Goodman SG, Flather MD, Anderson FA Jr, Granger CB (2006). "Prediction of risk of death and myocardial infarction in the six months after presentation with acute coronary syndrome: prospective multinational observational study (GRACE)". BMJ. 333 (7578): 1091. doi:10.1136/bmj.38985.646481.55. PMC 1661748  . PMID 17032691.
Jump up ^ Pell JP, Haw S, Cobbe S, et al. (2008). "Smoke-free Legislation and Hospitalizations for Acute Coronary Syndrome". New England Journal of Medicine. 359 (5): 482–91. doi:10.1056/NEJMsa0706740. PMID 18669427.
^ Jump up to: a b O'Connor RE, Brady W, Brooks SC, et al. (November 2010). "Part 10: acute coronary syndromes: 2010 American Heart Association Guidelines for Cardiopulmonary Resuscitation and Emergency Cardiovascular Care". Circulation. 122 (18 Suppl 3): S787–817. doi:10.1161/CIRCULATIONAHA.110.971028. PMID 20956226.
Jump up ^ Neumar, RW; Shuster, M; Callaway, CW; Gent, LM; Atkins, DL; Bhanji, F; Brooks, SC; de Caen, AR; Donnino, MW; Ferrer, JM; Kleinman, ME; Kronick, SL; Lavonas, EJ; Link, MS; Mancini, ME; Morrison, LJ; O'Connor, RE; Samson, RA; Schexnayder, SM; Singletary, EM; Sinz, EH; Travers, AH; Wyckoff, MH; Hazinski, MF (3 November 2015). "Part 1: Executive Summary: 2015 American Heart Association Guidelines Update for Cardiopulmonary Resuscitation and Emergency Cardiovascular Care". Circulation. 132 (18 Suppl 2): S315–67. doi:10.1161/cir.0000000000000252. PMID 26472989.
Jump up ^ Blankenship JC, Skelding KA (2008). "Rapid Triage, Transfer, and Treatment with Percutaneous Coronary Intervention for Patients with ST-Segment Elevation Myocardial Infarction". Acute Coronary Syndromes. 9 (2): 59–65. Archived from the original on 2011-07-15.
Jump up ^ Janda, SP; Tan, N (2009). "Thrombolysis versus primary percutaneous coronary intervention for ST elevation myocardial infarctions at Chilliwack General Hospital". The Canadian journal of cardiology. 25 (11): e382–4. doi:10.1016/S0828-282X(09)70165-5. PMC 2776568  . PMID 19898701.
Jump up ^ Bundhun, PK; Shaik, M; Yuan, J (8 May 2017). "Choosing between Enoxaparin and Fondaparinux for the management of patients with acute coronary syndrome: A systematic review and meta-analysis". BMC Cardiovascular Disorders. 17 (1): 116. doi:10.1186/s12872-017-0552-z. PMC 5422952  . PMID 28482804.
Jump up ^ Montalescot G, Cayla G, Collet JP, Elhadad S, Beygui F, Le Breton H, et al. (2009). "Immediate vs delayed intervention for acute coronary syndromes: a randomized clinical trial". JAMA. 302 (9): 947–54. doi:10.1001/jama.2009.1267. PMID 19724041.
Jump up ^ Vale, N; Nordmann, AJ; Schwartz, GG; de Lemos, J; Colivicchi, F; den Hartog, F; Ostadal, P; Macin, SM; Liem, AH; Mills, EJ; Bhatnagar, N; Bucher, HC; Briel, M (Sep 1, 2014). "Statins for acute coronary syndrome". The Cochrane Database of Systematic Reviews. 9: CD006870. doi:10.1002/14651858.CD006870.pub3. PMID 25178118.
Jump up ^ Cox, D. A.; Stone, G. W.; Grines, C. L.; Stuckey, T.; Zimetbaum, P. J.; Tcheng, J. E.; Turco, M.; Garcia, E.; Guagliumi, G.; Iwaoka, R. S.; Mehran, R.; O'Neill, W. W.; Lansky, A. J.; Griffin, J. J.; Cadillac, I. (2006). "Comparative Early and Late Outcomes After Primary Percutaneous Coronary Intervention in ST-Segment Elevation and Non–ST-Segment Elevation Acute Myocardial Infarction (from the CADILLAC Trial)". The American Journal of Cardiology. 98 (3): 331–337. doi:10.1016/j.amjcard.2006.01.102. PMID 16860018.
Jump up ^ McCord J, Jneid H, Hollander JE, et al. (April 2008). "Management of cocaine-associated chest pain and myocardial infarction: a scientific statement from the American Heart Association Acute Cardiac Care Committee of the Council on Clinical Cardiology". Circulation. 117 (14): 1897–907. doi:10.1161/CIRCULATIONAHA.107.188950. PMID 18347214.
Jump up ^ Antman EM, Cohen M, Bernink PJ, et al. (2000). "The TIMI risk score for unstable angina/non-ST elevation MI: A method for prognostication and therapeutic decision making". JAMA. 284 (7): 835–42. doi:10.1001/jama.284.7.835. PMID 10938172.
Jump up ^ Pollack CV, Sites FD, Shofer FS, Sease KL, Hollander JE (2006). "Application of the TIMI risk score for unstable angina and non-ST elevation acute coronary syndrome to an unselected emergency department chest pain population". Academic Emergency Medicine. 13 (1): 13–8. doi:10.1197/j.aem.2005.06.031. PMID 16365321.
Jump up ^ Chase M, Robey JL, Zogby KE, Sease KL, Shofer FS, Hollander JE (2006). "Prospective validation of the Thrombolysis in Myocardial Infarction Risk Score in the emergency department chest pain population". Annals of Emergency Medicine. 48 (3): 252–9. doi:10.1016/j.annemergmed.2006.01.032. PMID 16934646.
^ Jump up to: a b Killip, Thomas; Kimball, John T. (1967). "Treatment of myocardial infarction in a coronary care unit". The American Journal of Cardiology. 20 (4): 457–464. doi:10.1016/0002-9149(67)90023-9.
Jump up ^ Khoshchehreh M, Groves EM, Tehrani D, Amin A, Patel PM, Malik S (2016). "Changes in mortality on weekend versus weekday admissions for Acute Coronary Syndrome in the United States over the past decade". Int J Cardiol. 210: 164–172. doi:10.1016/j.ijcard.2016.02.087. PMC 4801736  . PMID 26950171.
Jump up ^ Kostis W.J.; Demissie K.; Marcella S.W.; Shao Y.-H.; Wilson A.C.; Moreyra A.E. (2007). "Weekend versus weekday admission and mortality from myocardial infarction". N Engl J Med. 356: 1099–1109. doi:10.1056/nejmoa063355. PMID 17360988.
External links[edit]
Classification
V · T · D
ICD-10: I24.9
MeSH: D054058
External resources
eMedicine: emerg/31
Patient UK: Acute coronary syndrome

TIMI Study Group
[show]
v
t
e
Cardiovascular disease (heart) (I00–I52, 390–429)
Ischaemic
Coronary disease
Coronary artery disease (CAD)
Coronary artery aneurysm
Spontaneous coronary artery dissection (SCAD)
Coronary thrombosis
Coronary vasospasm
Myocardial bridge
Active ischemia
Angina pectoris
Prinzmetal's angina
Stable angina
Acute coronary syndrome
Myocardial infarction
Unstable angina
Sequelae
hours
Hibernating myocardium
Myocardial stunning
days
Myocardial rupture
weeks
Aneurysm of heart / Ventricular aneurysm
Dressler syndrome
Layers
Pericardium
Pericarditis
Acute
Chronic / Constrictive
Pericardial effusion
Cardiac tamponade
Hemopericardium
Myocardium
Myocarditis
Chagas disease
Cardiomyopathy
Dilated
Alcoholic
Hypertrophic
Restrictive
Loeffler endocarditis
Cardiac amyloidosis
Endocardial fibroelastosis
Arrhythmogenic right ventricular dysplasia
Endocardium /
valves
Endocarditis
infective endocarditis
Subacute bacterial endocarditis
non-infective endocarditis
Libman–Sacks endocarditis
Nonbacterial thrombotic endocarditis
Valves
mitral
regurgitation
prolapse
stenosis
aortic
stenosis
insufficiency
tricuspid
stenosis
insufficiency
pulmonary
stenosis
insufficiency
Conduction /
arrhythmia
Bradycardia
Sinus bradycardia
Sick sinus syndrome
Heart block: Sinoatrial
AV
1°
2°
3°
Intraventricular
Bundle branch block
Right
Left
Left anterior fascicle
Left posterior fascicle
Bifascicular
Trifascicular
Adams–Stokes syndrome
Tachycardia
(paroxysmal and sinus)
Supraventricular
Atrial
Multifocal
Junctional
AV nodal reentrant
Junctional ectopic
Ventricular
Accelerated idioventricular rhythm
Catecholaminergic polymorphic
Torsades de pointes
Premature contraction
Atrial
Junctional
Ventricular
Pre-excitation syndrome
Lown–Ganong–Levine
Wolff–Parkinson–White
Flutter / fibrillation
Atrial flutter
Ventricular flutter
Atrial fibrillation
Familial
Ventricular fibrillation
Pacemaker
Ectopic pacemaker / Ectopic beat
Multifocal atrial tachycardia
Pacemaker syndrome
Parasystole
Wandering pacemaker
Long QT syndrome
Andersen–Tawil
Jervell and Lange-Nielsen
Romano–Ward
Cardiac arrest
Sudden cardiac death
Asystole
Pulseless electrical activity
Sinoatrial arrest
Other / ungrouped
hexaxial reference system
Right axis deviation
Left axis deviation
QT
Short QT syndrome
T
T wave alternans
ST
Osborn wave
ST elevation
ST depression
Strain pattern
Cardiomegaly
Ventricular hypertrophy
Left
Right / Cor pulmonale
Atrial enlargement
Left
Right
Other
Cardiac fibrosis
Heart failure
Diastolic heart failure
Cardiac asthma
Rheumatic fever
Retrieved from "https://en.wikipedia.org/w/index.php?title=Acute_coronary_syndrome&oldid=835106866"
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text:
90 Day Fiancé
From Wikipedia, the free encyclopedia
Jump to: navigation, search
90 Day Fiancé
Genre
Reality television
Country of origin
United States
Original language(s)
English
No. of seasons
5
No. of episodes
57
Production
Running time
42 minutes[1]
Release
Original network
TLC
Original release
January 12, 2014 (2014-01-12) – present (present)
Chronology
Followed by
90 Day Fiancé: Happily Ever After?
External links
tlc.com
www.tlc.com/tv-shows/90-day-fiance/
90 Day Fiancé is an American documentary series on TLC that debuted January 12, 2014.[2] The series follows couples who have 90 days to decide to marry before their 90-day K-1 visas (available uniquely to foreign fiancés of American citizens) expire. First the petitioner must meet the beneficiary inside or outside the USA and then file a I-129F petition with evidence of meeting and of a relationship. After the petition is approved, the petitioner must pass biometrics and then the process is sent to the foreign embassy of the beneficiary. The beneficiary then files for a visa, before or after passing the medical requirements and is called for an interview. The beneficiary must prove that they meet the requirements of the visa including strong evidence of meeting and a valid relationship. The foreign fiancé travels to the States to live with his or her prospective American spouse. The couples must marry within 90 days, or leave the country. The couples may face language barriers, culture shock, the stigma of being thought of as a "mail order bride" as well as skepticism of friends and family.
Contents
[hide]
1 Season 1 Cast
1.1 Russ & Pao
1.2 Alan & Kirlyam
1.3 Louis & Aya
1.4 Mike & Aziza
2 Season 2 cast
2.1 Chelsea & Yamir
2.2 Danielle & Mohamed
2.3 Justin & Evelin
2.4 Brett & Daya
2.5 Jason & Cássia
2.6 Danny & Amy
3 Season 3 Cast
3.1 Mark & Nikki
3.2 Loren & Alexei
3.3 Kyle & Noon
3.4 Melanie & Devar
3.5 Fernando & Carolina
3.6 Josh & Aleksandra
4 Season 4 Cast
4.1 Jorge & Anfisa
4.2 Nicole & Azan
4.3 Narkyia & Olulowo
4.4 Matt & Alla
4.5 Chantel & Pedro
5 Season 5 Cast
5.1 Elizabeth & Andrei
5.2 Evelyn & David
5.3 Molly & Luis
5.4 David & Annie
5.5 Josh & Aika
6 Episodes
6.1 Series overview
6.2 Season 1 (2014)
6.3 Season 2 (2014)
6.4 Season 3 (2015)
6.5 Season 4 (2016)
6.6 Season 5 (2017)
7 Spin-offs
7.1 90 Day Fiancé: Happily Ever After?
7.1.1 Season 1
7.1.2 Season 2
7.2 90 Day Fiancé: Before the 90 Days
7.3 90 Day Fiancé: What Now?
8 References
Season 1 Cast[edit]
Russ & Pao[edit]
Russ Mayfield, 27, of Owasso, Oklahoma, met Paola aka Pao, 26, of Bucaramanga, Colombia, while he was in Colombia on a work assignment. She moved to America, and the two were married. They moved to Tulsa, Oklahoma. Russ is a graduate of Oklahoma State University and works as a field engineer. Pao was a fashion designer in Colombia. Since moving to America, she has started modeling and is a personal trainer.
As of the airing of "90 Day Fiancé: Happily Ever After?", Russ and Pao are still married, but they live in different cities with Pao working as a model/personal trainer in Miami. Eventually, Russ moves to Miami, but is concerned about Pao's revealing outfits during her modeling jobs.
As of 2017, they are still together. Paola advanced to the second round of the 2017 Maxim's Finest competition, but was eventually eliminated.
Alan & Kirlyam[edit]
Alan Cox, 29, of Los Angeles, California, met Kirlyam, 21, of Goiânia, Brazil, while he was on a Mormon mission to her hometown. She moved to America to live with him, although the two were virgins at the time of their wedding. She tried modeling, but Alan was jealous of the attention that she was getting. They were married in a Mormon temple, and although Kirlyam's family was unable to attend, they watched a livestream of the event from Brazil. The couple honeymooned in Hawaii.
As of the season 2 update, Kirlyam is waiting for her green card so that she can find employment. Alan is employed by Breen Engineering as a project lead/photo simulation specialist.
As of 2017, they are still together and Kirlyam gave birth to the couple's first child, a boy they have named Liam.
Louis & Aya[edit]
Louis Gattone 37, of Indianapolis, Indiana, met Aya, 33, of Ormoc City, Philippines, on an international dating website. Aya wanted Louis to move to the Philippines, but they decided to live in America because he has two young sons. They were married in a Catholic church. Louis is taking classes and is almost done with his degree. Aya is working as well and they’ll be buying a house shortly. The boys live with them now and they plan on having a child or children of their own.
The couple decided not to participate in the season 2 update.
As of 2017, the couple are still together.
Mike & Aziza[edit]
Mike Eloshway, 31, of Cleveland, Ohio, and Aziza, 21, of Volgograd, Russia, met on a language learning website. Their relationship was initially platonic. Sometime after Aziza's application for a work visa was denied, their relationship turned romantic. In the Summer of 2014 she arrived to America to live with Mike. They were married although Aziza was very saddened because her family was unable to attend the wedding. Mike is employed as a technical support specialist for the Cleveland Municipal Court. Mike wants to have children right away, while Aziza does not.
As of the season 2 update, Aziza found employment at an optics lab. The couple traveled to Russia where Mike finally met Aziza's parents.
As of 2017, they are still together.
Season 2 cast[edit]
Chelsea & Yamir[edit]
Yamir, 28, of Managua, Nicaragua, and Chelsea, 25, of Galesburg, Illinois, met while she was doing volunteer work in Nicaragua. Yamir was a member of a Nicaraguan boy band. He moved to the United States to live with Chelsea and her parents. This caused a large rift between him and his manager and bandmates. Chelsea’s parents are very supportive of the relationship. Yamir sends some demo tapes to a few music producers in Chicago and receives a reply. He travels to Chicago to meet with producers. The producers say that he needs to move to Chicago to have better opportunities. Unfortunately, Chelsea is resistant to the idea because neither is employed and they can live for free with her parents in Galesburg. The two are married with Yamir’s family also in attendance.
On the season 3 update, Yamir and Chelsea were still married. Yamir made his music debut in the U.S. with Chelsea playing his love interest in the music video, "Party Love". Chelsea found employment as an elementary school teacher.
Yamir and Chelsea filed for divorce in 2017 and Yamir is still living in Chicago, working on his music.
Danielle & Mohamed[edit]
Mohamed Jbali, 26, of Tunis, Tunisia, met Danielle Mullins, 41, of Norwalk, Ohio, in an online chat room. The two were engaged, and Mohammed moved to America.
She had three teenage daughters and one adult son from previous relationships. Mohammed claimed to have a job, but Danielle discovered that he lied about that. Mohamed also found out that Danielle had lied about aspects of her private life including passing a bad checks and using someone else's credit card fraudulently. Shortly after the wedding, Mohamed left Danielle. He went to Florida with a female friend, and Danielle found out about this and consulted a lawyer. She filed for an annulment which if granted would mean that the marriage never took place and Mohamed would therefore be deported back to Tunisia. Mohamed pressured her to change the filing, and she removed the annulment but refused to yet file for divorce.
As of 2017, they are officially divorced, and in October 2017 Mohamed moved to Texas. Danielle is still trying to get Mohamed deported, despite pleas from fellow cast members and fans to "let it go."
Justin & Evelin[edit]
Justin, 34, of San Jose, California, and Evelin, 29, of Santiago de Cali, Colombia, met while they were both attending a rugby match at the 2013 World Games in Colombia. Justin works as a physical education teacher at an elementary school. In Colombia, Evelin worked as a dance instructor. Since moving to America, Evelin has changed the spelling of her name to Evelyn. The couple elected not to participate in the season 3 update.
As of 2017, they are still together.
Brett & Daya[edit]
Brett Otto, 31, of Snohomish, Washington, and Daya De Arce, 29, of San Carlos City, Philippines met on an international dating website. Brett is divorced and has a 6-year-old daughter from his first marriage. His daughter lives with her mother in Montana. Brett works in tool services for Boeing, and Daya found a job in the United States. He had two roommates, but they moved out once Daya arrived. Brett and Daya were married on February 14, 2015. Brett's mother chose not to attend the wedding. The couple elected not to participate in the season 3 update, but later participated in 90 Day Fiance: Happily Ever After?
As of 2017, they are still married and they have a daughter together named Isabella.
Jason & Cássia[edit]
Jason Hitch, 38, of Spring Hill, Florida, and Cássia Tavares, 23, of Curitiba, Brazil met through Facebook while Cássia was in an online relationship with Jason's friend. Once that relationship ended, Jason and Cássia began dating. Cássia came to America and moved in with Jason and his father who share a house. Jason is originally from Champaign, Illinois, and is an Army veteran. He lives very frugally. He buys items from garage sales, auctions, estate sales, etc. and sells them online for a profit. They started a mail order snack business called Gifting Fun.
As of 2017, they are separated.
Danny & Amy[edit]
Danny Frishmuth, 23, of Norristown, Pennsylvania, and Amy, 21, of Cape Town, South Africa met in Australia while the two were on a Bible study trip. They fell in love and got engaged. When Amy arrived in America, she lived with Danny's brother because she and Danny wanted to be virgins when they wed. Danny works in home construction for X-Treme Works in Malvern, Pennsylvania. Danny's father initially objected to the marriage because Danny is white and Amy is black, but he eventually accepted her into the family.
As of 2017, they are still together and are now living in Texas. They have one son, Jedidiah John Frishmuth and a daughter Anna Elise Frishmuth.
Season 3 Cast[edit]
Mark & Nikki[edit]
Mark, 58, of Baltimore, Maryland, and Nikki, 19, of Cebu, Philippines, met on an online dating site. Mark owns a piano rental business. He has four adult children from that marriage who are all older than Nikki. He and his first wife's relationship ended when the children were very young, and Mark was left to raise the children. Mark's first wife and Nikki are from Cebu, Philippines. After meeting on an online dating site, Mark went to the Philippines to meet Nikki and shortly after meeting he proposed to her with a zip tie in the shape of a ring. When Nikki came to Maryland Mark surprised her with a car and taught her how to drive. When Mark told Nikki that the car was the same make and model as the car that he put a deposit on for his first wife, Nikki was confused as she thought it was the very exact same car. Mark's daughter, Elise, felt uncomfortable with the relationship because she is a year older than Nikki. Elise shared her discomfort when Mark wanted to give Nikki clothes that she had previously discarded.
As of 2017, their relationship status is unknown.
Loren & Alexei[edit]
Alexei Brovarnik, 27, of Nazareth Illit, Israel, and Loren, 27, of New York City, met while she was on a Jewish Birthright trip to Israel. He was a medic for her group during the trip. Loren was employed as an executive assistant while in New York, but she left her job and moved to Parkland, Florida to live with her parents as she wouldn't be able to afford to support Alexei during the time that he could not legally work. She is a graduate of the University of North Florida.
Alexei and Loren got married in Israel too, surrounded by Alexei's family and friends and Loren's parents. At a meeting with Alexei's parents, Loren's parents misinformed them about Tourette's syndrome that Loren has. Later on Alexei confronts Loren and her parents why he was not informed that her illness can be genetic and affect their future children.
Alexei's mom later travels to Florida exploring avenues to move the whole family from Israel to the US.
The couple resides in Fort Lauderdale, Florida.
As of 2017, they are still together.
Kyle & Noon[edit]
Kyle Huckabee, 28, of New Orleans, Louisiana, and Bajaree Boonma aka Noon, 25, of Bangkok, Thailand, met online through Facebook while he was doing research for a trip to Thailand. The two met in person while he was there on vacation. They were engaged and Noon came to America even though Kyle hadn't officially proposed. They initially lived in Kyle's bachelor apartment with his roommate, but the situation was less than ideal. Kyle started working extra shifts at his job as a bartender on Bourbon Street so that they could afford an apartment of their own. Kyle proposed during a sky-diving trip, and they moved into a new apartment.
Before he met Noon, he was estranged from his parents who are divorced. With Noon's support, he has restated the relationship with his mother. The two were married in a Buddhist temple, but unfortunately, Noon's family was unable to attend the ceremony. Kyle’s mom chose not to attend.
As of 2017, they are still together.
Melanie & Devar[edit]
Devar Walters, 28, of Runaway Bay, Jamaica, and Melanie Bowers, 33, Orwigsburg, Pennsylvania, met while Melanie was on vacation at a Jamaican resort where Devar was employed as a lifeguard. Melanie is a registered nurse. She has custody of her 11-year-old son Hunter on weekends. She was married to his father for 5 years before the marriage ended in divorce when she was 26. Devar proposed to Melanie while she was still vacationing, and she accepted.
Back in Pennsylvania, Melanie’s sister, Bev, is extremely concerned and does not trust Devar. The couple hits a rough patch when Devar mentions sending back most of the money he earns to his family in Jamaica; Melanie ponders out loud that she will look into a prenup.
As of 2017, they are still together and the couple now has a little girl named Avah who was delivered in November of 2017.
Fernando & Carolina[edit]
Fernando, 39, of Doral, Florida, and Carolina, 22, of Medellín, Colombia, met in Colombia while both on dates with other people. The two were engaged before he returned to America. She moved to Florida to live with him.
After his marriage ended, he invited his parents to share his house. They were able to move past this issue and were married.
A re-cap a few months later reveals the couple has happily settled in together, though Carolina admits she calls her mom several times a day and misses her cat (unfortunately Fernando is allergic to cats).
As of 2017, they are still together.
Josh & Aleksandra[edit]
Josh Strobel, 22, of Rexburg, Idaho, and Aleksandra Iarovikova, 21, of Kirov, Russia, met in Prague, Czech Republic, while Josh was on a Mormon mission and Aleksandra was attending Metropolitan University Prague. Initially an atheist, Aleksandra converted to Mormonism and Josh played a role in this. Before converting, she was also employed as a go-go dancer at a club and loved drinking and partying.[3]
The couple kept in touch after Josh's mission and began dating. Josh visited Russia and proposed in 2015.[3]
Josh and Aleksandra were married in August 2015, soon after Aleksandra's arrival to the US from Prague where she had to finalize her semester in June. A re-cap a few months later reveals that the couple were then expecting their first child. They had a biracial daughter named Kaya in March 2016. Aleksandra claimed that her own biological father is Black, and that is why her daughter is biracial.
Josh graduated with BS from Creighton University in 2016, but was not accepted to a medical school that year and started working for his father.
As of 2017, they are still together.
Season 4 Cast[edit]
Jorge & Anfisa[edit]
Anfisa Arkhipchenko, 20, Moscow, Russia, was contacted by Jorge Nava, 27, Riverside, California, via Facebook after he stumbled onto her photos. Though Anfisa was at first resistant to his messages (Jorge claims he "fell in love" with her just by viewing her noticeably sexy photos). Anfisa eventually agreed to meet him and Jorge ends up taking her on an expensive vacation around Europe. Shortly before Anfisa was scheduled to come to the United States, she asked Jorge for an expensive handbag, which Jorge declined to buy for her. Anfisa managed to wipe Jorge's cellphone and cancel the flights, though the two reconciled and eventually Anfisa agrees to travel to the U.S. Jorge is a convicted felon, having pleaded guilty to drug trafficking, which makes it hard for him to rent an apartment.
Anfisa is less than impressed at their living arrangements - a hotel - though why exactly Jorge does not have his own place to live has not been revealed. They live in a hotel, and later at a small rental apartment. Jorge fails to buy an engagement ring or wedding dress for Anfisa. Jorge's friends and family are concerned about Anfisa's motives.
At a restaurant, Anfisa admits that she is indeed interested in Jorge providing for her, and she also believes that he is primarily interested in her for her looks and would not want to marry her if she was ugly. At some point, Anfisa was considering going back to Russia, and Jorge considered for a while that he would not try to stop her. Later on, they get married alone in a simple courthouse ceremony, after which Jorge promises to buy the ring to Anfisa and to have a bigger ceremony later on so that her family could attend.
Later on it is shown how Jorge's sister confronting Anfisa at a restaurant about her demands. They still live in a small apartment, he still did not buy her a ring, she does not have a car. They eventually got married but had a courthouse wedding as of 2017 Anfisa and Jorge are still married.
Nicole & Azan[edit]
Nicole, 21, Bradenton, Florida, and Azan, 23, Morocco, met via an app that allows users to connect with people all over the world. After hitting it off, though somewhat against her parents wishes, Nicole decides to stay with him for five weeks, leaving her toddler-aged daughter May with her sister. Upon meeting Nicole at the airport, Azan remarks that she is "big...a little bit" but concedes that he is happy. Nicole is thrilled to be in Morocco with Azan (later calling him her "Arabian Prince"), though he has a hard time persuading her that in his culture it is not acceptable for unmarried couples to be physically affectionate. Nicole persists in trying to hug and kiss Azan, which only causes him to become irritated. Nicole, meanwhile, feels shunned and unsure of their relationship.
Azan takes Nicole to his hometown to visit his family; she is warmly welcomed and we learn that his mother especially is thrilled with Azan's girlfriend. Unfortunately, Nicole later reveals that she cheated on Azan, something that could end the relationship should his family find out.
Azan takes Nicole to the desert and proposes, and she accepts. However, she continues to chafe at the customs of the Muslim culture. She refuses to convert to Islam and he refuses to convert to Christianity.
Their wedding is delayed indefinitely due to Nicole not being able to yet afford to fund the government sponsorship requirements for Azan's staying in the U.S, and her Mom refusing to co sponsor the effort. Nicole believes it will take two years minimum and hopes Azan will wait that long. In addition, Nicole was supposed to be following a strict diet, and Azan became irritated when he caught her hoarding mini-donuts and Little Debbie oatmeal creme pies. Their future is unsure, but as of today they are still together, but continuing to live in separate countries. In late-2017, Nicole's father agreed to sponsor Azan.
Narkyia & Olulowo[edit]
Olulowo is currently in Nigeria and used to be in Vietnam. He is trying to meet Narkyia but various obstacles keep popping up. Narkyia and her friends and family are skeptical of him and are wary of a romance scam, but he has not asked for any money and Narkyia is still willing to see where it goes.
They broke up though since Olulowo had been lying to Narkyia about still having been contacting and pursuing a relationship with a woman he had previously had a baby with in the early stages of his relationship with Narkyia. They got back together though and as of 2017 are a couple living in America.
Matt & Alla[edit]
Matt, 42, Williamstown, Kentucky, and Alla, 30, Kiev, Ukraine, met several years ago using an online dating site but lost touch after Matt married his third wife. A few years and a divorce later, Matt and Alla reconnect. Alla, also a divorcee, has a 7-year-old son named Max. The reserved Alla is easily overwhelmed by Matt's friends and family while Matt continues to deal with lingering issues caused by his previous wives (he claims his first and third wife cheated on him). Alla dreams of a wedding on the beach but Matt's family tries to persuade her to scale back her plans. When Alla opens up that she does not love Matt yet, his friends are very concerned. However, the couple marry. They are later shown looking for a new house, closer to city and Matt's family.
As of 2017 they are still together.
Chantel & Pedro[edit]
Chantel met Pedro while on a trip to the Dominican Republic, while she was trying to learn Spanish. Chantel would frequently go back to the DR to visit him, and on one of those trips he proposed to her. Because Chantel was worried that her family would think that Pedro was only going after a green card to enter the U.S, Chantel told her parents that he was in America on a student visa. Eventually Chantel and Pedro marry in the US. However, Chantel and Pedro are planning to get married in the Dominican Republic as well, but Pedro doesn't think her family will want to go. They go to the Dominican Republic, but then have some explosive fights and arguments between the family members, as it seems that Pedro's family is using the fact that he is living in the US now and can send them money. Chantel's family is upset because of the obvious improvement of Pedro's family living, while Chantel and Pedro in the US have very modest living. Pedro's family offers Chantel's family chicken feet that is taken as a sign of disrespect, especially considering that they themselves don't eat chicken feet. The marriage did eventually take place. The couple currently resides in Georgia.
Season 5 Cast[edit]
Elizabeth & Andrei[edit]
Elizabeth, 27, Tampa, Florida, met Andrei, 31, Chisinau, Moldova, while visiting Dublin.[4]
Evelyn & David[edit]
Molly & Luis[edit]
Molly, 41, Woodstock, Georgia, met Luis at the bar he worked at while she was on a trip with friends to the Dominican Republic.[5]
David & Annie[edit]
David, 48, Louisville, Kentucky, met Annie, 24, Bueng Kan, at a bar while living overseas in Thailand.[6]
Josh & Aika[edit]
Episodes[edit]
Series overview[edit]
Season
Episodes
Originally aired
First aired
Last aired
1 6 January 12, 2014 (2014-01-12) February 23, 2014 (2014-02-23)
2 12 October 19, 2014 (2014-10-19) December 28, 2014 (2014-12-28)
3 12 October 11, 2015 (2015-10-11) December 6, 2015 (2015-12-06)
4 14 September 11, 2016 (2016-09-11) November 20, 2016 (2016-11-20)
5 13 October 8, 2017 (2017-10-08) December 18, 2017 (2017-12-18)
Season 1 (2014)[edit]
No.
overall
No. in
season
Title
Directed by
Original air date
1
1 "I Got My Visa!" Jessica Hernandez January 12, 2014 (2014-01-12)
Four women come to the US to live with their American fiances using a unique 90 day K-1 visa. The couples have 90 days to wed before the visas expire.
2
2 "Culture Shock" Jessica Hernandez January 19, 2014 (2014-01-19)
Paola has to adapt to living with Russ' parents and her wild ways leads to collisions with Russ's friends. Kirlyam misses her parents. Aziza meets Mike's skeptical family. Louis prepares his sons and ex-wife for Aya.
3
3 "Enough Is Enough" Jessica Hernandez January 26, 2014 (2014-01-26)
Paola and Russ move into their new apartment. Aya meets Louis' ex-wife and sons. Kirlyam goes to a salon where she is been referred to a modeling agency. Aziza and Mike hit a milestone in their relationship.
4
4 "90 Days Isn't Enough" Jessica Hernandez & Kevin Rhoades February 9, 2014 (2014-02-09)
Russ takes Paola to a tailgate but their wedding plans are jeopardized. Alan is concerned when Kirlyam gets a modelling opportunity. Aziza is confronted by Mike's Mom at her bachelorette party. Aya gets upset as Louis cuts corners on their wedding.
5
5 "Didn't Expect This..." Jessica Hernandez & Kevin Rhoades February 16, 2014 (2014-02-16)
Aziza upsets Mike when he went missing after his bachelor party. Kirlyam and Alan rush their wedding. Paola shops for a wedding dress but Russ might be called back to work. Aya cannot have the wedding of her dreams because of a limited budget.
6
6 "Time's Up" Jessica Hernandez & Kevin Rhoades February 23, 2014 (2014-02-23)
Paola has her bachelorette party but is unsure if her wedding will take place. Aziza gets nervous before her wedding. Kirylam and Alan are both virgins at their wedding night. Louis has Aya doubt as he arrives late for filing in this his wedding.
Season 2 (2014)[edit]
No.
overall
No. in
season
Title
Original air date
7
1 "Where Are They Now? Season 1 Couples" October 19, 2014 (2014-10-19)
8
2 "New Couples, New Journeys" October 19, 2014 (2014-10-19)
9
3 "I'm Home, America!" October 26, 2014 (2014-10-26)
10
4 "Watch You Like a Hawk" November 2, 2014 (2014-11-02)
11
5 "Touchdown!" November 10, 2014 (2014-11-10)
12
6 "Mo' Money, Mo' Problems" November 17, 2014 (2014-11-17)
13
7 "Fears, Family, Future" November 23, 2014 (2014-11-23)
14
8 "I Have to Tell You Something" November 30, 2014 (2014-11-30)
15
9 "Going Once, Going Twice...Gone?" December 7, 2014 (2014-12-07)
16
10 "Red Flags" December 14, 2014 (2014-12-14)
17
11 "I'm Gonna Go Home" December 21, 2014 (2014-12-21)
18
12 "The Couples Tell All" December 28, 2014 (2014-12-28)
Season 3 (2015)[edit]
No.
overall
No. in
season
Title
Original air date
19
1 "Where Are They Now? Season 2 Couples" October 11, 2015 (2015-10-11)
20
2 "Departures and Arrivals" October 11, 2015 (2015-10-11)
21
3 "Welcome to the Family" October 18, 2015 (2015-10-18)
22
4 "Questions & Answers" October 25, 2015 (2015-10-25)
23
5 "Full of Surprises" November 1, 2015 (2015-11-01)
24
6 "Missing Home" November 8, 2015 (2015-11-08)
25
7 "Lights, Camera, Drama" November 15, 2015 (2015-11-15)
26
8 "Don't Push Me" November 22, 2015 (2015-11-22)
27
9 "Bachelorette Blues" November 29, 2015 (2015-11-29)
28
10 "What Do You Know About Love?" November 29, 2015 (2015-11-29)
29
11 "This Is It" December 6, 2015 (2015-12-06)
30
12 "Season 3 Tell All" December 6, 2015 (2015-12-06)
Season 4 (2016)[edit]
No.
overall
No. in
season
Title
Original air date
31
1 "For Your Eyes Only" August 22, 2016 (2016-08-22)
32
2 "You Say Goodbye, I Say Hello" September 11, 2016 (2016-09-11)
33
3 "Meet the Family" September 18, 2016 (2016-09-18)
34
4 "Life's a Beach" September 25, 2016 (2016-09-25)
35
5 "Testing the Waters" October 2, 2016 (2016-10-02)
36
6 "I Can See the Cracks" October 9, 2016 (2016-10-09)
37
7 "Time to Tell the Truth" October 16, 2016 (2016-10-16)
38
8 "This Is What You Came For" October 23, 2016 (2016-10-23)
39
9 "You're Gonna Miss Me When I'm Gone" October 30, 2016 (2016-10-30)
40
10 "Confessions of a Foreign Fiancé" November 6, 2016 (2016-11-06)
41
11 "Are You Ready for This?" November 13, 2016 (2016-11-13)
42
12 "Too Little Too Late" November 13, 2016 (2016-11-13)
43
13 "Speak Now or Forever Hold Your Peace" November 20, 2016 (2016-11-20)
44
14 "Season 4 Tell All" November 20, 2016 (2016-11-20)
Season 5 (2017)[edit]
No.
overall
No. in
season
Title
Original air date
45
1 "Waiting Is The Hardest Part" October 8, 2017 (2017-10-08)
46
2 "Parental Approval" October 15, 2017 (2017-10-15)
47
3 "Bring on the 90 Days" October 22, 2017 (2017-10-22)
48
4 "Good Morning America" October 29, 2017 (2017-10-29)
49
5 "Family First" November 5, 2017 (2017-11-05)
50
6 "Crossing the Line" November 12, 2017 (2017-11-12)
51
7 "Welcome to Real Life" November 19, 2017 (2017-11-19)
52
8 "Out of Nowhere" November 26, 2017 (2017-11-26)
53
9 "Wake Up Call" December 3, 2017 (2017-12-03)
54
10 "Breaking Point" December 10, 2017 (2017-12-10)
55
11 "Second Thoughts" December 17, 2017 (2017-12-17)
56
12 "I Now Pronounce You" December 18, 2017 (2017-12-18)
57
13 "Season 5: Tell All" December 18, 2017 (2017-12-18)
Spin-offs[edit]
90 Day Fiancé: Happily Ever After?[edit]
90 Day Fiancé: Happily Ever After? is an American documentary series (Docu-Series) on TLC and a spin-off of 90 Day Fiancé. The series follows six couples from previous seasons and documents the ups and downs of their relationships post-marriage.
90 Day Fiancé: Happily Ever After? Couples
Couples
Original Season
Seasons
Season 1 (2016)
Season 2 (2017)
Russ & Paola
Season 1
Main
Danielle & Mohamed
Season 2
Main
Brett & Daya
Main
Melanie & Devar
Season 3
Main
Kyle & Noon
Main
Loren & Alexei
Main
Jorge & Anfisa
Season 4
Main
Chantel & Pedro
Main
Season 1[edit]
Returning couples included Season 1's Russ & Paola; Season 2's Danielle & Mohamed and Brett & Daya; and Season 3's Melanie & Devar, Loren & Alexei, and Kyle & Noon. TLC announced the spin-off series in August 2016. The series debuted on September 11, 2016 following the premiere of season 4 of 90 Day Fiancé. The first season ended in November 2016 with a two-part "Tell All" special.
Episodes
No. in
series
No. in
season
Title
Original air date
1
1 "It's Only the Beginning" September 11, 2016 (2016-09-11)
2
2 "It's My Secret to Tell" September 18, 2016 (2016-09-18)
3
3 "Something's Up" September 25, 2016 (2016-09-25)
4
4 "What Don't I Know?" October 2, 2016 (2016-10-02)
5
5 "The Truth Hurts" October 9, 2016 (2016-10-09)
6
6 "Facing the Past" October 16, 2016 (2016-10-16)
7
7 "Destination Impossible" October 23, 2016 (2016-10-23)
8
8 "You Can't Run..." October 30, 2016 (2016-10-30)
9
9 "I Came All This Way" October 30, 2016 (2016-10-30)
10
10 "The Roles Reverse" November 6, 2016 (2016-11-06)
11
11 "The Couples Tell All Part 1" November 6, 2016 (2016-11-06)
12
12 "The Couples Tell All Part 2" November 13, 2016 (2016-11-13)
Season 2[edit]
90 Day Fiancé: Happily Ever After? was renewed for a second season in November 2016.[7] The second season debuted on June 25, 2017, and features 90 Day Fiancé Season 1's Russ & Paola, Season 2's Danielle & Mohamed, Season 3's Loren & Alexei, and Season 4's Jorge & Anfisa and Chantel & Pedro.
No. in
series
No. in
season
Title
Original air date
13
1 "Happy Wife, Happy Life?" June 25, 2017 (2017-06-25)
14
2 "When The Past Catches Up" July 2, 2017 (2017-07-02)
15
3 "We Got Bad Blood" July 9, 2017 (2017-07-09)
16
4 "Family Secrets" July 16, 2017 (2017-07-16)
17
5 "Lost in Translation" July 23, 2017 (2017-07-23)
18
6 "Lies & Goodbyes" July 30, 2017 (2017-07-30)
19
7 "Models, Moms & Meltdowns" August 6, 2017 (2017-08-06)
20
8 "I Do's & I Don'ts" August 13, 2017 (2017-08-13)
21
9 "Where Do We Go From Here?" August 20, 2017 (2017-08-20)
22
10 "The Couples Tell All Part 1" August 27, 2017 (2017-08-27)
23
11 "The Couples Tell All Part 2" September 3, 2017 (2017-09-03)
24
12 "The Couples Tell All Part 3" September 10, 2017 (2017-09-10)
90 Day Fiancé: Before the 90 Days[edit]
In November 2016, TLC announced a second spin-off series titled 90 Day Fiancé: Before the 90 Days.[7][8] The premise follows six couples - Paul and Karine, Darcey and Jesse, Larry and Jenny, Cortney and Antonio, Sean and Abby, and Patrick and Myriam - as they start a relationship before the K-1 Visa process begins. It premiered on August 6, 2017.[9]
Episodes
No. in
series
No. in
season
Title
Original air date
1
1 "Bon Voyage!" August 6, 2017 (2017-08-06)
2
2 "Going the Distance" August 13, 2017 (2017-08-13)
3
3 "Language of Love" August 20, 2017 (2017-08-20)
4
4 "Meet the Parents" August 27, 2017 (2017-08-27)
5
5 "Secrets and Lies" September 3, 2017 (2017-09-03)
6
6 "Decisions, Decisions" September 10, 2017 (2017-09-10)
7
7 "Baby, I'm Worth It" September 17, 2017 (2017-09-17)
8
8 "Moment of Truth" September 24, 2017 (2017-09-24)
9
9 "Red Flags" October 1, 2017 (2017-10-01)
10
10 "Reality Check" October 8, 2017 (2017-10-08)
11
11 "On The Brink" October 15, 2017 (2017-10-15)
12
12 "Line in the Sand" October 22, 2017 (2017-10-22)
13
13 "All or Nothing" October 29, 2017 (2017-10-29)
14
14 "The Couples Tell All" October 30, 2017 (2017-10-30)
90 Day Fiancé: What Now?[edit]
In March 2017, TLC also announced an original digital spin-off series with the title of 90 Day Fiancé: What Now? for TLCgo.[8] The show provides updates on season 1's Kirlyam & Alan, season 3's Aleksandra & Josh and Melanie & Devar, and season 4's Alla & Matt and Narkyia & Olulowo. TLC uploaded all seven episodes online on July 30, 2017. The network combined the segments into TV episodes that aired on September 17 and September 24, 2017 following 90 Day Fiancé: Before the 90 Days.
References[edit]
Jump up ^ 90 Day Fiance - 3 Seasons 2014
Jump up ^ "90 Day Fiancé". imdb.com. Retrieved April 26, 2016.
^ Jump up to: a b "Amazon.com: 90 Day Fiance Season 1: Amazon Digital Services LLC". www.amazon.com.
Jump up ^ https://www.tlc.com/tv-shows/90-day-fiance/full-episodes/waiting-is-the-hardest-part
Jump up ^ https://www.tlc.com/tv-shows/90-day-fiance/full-episodes/waiting-is-the-hardest-part
Jump up ^ https://www.tlc.com/tv-shows/90-day-fiance/full-episodes/waiting-is-the-hardest-part
^ Jump up to: a b Tony Maglio (2016-11-11). "'90 Day Fiance' Gets Season 5 Renewal, Second Spinoff at TLC (Exclusive)". thewrap.com. Retrieved 2017-06-11.
^ Jump up to: a b Staff (2017-03-28). "TLC Announces An Aggressive 2017-2018 Upfront Slate With 120 More Hours Of Original Programming". corporate.discovery.com. Retrieved 2017-06-11.
Jump up ^ Staff (2017-07-18). "Get a Sneak Peek of TLC's New Series '90 Day Fiancé: Before the 90 Days', Meet the Cast". usmagazine.com. Retrieved 2017-07-19.
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