scholarly journals Recurrent acute coronary syndrome due to coronary artery spasm in different coronary arteries

2013 ◽  
Vol 8 (3) ◽  
pp. 95-98
Author(s):  
Saman Rasoul ◽  
Jan-Henk E. Dambrink
Keyword(s):  
Acute Coronary Syndrome ◽  
Coronary Artery ◽  
Coronary Arteries ◽  
Coronary Artery Spasm ◽  
Coronary Syndrome

scholarly journals KOUNIS SYNDROME - ALLERGIC MYOCARDIAL INFARCTION. A CASE REPORT

2019 ◽  
Vol 72 (1) ◽  
pp. 137-141
Author(s):  
Olga Wajtryt ◽  
Tadeusz M Zielonka ◽  
Aleksandra Kaszyńska ◽  
Andrzej Falkowski ◽  
Katarzyna Życińska
Keyword(s):  
Myocardial Infarction ◽  
Acute Coronary Syndrome ◽  
Coronary Artery ◽  
Allergic Reaction ◽  
Anaphylactic Shock ◽  
Coronary Artery Spasm ◽  
Kounis Syndrome ◽  
Permanent Damage ◽  
Coronary Syndrome

Kounis syndrome or allergic myocardial infarction is an acute coronary syndrome in the course of an allergic reaction. In allergic patients in response to a specific condition - nourishment, inhalation, environmental substances, drug or insect bite there is an allergic reaction involving many different cells and mediators that can cause coronary artery spasm or initiate the process of rupture and activation of atherosclerotic plaque resulting in acute coronary syndrome. The paper describes a case of a young man with allergy to pollen and confirmed sensitization to nuts, who developed a full-blown anaphylactic shock after eating the nut mix and experienced a rapidly passing acute coronary syndrome with troponin up to 4.7 μg/L. An increased concentration of tryptase (15 μg/L), total IgE (> 3,000 IU/mL) and specific anti-nut IgE (55.1 kUA/L) were found. Based on the course of the disease and the results of allergic and cardiac tests, allergic type 1 myocardial infarction, i.e. caused by coronary artery spasm, was diagnosed. During the hospitalization, the patient’s condition improved quickly and after a few days he left the hospital without the signs of permanent damage to the heart muscle.

scholarly journals HUBUNGAN KADAR LEUKOSIT DENGAN SEVERITAS LESI PEMBULUH DARAH KORONER PADA PASIEN SINDROM KORONER AKUT DI RSUP. PROF. DR. R. D. KANDOU PERIODE JULI-SEPTEMBER 2015

e-CliniC ◽  
2016 ◽  
Vol 4 (1) ◽  
Author(s):  
Lucky A. Tulung ◽  
A. Lucia Panda ◽  
Starry H. Rampengan
Keyword(s):  
Acute Coronary Syndrome ◽  
Coronary Artery ◽  
Coronary Arteries ◽  
Pearson Correlation ◽  
Gensini Score ◽  
Cross Sectional ◽  
Coronary Syndrome ◽  
Pearson Correlation Test ◽  
Artery Disease ◽  
The Relationship

Abstract: Acute Coronary Syndrome (ACS) is a set of manifestations or symptoms of coronary artery disease and thrombosis which can threaten the patien’s life due to interfering the blood supply of heart muscle. The infarct size is determined by assessing the coronary arteries lesion, stenosis. This study was aimed to determine the relationship between levels of leukocytes and the severity of coronary arteries lesions in patients with ACS. This was a descriptive analytical study with a cross-sectional retrospective design. The modified Gensini score was used to assess the severity of coronary artery lesion. The first leukocyte count examined when the patients was admitted to the hospital was obtained from the medical records period July to September 2015. Data were analyzed by using SPSS 20.0. The Pearson correlation test showed no significant relationship between the levels of leukocytes and the severity of coronary arteries lesions in patients with ACS (p >0.05). Conclusion: There was no significant correlation between the levels of leukocytes and the severity of coronary arteries lesions in patients with ACS.Keywords: leukocyte, severity of lesion, acute coronary syndrome, modified Gensini score Abstrak: Sindrom koroner akut (SKA) merupakan sekumpulan manifestasi atau gejala akibat penyakit arteri koroner dan trombosis yang dapat mengancam kehidupan pasien karena mengganggu pasokan darah ke otot jantung. Penilaian luas infark dilakukan dengan menilai lesi pembuluh darah koroner yang mengalami stenosis. Penelitian ini bertujuan untuk mengetahui hubungan antara kadar leukosit dengan severitas lesi pembuluh darah koroner pada pasien SKA. Jenis penelitian ialah deskriptif analitik retrospektif dengan desain potong lintang. Penilaian severitas pembuluh darah yang mengalami lesi menggunakan skor modifikasi Gensini. Hitung leukosit yang digunakan ialah saat pasien pertama kali masuk Rumah Sakit yang diperoleh dari rekam medis periode Juli-September 2015. Data dianalisis menggunakan SPSS 20.0. Hasil uji korelasi Pearson memperlihatkan tidak terdapat hubungan bermakna antara kadar leukosit dan severitas lesi pembuluh darah koroner pada pasien SKA (p >0,05). Simpulan: Tidak terdapat hubungan bermakna antara kadar leukosit dan severitas lesi pembuluh darah koroner pada pasien Sindrom Koroner Akut. Kata kunci: leukosit, severitas lesi, sindrom koroner akut, skor modifikasi Gensini

P6005Incidence and clinical characteristics of coronary artery spasm in patients with out-of-hospital cardiac arrest

2019 ◽  
Vol 40 (Supplement_1) ◽  
Author(s):  
G Kawamura ◽  
H Okayama ◽  
S Kido ◽  
T Aono ◽  
K Matsuda ◽  
...  
Keyword(s):  
Acute Coronary Syndrome ◽  
Cardiac Arrest ◽  
Heart Disease ◽  
Coronary Artery ◽  
Coronary Artery Spasm ◽  
Coronary Spasm ◽  
Coronary Syndrome ◽  
Organic Heart Disease ◽  
Japanese Guideline ◽  
Hospital Cardiac Arrest

Abstract Background Substantial cases of out-of-hospital cardiac arrest (OHCA) due to acute coronary syndrome have been recognized thus far, but there have been few reports about the aetiology of patients with OHCA without the organic heart disease. Especially, coronary artery spasm would be one of the causes of OHCA. Purpose This study aimed to investigate causes of OHCA without the organic heart disease and to investigate the characteristics and angiographic findings of OHCA patients with vasospastic angina (VSA). Methods Between January 2010 and April 2018, 920 patients with OHCA caused by probable or definite cardiovascular disease were transferred to our hospital. Return of spontaneous contraction was successfully achieved in 151 patients, among whom diagnosis was made in 130 patients. First, we analysed the causes of OHCA in these patients. Second, we compared clinical and angiographic characteristics between the VSA group with OHCA (OHCA-VSA) and the VSA group without OHCA (stable VSA; n=72) from our database. Results Among the 130 patients, 95 (73%) had the organic heart disease; 72, acute coronary syndrome; 19, myocardial disease; 2, valvular heart disease; and 1, congenital heart disease. There were 35 patients (27%) without the organic heart disease. Nineteen patients had primary (i.e., Brugada syndrome, QT prolongation) or secondary arrhythmia (i.e. drug adverse effect). Electrocardiogram, coronary angiogram, and LV structure and function were normal in 35 patients. However, there were 16 patients (11%) with VSA defined by Japanese guideline. The OHCA-VSA group was significantly younger (50±14) than the stable VSA group (64±11, P=0.003). The incidence of diffuse-type spasm in the OHCA-VSA group (100%) was significantly higher than that in the stable VSA group (100% vs. 69%, P<0.05). In addition, the incidence of triple-vessel coronary spasm in the OHCA-VSA group was significantly higher than that in the stable VSA group (86% vs. 25%, P=0.003). Conclusion OHCA patients without the organic heart disease had considerable cases of VSA, in addition to primary or secondary arrhythmia. Furthermore, the severity of spasm in the OHCA-VSA group was more serious and extensive than in comparison with the stable VSA group.

scholarly journals Role of cardiovascular magnetic resonance in the prognosis of patients with myocardial infarction with non-obstructive coronary arteries

2021 ◽  
Vol 23 (1) ◽  
Author(s):  
Nuria Vicente-Ibarra ◽  
Eloisa Feliu ◽  
Vicente Bertomeu-Martínez ◽  
Pedro Cano-Vivar ◽  
Pilar Carrillo-Sáez ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Acute Coronary Syndrome ◽  
Cardiovascular Magnetic Resonance ◽  
Coronary Artery ◽  
Magnetic Resonance ◽  
Coronary Arteries ◽  
Coronary Artery Lesions ◽  
Cardiac Events ◽  
Coronary Syndrome ◽  
Adverse Cardiac Events

Abstract Background It is estimated that 5% to 10% of patients with myocardial infarction (MI) present with no obstructive coronary artery lesions. Until now, most studies have focused on acute coronary syndrome, including different clinical entities with a similar presentation encompassed under the term MINOCA (MI with non-obstructive coronary arteries). The aim of this study is to assess the prognosis of patients diagnosed with true infarction, confirmed by cardiovascular magnetic resonance (CMR), in the absence of significant coronary lesions. Methods Prospective multicenter registry study, including 120 consecutive patients with a CMR-confirmed MI without obstructive coronary artery lesions. The primary clinical outcome was major adverse cardiovascular events (MACE: death, non-fatal infarction, stroke, or cardiac readmission), assessed over three years. Results Seventy-six patients (63.3%) were admitted with a diagnosis of acute coronary syndrome, and 44 (36.6%) for other causes (mainly heart failure); the definitive diagnosis was established by CMR. Most patients (64.2%) were men, and the mean age was 58.8 ± 13.5 years. Patients presented with small infarcts: 83 (69.1%) showed late gadolinium enhancement (LGE) in one or two myocardial segments, mainly transmural (in 77.5% of patients) and with a preserved left ventricular ejection fraction (median 54.8%, interquartile range 37–62). The most frequent infarct location was inferolateral (n = 38, 31.7%). During follow-up, 43 patients (35.8%) experienced a MACE, including 9 (7.5%) who died. In multivariable analysis, LGE in two versus one myocardial segment doubled the risk of adverse cardiac events (hazard ratio [HR] 2.32, 95% confidence interval [CI] 0.97–5.83, p = 0.058). Involvement of three or more myocardial segments almost tripled the risk (HR 2.71, 95% CI 1.04–7.04, p = 0.040 respectively). Conclusions Patients with true MI but without significant coronary artery lesions predominantly had small infarcts. Myocardial 3-segment LGE involvement is associated with a significantly higher risk of adverse cardiac events.

scholarly journals Features of coronary artery patterns and percutaneous coronary intervention in patients with acute coronary syndrome and stable angina in patients aged below 40 years

2020 ◽  
Vol 101 (1) ◽  
pp. 18-24 ◽  
Author(s):  
F Z Abdullaev ◽  
N M Babaev ◽  
L S Shikhieva
Keyword(s):  
Percutaneous Coronary Intervention ◽  
Acute Coronary Syndrome ◽  
Coronary Artery ◽  
Coronary Arteries ◽  
Right Coronary Artery ◽  
Stable Angina ◽  
Coronary Intervention ◽  
Left Circumflex Artery ◽  
Coronary Syndrome ◽  
Percutaneous Coronary

Aim. To study the features of risk profile, coronary artery patterns, and percutaneous coronary intervention in patients aged below 40 years with acute coronary syndrome and stable angina. Methods. 208 patients with coronary artery disease aged below 40 years were examined: 51 (24.5%) patients aged 35 years and younger and 157 (75.5%) aged 3640 years. 98 (47.1%) patients were admitted with acute coronary syndrome; 110 (52.9%) patients with stable angina. In groups of acute coronary syndrome and stable angina, myocardial infarction in past medical history was revealed in 23.5% and 36.4%, respectively. 165 patients underwent percutaneous coronary intervention: 84 (50.9%) with acute coronary syndrome; 81 (40.1%) with stable angina. Results. Patients with stable angina differed by prevalence of myocardial infarction in past medical history, overweight, and family history of coronary artery disease. In group of acute coronary syndrome urban cohort prevailed as well as consumption of energy drinks among patients below 35 years; high prevalence of left ventricular dysfunction. Patients with acute coronary syndrome were characterized by involvement of one and three coronary arteries, and patients with stable angina by pathology of two and three coronary arteries. Involvement of three coronary arteries was equal in both groups. In both groups, anterior interventricular artery was target coronary artery. Patients with stable angina had the same rate of right coronary artery and left circumflex artery involvement. In patients with stable angina, right coronary artery involvement was rarer, and left main coronary artery involvement was two times more frequent than in patients with acute coronary syndrome. The group with acute coronary syndrome was characterized by predominance of discrete lesions and coronary occlusions over diffuse lesions; and the group of stable angina by diffuse lesions, and two-times less frequent coronary occlusions. Conclusion. Among patients with acute coronary syndrome aged below 36 years, revascularization of right coronary artery was predominant, and among patients aged 3640 years with acute coronary syndrome revascularization of left circumflex artery.

scholarly journals Coronary Artery Spasm as a Frequent Cause of Acute Coronary Syndrome

2008 ◽  
Vol 52 (7) ◽  
pp. 523-527 ◽  
Author(s):  
Peter Ong ◽  
Anastasios Athanasiadis ◽  
Stephan Hill ◽  
Holger Vogelsberg ◽  
Matthias Voehringer ◽  
...  
Keyword(s):  
Acute Coronary Syndrome ◽  
Coronary Artery ◽  
Coronary Artery Spasm ◽  
Coronary Syndrome

scholarly journals Myocardial infarction or acute coronary syndrome with non-obstructive coronary arteries and sudden cardiac death: a missing connection

EP Europace ◽  
2020 ◽  
Vol 22 (9) ◽  
pp. 1303-1310
Author(s):  
Nikolaos Kosmas ◽  
Antonis S Manolis ◽  
Nikolaos Dagres ◽  
Efstathios K Iliodromitis
Keyword(s):  
Myocardial Infarction ◽  
Acute Coronary Syndrome ◽  
Coronary Artery ◽  
Sudden Cardiac Death ◽  
Coronary Arteries ◽  
Cardiac Death ◽  
Large Scale ◽  
Artery Dissection ◽  
Atheromatous Plaque ◽  
Coronary Syndrome

Abstract Myocardial infarction with non-obstructive coronary arteries or any acute coronary syndrome (ACS) with normal or near-normal (non-obstructive) coronary arteries (ACS-NNOCA) is an heterogeneous clinical entity, which includes different pathophysiology mechanisms and is challenging to treat. Sudden cardiac death (SCD) is a catastrophic manifestation of ACS that is crucial to prevent and treat urgently. The concurrence of the two conditions has not been adequately studied. This narrative review focuses on the existing literature concerning ACS-NNOCA pathophysiology, with an emphasis on SCD, together with risk and outcome data from clinical trials. There have been no large-scale studies to investigate the incidence of SCD within ACS-NNOCA patients, both early and late in the disease. Some pathophysiology mechanisms that are known to mediate ACS-NNOCA, such as atheromatous plaque erosion, anomalous coronary arteries, and spontaneous coronary artery dissection are documented causes of SCD. Myocardial ischaemia, inflammation, and fibrosis are probably at the core of the SCD risk in these patients. Effective treatments to reduce the relevant risk are still under research. ACS-NNOCA is generally considered as an ACS with more ‘benign’ outcome compared to ACS with obstructive coronary artery disease, but its relationship with SCD remains obscure, especially until its incidence and effective treatment are evaluated.

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