Left ventricular apical mass after myocardial infarction—not always a thrombus: a diagnostic dilemma

2021 ◽  
Vol 14 (10) ◽  
pp. e245963
Author(s):  
Jayanty Venkata Balasubramaniyan ◽  
Judah Nijas Arul ◽  
Jebaraj Rathinasamy ◽  
Thangavel Periyasamy
Keyword(s):  
Myocardial Infarction ◽  
Systolic Dysfunction ◽  
Anterior Wall ◽  
Left Ventricular ◽  
Prior History ◽  
Surgical Removal ◽  
Diagnostic Dilemma ◽  
Echocardiographic Evaluation ◽  
Lv Mass ◽  
History Of

Myxomas arising from the left ventricle (LV) are extremely rare and can be easily mistaken for a thrombus. We report a case of a 35-year-old man who presented with an acute cerebrovascular accident, having had a prior history of an anterior wall myocardial infarction 2 years back with an echocardiographic evaluation showing mild LV systolic dysfunction. His present prothrombotic workup revealed hyperhomocystinaemia and elevated levels of factor VIII. Present echocardiography revealed a mass arising from a scarred LV wall. Considering the possibility of a thrombus, he was initially started on parenteral anticoagulation. Unfortunately, consequent echocardiogram evaluation showed no reduction in size of the LV mass hence surgical removal was done. Histopathological evaluation unveiled the mass to be a myxoma.

Incidence and Natural History of Left Ventricular Thrombus Following Anterior Wall Acute Myocardial Infarction

1997 ◽  
Vol 80 (4) ◽  
pp. 442-448 ◽  
Author(s):  
Sally C. Greaves ◽  
Guang Zhi ◽  
Richard T. Lee ◽  
Scott D. Solomon ◽  
Jean MacFadyen ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Acute Myocardial Infarction ◽  
Natural History ◽  
Anterior Wall ◽  
Left Ventricular ◽  
Left Ventricular Thrombus ◽  
Ventricular Thrombus ◽  
History Of

scholarly journals Clinical analysis of cardiac failure in post-myocardial infarction patients

2018 ◽  
Vol 5 (3) ◽  
pp. 587
Author(s):  
R. Jaya Prakash Reddy ◽  
P. Vijaya Narasimha Reddy
Keyword(s):  
Myocardial Infarction ◽  
Cardiac Failure ◽  
Clinical Analysis ◽  
Cross Sectional Study ◽  
Anterior Wall ◽  
Prior History ◽  
Medical Sciences ◽  
Cross Sectional ◽  
Number Of Patients ◽  
History Of

Background: Cardiac failure is one of the common complications of Acute Myocardial Infarction. As CAD is the leading cause of death and post MI Cardiac failure also causing increase in rate of Mortality. It directs us to assess the complications of MI and to evaluate the precautionary & preventive steps of cardiac failure.Methods: The present study comprises of 50 cardiac failure patients with history of MI in the past and who presented with myocardial infarction with cardiac failure were included in this study. We excluded the patients who presented with Cardiac failure without Prior history of MI. This hospital based cross sectional study was conducted at Rajiv Gandhi Institute of Medical Sciences (RIMS), Ongole, Prakasam District, Andhra Pradesh. The study was carried out for a period of 1 year with informed consent.Results: In present study majority number of patients (33) show hypokinesia and 10 are found to have dyskinesia and only 4 are akinesia. In this study More than 50% patients are with history of anterior wall involvement. 36(72%) patients have elevated JVP, 34(68%) have cardiomegaly, 38 patients presented with PND. 29(58%) patients are DM and 35(70%) are HTN and only 6(12%) patients are neither DM, nor HTN.Conclusions: Cardiac failure is a common complication after MI. Most common presentations are breathlessness, chest pain, PND, JVP etc. Anterior wall MI on ECG either isolated or associated with other walls is the leading cause of post MI cardiac failure.

Echocardiographic assessment of cardiac function in conscious and anesthetized mice

1999 ◽  
Vol 277 (5) ◽  
pp. H1967-H1974 ◽  
Author(s):  
Xiao-Ping Yang ◽  
Yun-He Liu ◽  
Nour-Eddine Rhaleb ◽  
Nobutaka Kurihara ◽  
Henry E. Kim ◽  
...  
Keyword(s):  
Cardiac Function ◽  
High Frequency ◽  
Systolic Dysfunction ◽  
Left Ventricular ◽  
Pentobarbital Sodium ◽  
Linear Transducer ◽  
Echocardiographic Evaluation ◽  
Lv Mass ◽  
Echocardiographic Assessment ◽  
And Function

Using a high-frequency linear transducer (15L8), we studied 1) the feasibility of performing echocardiography in nonanesthetized mice compared with mice given pentobarbital sodium (Pento) or a mixture of ketamine and xylazine and 2) the feasibility of echocardiographic evaluation of left ventricular (LV) hypertrophy, dilatation, and function in mice with two-kidney, one-clip hypertension or myocardial infarction (MI). Heart rate (HR) in awake mice was 658 ± 9 beats/min; Pento and ketamine plus xylazine reduced HR to 377 ± 11 and 293 ± 19 beats/min, respectively, associated with a significant decrease in shortening fraction (SF), ejection fraction (EF), and cardiac output (CO) and an increase in LV end-diastolic (LVEDD) and end-systolic dimensions (LVESD). Mice with 4 wk of two-kidney, one-clip hypertension had increased LV mass (15.62 ± 0.62 vs. 22.17 ± 1.79 mg) without altered LV dimensions, SF, EF, or CO. Mice studied 4 wk post-MI exhibited obvious LV dilatation and systolic dysfunction, as evidenced by increased LVEDD and LVESD and decreased SF, EF, and CO. Our findings clearly show the adverse impact of anesthesia on basal cardiac function and the difficulty in interpreting data obtained from anesthetized mice. We believe this is the first study to demonstrate the feasibility of using echocardiography to assess cardiovascular function in the nonanesthetized mouse.

Abstract 16749: Prevalence, Predictors, and Prognostic Implications of Left Ventricular Systolic Dysfunction Among Patients With STEMI in India: The Prospective NORIN-STEMI Registry

Circulation ◽  
2020 ◽  
Vol 142 (Suppl_3) ◽  
Author(s):  
Ambarish Pandey ◽  
Shreya Rao ◽  
Girish MP ◽  
Puneet Gupta ◽  
Sameer Arora ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Left Ventricular Systolic Dysfunction ◽  
Systolic Dysfunction ◽  
Tertiary Care ◽  
Anterior Wall ◽  
Left Ventricular ◽  
Middle Income ◽  
Logistic Regression Models ◽  
Low Middle Income Countries ◽  
Prognostic Implications

Introduction: Left ventricular (LV) systolic dysfunction (LVSD) and HF are important complications of ST-elevation myocardial infarction (STEMI). The prevalence and prognostic implications of LVSD in patients with STEMI in low/middle-income countries such as India are not well established. Methods: The present analysis was performed using data from the ongoing , prospective NORIN-STEMI registry of patients presenting with STEMI to 2 tertiary care medical centers in New Delhi, India from January to November 2019. LV ejection fraction (EF) was assessed at STEMI presentation using transthoracic echocardiography. Covariate-adjusted logistic regression models were constructed to evaluate the association of LVSD (mild: EF = 40-50%; moderate/severe: EF<40%; ref: EF>50%) with risk of in-hospital and 30-day mortality. Results: Among 3,635 patients with STEMI (age: 55[45-62], 33%≤50 years, 16% women), 1,489 (41%) had mild and 1,675 (46%) had moderate/severe LVSD on presentation. Patients with greater LVSD more commonly presented with anterior wall STEMI and had more frequent involvement of the left anterior descending artery as the culprit vessel. Among those with no, mild or moderate/severe LVSD, PCI was performed in 70% and 62% of patients, respectively. Hypertension, prior myocardial infarction, physical inactivity, greater time since symptom onset, and lower literacy levels were each independently associated with higher likelihood of LVSD. In adjusted analysis, LVSD was significantly associated with higher likelihood of in-hospital but not 30-day mortality ( See Table ). Conclusion: Among patients presenting to tertiary care centers in India with STEMI, LVSD is common, with 87% demonstrating LVEF<50%. LVSD was significantly associated with higher risk of in-hospital and 30-day mortality. Future studies are needed to determine if quality improvement efforts to standardize pathways for primary PCI may lessen occurrence of LVSD.

Acute Myocardial Infarction Secondary to Suspected Paradoxical Emboli through Patent Foramen Ovale in a Young Woman

2011 ◽  
Vol 9 (2) ◽  
pp. 122
Author(s):  
Mohammad Hassan Namazi ◽  
Marjan Biglari ◽  
Mohammad Khani ◽  
Vahid Eslami ◽  
Mohammad Reza Movahed ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Patent Foramen Ovale ◽  
Left Ventricular Systolic Dysfunction ◽  
Systolic Dysfunction ◽  
Anterior Wall ◽  
Left Ventricular ◽  
Foramen Ovale ◽  
Anterior Myocardial Infarction ◽  
Severe Left Ventricular Dysfunction ◽  
Paradoxical Embolus

A 40-year-old woman presented with an extensive anterior myocardial infarction. After initial thrombolytic therapy, coronary angiography was performed a few days later revealing normal coronaries with severe left ventricular dysfunction secondary to anterior wall akinesia. Echocardiography showed severe left ventricular systolic dysfunction and a patent foramen ovale (PFO). The patient had a history of long-term oral contraceptive consumption. A paradoxical embolus into the left coronary artery via a large PFO was suspected and was successfully treated with PFO closure.

scholarly journals Rare recurrence of apical ballooning (takotsubo) syndrome in an elderly man

2018 ◽  
pp. bcr-2017-222451
Author(s):  
Rosalyn Adigun ◽  
Samantha Morley ◽  
Abhiram Prasad
Keyword(s):  
Myocardial Infarction ◽  
Acute Myocardial Infarction ◽  
Left Ventricular Systolic Dysfunction ◽  
Systolic Dysfunction ◽  
Obstructive Coronary Artery Disease ◽  
Apical Ballooning ◽  
Left Ventricular ◽  
Major Surgery ◽  
Apical Ballooning Syndrome ◽  
Elderly Male

Apical ballooning syndrome (ABS) is an under recognised clinical entity characterised by acute reversible left ventricular systolic dysfunction that mimics acute myocardial infarction in the absence of obstructive coronary artery disease; typically occurring in the setting of profound stress.1 ABS disproportionately affects older women and recurrences are infrequent. We, hereby, describe a rare phenomenon of recurrent ABS in an elderly male patient, 10 years apart, presenting with the same left ventricular morphological appearance following non-cardiac surgeries. The case illustrates the importance of considering ABS in the differential diagnosis of perioperative acute myocardial infarction in older men undergoing major surgery.

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