scholarly journals Anticoagulation-induced unilateral adrenal haemorrhage and pseudoaneurysm

2019 ◽  
Vol 12 (12) ◽  
pp. e232539 ◽  
Author(s):  
Yi Th'ng Seow ◽  
Zi Qin Ng ◽  
Sze Ling Wong
Keyword(s):  
Myocardial Infarction ◽  
Abdominal Pain ◽  
Chest Pain ◽  
High Morbidity ◽  
Digital Subtraction ◽  
Adrenal Haemorrhage ◽  
Previously Treated ◽  
St Elevation ◽  
High Degree ◽  
Significant Size

Spontaneous unilateral adrenal haemorrhage (AH) is extremely rare. Its presentation is usually non-specific and requires a high degree of suspicion as it is associated with high morbidity and mortality if diagnosis is delayed. Hereby, we present a case of 67-year-old man with significant cardiac history presented with right-sided chest pain and non-specific abdominal pain. He was previously treated for non-ST elevation myocardial infarction 5 days ago prior to the current presentation. CT scan of abdomen and pelvis demonstrated a right-sided active AH. The patient subsequently underwent digital subtraction angiography. Angio-embolisation was attempted for the pseudoaneurysm but failed due to spasm of the vessel. He was managed conservatively and discharged after clinical improvement. Clinic review 6 months later showed significant size reduction of the pseudoaneurysm.

scholarly journals Cerebral embolism due to left atrial myxoma in a patient presenting with chest pain and ST-segment elevation: a case report

2020 ◽  
Author(s):  
António Fontes ◽  
Nuno Dias-Ferreira ◽  
Anabela Tavares ◽  
Fátima Neves
Keyword(s):  
Myocardial Infarction ◽  
Chest Pain ◽  
Magnetic Resonance ◽  
Left Atrial ◽  
Left Ventricular ◽  
Atrial Myxoma ◽  
Left Atrial Myxoma ◽  
St Segment ◽  
Wide Range ◽  
St Elevation

Abstract Background Myocarditis is an uncommon, potentially life-threatening disease that presents with a wide range of symptoms. In acute myocarditis, chest pain (CP) may mimic typical angina and also be associated with electrocardiographic changes, including an elevation of the ST-segment. A large percentage (20–56%) of myxomas are found incidentally. Case summary A 62-year-old female presenting with sudden onset CP and infero-lateral ST-elevation in the electrocardiogram. The diagnosis of ST-elevation myocardial infarction was presumed and administered tenecteplase. The patient was immediately transported to a percutaneous coronary intervention centre. She complained of intermittent diplopia during transport and referred constitutional symptoms for the past 2 weeks. Coronary angiography showed normal arteries. The echocardiogram revealed moderate to severe left ventricular systolic dysfunction due to large areas of akinesia sparing most of the basal segments, and a mobile mass inside the left atrium attached to the septum. The cardiac magnetic resonance (CMR) suggested the diagnosis of myocarditis with concomitant left atrial myxoma. The patient underwent resection of the myxoma. Neurological evaluation was performed due to mild vertigo while walking and diplopia in extreme eye movements. The head magnetic resonance imaging identified multiple infracentimetric lesions throughout the cerebral parenchyma compatible with an embolization process caused by fragments of the tumour. Discussion Myocarditis can have various presentations may mimic acute myocardial infarction and CMR is critical to establish the diagnosis. Myxoma with embolic complications requires emergent surgery. To the best of our knowledge, this is the first case reported in the applicable literature of a myxoma diagnosed during a myocarditis episode.

scholarly journals Use of Circulating MicroRNAs to Diagnose Acute Myocardial Infarction

2012 ◽  
Vol 58 (3) ◽  
pp. 559-567 ◽  
Author(s):  
Yvan Devaux ◽  
Mélanie Vausort ◽  
Emeline Goretti ◽  
Petr V Nazarov ◽  
Francisco Azuaje ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Acute Myocardial Infarction ◽  
Chest Pain ◽  
Troponin T ◽  
Correct Diagnosis ◽  
Patient Treatment ◽  
Healthy Controls ◽  
Clinical Model ◽  
Acute Mi ◽  
St Elevation

Abstract BACKGROUND Rapid and correct diagnosis of acute myocardial infarction (MI) has an important impact on patient treatment and prognosis. We compared the diagnostic performance of high-sensitivity cardiac troponin T (hs-cTnT) and cardiac enriched microRNAs (miRNAs) in patients with MI. METHODS Circulating concentrations of cardiac-enriched miR-208b and miR-499 were measured by quantitative PCR in a case-control study of 510 MI patients referred for primary mechanical reperfusion and 87 healthy controls. RESULTS miRNA-208b and miR-499 were highly increased in MI patients (>105-fold, P < 0.001) and nearly undetectable in healthy controls. Patients with ST-elevation MI (n= 397) had higher miRNA concentrations than patients with non–ST-elevation MI (n = 113) (P < 0.001). Both miRNAs correlated with peak concentrations of creatine kinase and cTnT (P < 10−9). miRNAs and hs-cTnT were already detectable in the plasma 1 h after onset of chest pain. In patients who presented <3 h after onset of pain, miR-499 was positive in 93% of patients and hs-cTnT in 88% of patients (P= 0.78). Overall, miR-499 and hs-cTnT provided comparable diagnostic value with areas under the ROC curves of 0.97. The reclassification index of miR-499 to a clinical model including several risk factors and hs-cTnT was not significant (P = 0.15). CONCLUSION Circulating miRNAs are powerful markers of acute MI. Their usefulness in the establishment of a rapid and accurate diagnosis of acute MI remains to be determined in unselected populations of patients with acute chest pain.

scholarly journals Meningococcemia Presenting as a Myocardial Infarction

2015 ◽  
Vol 2015 ◽  
pp. 1-4
Author(s):  
Daniel Lachant ◽  
David Trawick
Keyword(s):  
Myocardial Infarction ◽  
Emergency Department ◽  
Chest Pain ◽  
Cardiogenic Shock ◽  
Neisseria Meningitidis ◽  
Early Recognition ◽  
Myocardial Dysfunction ◽  
Shortness Of Breath ◽  
Gram Negative ◽  
St Elevation

Neisseria meningitidisis an encapsulated gram negative diplococcus that colonizes the nasopharynx and is transmitted by aerosol or secretions with the majority of cases occurring in infants and adolescents. Meningococcemia carries a high mortality which is in part due to myocarditis. Early recognition and prompt use of antibiotics improve morbidity and mortality. We report a 55-year-old male presenting to the emergency department with chest pain, shortness of breath, and electrocardiogram changes suggestive of ST elevation MI who developed cardiogenic shock and multisystem organ failure fromN. meningitidis. We present this case to highlight the unique presentation of meningococcemia, the association with myocardial dysfunction, and the importance of early recognition and prompt use of antibiotics.

ECG of the month

2021 ◽  
Vol 16 (1) ◽  
pp. 1-1
Author(s):  
Charles Bloe
Keyword(s):  
Myocardial Infarction ◽  
Chest Pain ◽  
Acute Chest Pain ◽  
St Elevation Myocardial Infarction ◽  
St Elevation ◽  
Lost To Follow Up

In this issue's ECG of the month, Charles Bloe highlights a case of a 36-year-old woman presenting with severe acute chest pain after previously being lost to follow up post ST-elevation myocardial infarction.

Cardiology

2019 ◽  
pp. 177-198
Keyword(s):  
Myocardial Infarction ◽  
Heart Failure ◽  
Atrial Fibrillation ◽  
Heart Disease ◽  
Chest Pain ◽  
Venous Pressure ◽  
Structural Defects ◽  
Pressure Waveform ◽  
St Elevation ◽  
Electrocardiogram Interpretation

Cardiology specializes in disorders of the heart, primarily ischaemic heart disease, rhythm disturbances (arrhythmias), and structural defects. Emergency presentations with chest pain, breathlessness, or palpitations are extremely common. This chapter describes the pathophysiology, presentation, diagnosis, and management of the leading cardiac complaints including unstable angina, ST elevation myocardial infarction (STEMI), non-STEMI, atrial fibrillation, heart failure, hypertension, infective endocarditis, and syncope. Basic electrocardiogram interpretation is explained, in addition to the jugular venous pressure waveform and risk stratification tools for atrial fibrillation and heart failure. A practical guide to the cardiovascular examination (as well as tips for success in exam situations) is included.

scholarly journals Induced by infection? A case of acute myocardial infarction with hypothermia

2019 ◽  
Vol 47 (8) ◽  
pp. 3963-3967
Author(s):  
Liang Li ◽  
Shudong Xia ◽  
Chao Feng
Keyword(s):  
Myocardial Infarction ◽  
Abdominal Pain ◽  
Body Temperature ◽  
Vital Signs ◽  
Reactive Protein ◽  
St Segment ◽  
Intravenous Antibiotics ◽  
St Elevation ◽  
Electrocardiographic Findings ◽  
The Right

A 52-year-old man was admitted to our hospital because of abdominal pain, nausea, and vomiting. On arrival, his body temperature was <35°C. Although his other vital signs and electrocardiographic findings were normal, his white blood cell count and C-reactive protein concentration were elevated. He was diagnosed with severe infectious disease and treated with intravenous antibiotics and rewarming therapy. Two hours later, his body temperature had increased to 38.4°C, but his abdominal pain persisted. A repeat electrocardiographic examination showed an elevated ST-segment in leads II, III, and aVF. He was then diagnosed with ST-elevation myocardial infarction. Coronary angiography showed occlusion of the right coronary artery, and he underwent implantation of two stents. His symptoms were relieved soon thereafter, and his body temperature returned to normal without antibiotics.

scholarly journals Spontaneous Coronary Artery Dissection – A Case Report

2018 ◽  
Vol 12 (2) ◽  
pp. 105-107
Author(s):  
Samsun Nahar ◽  
Fatema Begum ◽  
Momenuzzaman ◽  
KN Khan
Keyword(s):  
Myocardial Infarction ◽  
Case Report ◽  
Chest Pain ◽  
Coronary Artery ◽  
Artery Dissection ◽  
Spontaneous Coronary Artery Dissection ◽  
Coronary Artery Dissection ◽  
St Elevation ◽  
The Right ◽  
Spontaneous Dissection

Spontaneous coronary artery dissection is a rather rare cause of myocardial infarction, chest pain, and sudden death.There are currently no known direct causes of this condition.Most of the reported dissections have occurred in the left anterior descending coronary artery.Herein, we report the case of a 58-year-old woman who presented at our institution with an acute ST-elevation myocardial infarction secondary to a spontaneous dissection of the right coronary artery. Primary PCIresolved the occlusion of the artery, and the patient was discharged from the hospital on medical therapy.University Heart Journal Vol. 12, No. 2, July 2016; 105-107

Chest Pain, ST Elevation, and Increasing Troponin: Is It Really Myocardial Infarction?

CHEST Journal ◽  
2012 ◽  
Vol 142 (4) ◽  
pp. 353A
Author(s):  
Kovid Trivedi ◽  
Pranay Trivedi ◽  
Hasnain Bawaadam ◽  
Nitesh Jain ◽  
Aman Sethi ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Chest Pain ◽  
St Elevation

scholarly journals Mass-Querade: Spontaneous Intramural Oesophageal Haematoma Following Thrombolysis in the Setting of Myocardial Infarction

2020 ◽  
Author(s):  
Rajoo Ramachandran ◽  
Sanchanaa Sree Balakrishnan ◽  
Sheela Chinnappan ◽  
MP Venkata Sai
Keyword(s):  
Myocardial Infarction ◽  
Computed Tomography ◽  
Cardiac Arrest ◽  
Chest Pain ◽  
Mediastinal Mass ◽  
Complete Recovery ◽  
Neck Swelling ◽  
Clinical Complications ◽  
Extrinsic Compression ◽  
St Elevation

Spontaneous Intramural Oesophageal Haematoma (IEH) is a rare oesophageal emergency. This report describes the case of a 70-year-old diabetic male, who presented with chest pain and was started on thrombolysis as Electrocardiography (ECG) showed ST elevation Myocardial Infarction (MI). As the patient developed gum bleeding and neck swelling, thrombolysis was stopped. Computed Tomography (CT) showed a non-enhancing mediastinal mass, causing significant extrinsic compression of the distal trachea and a diagnosis of IEH, possibly secondary to thrombolysis was made. Although IEH generally resolves spontaneously with conservative management, the patient remained poorly ventilated despite intubation and expired due to cardiac arrest following failure of resuscitative efforts, eight days after the initial thrombolysis. Several cases of uncomplicated IEH where complete recovery was achieved with conservative treatment are reported in literature; however, there are fewer reports on the poorer outcomes in patients with multiple co-morbidities and co-existent clinical complications.

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