scholarly journals Hypercalcaemia Mimicking STEMI on Electrocardiography

2010 ◽  
Vol 2010 ◽  
pp. 1-3 ◽  
Author(s):  
Joseph Donovan ◽  
Mark Jackson
Keyword(s):  
Myocardial Infarction ◽  
Acute Myocardial Infarction ◽  
Cardiac Disease ◽  
Ecg Changes ◽  
Common Cause ◽  
St Segment Elevation ◽  
Coronary Syndrome ◽  
St Segment ◽  
Risk Patients ◽  
Electrocardiogram Ecg

Acute coronary syndrome is a common cause of presentation to hospital. ST segment elevation on an electrocardiogram (ECG) is likely to be cardiac in origin, but in low-risk patients other causes must be ruled out. We describe a case of a man with hypercalcaemia, no evidence of cardiac disease, and ECG changes mimicking acute myocardial infarction. These ECG changes resolved after treatment of the hypercalcaemia.

scholarly journals High risk electrocardiographic patterns in patients with acute coronary syndrome.

2020 ◽  
Vol 2 (1) ◽  
pp. 25-34
Author(s):  
Diego Echeverri- Marín ◽  
Cristhian Felipe Ramirez Ramos ◽  
Andrés Miranda-Arboleda ◽  
Gustavo Castilla-Agudelo ◽  
Clara Saldarriaga-Giraldo
Keyword(s):  
Myocardial Infarction ◽  
Acute Myocardial Infarction ◽  
Reperfusion Therapy ◽  
Early Reperfusion ◽  
St Segment Elevation ◽  
Coronary Syndrome ◽  
Acute Coronary Occlusion ◽  
St Segment ◽  
St Elevation ◽  
Electrocardiographic Findings

Acute myocardial infarction is the leading cause of death in the world and the electrocardiogram remains the diagnostic tool for determining an acute myocardial infarction with ST-segment elevation. In spite of this, only half of the patients present classic electrocardiogram findings compatible with the ST-elevation infarction criteria. There is a spectrum of electrocardiographic findings that may reflect a phenomenon of acute coronary occlusion, which should be promptly recognized by the clinician to offer early reperfusion therapy.

scholarly journals Clinical examples of microcirculation disorders in acute myocardial infarction

2016 ◽  
Vol 15 (1) ◽  
pp. 56-64
Author(s):  
K. A. Kireev ◽  
A. V. Krasnopeev
Keyword(s):  
Myocardial Infarction ◽  
Acute Myocardial Infarction ◽  
Fatal Outcome ◽  
Reperfusion Therapy ◽  
Left Ventricular ◽  
Early Postoperative Period ◽  
St Segment Elevation ◽  
Coronary Syndrome ◽  
St Segment ◽  
Angiographic Result

Objective. To improve the results of acute myocardial infarction (AMI) treatment. Material and methods. We have analyzed 2 clinical cases of unfavorable course of AMI. Results. The middle aged patient who had ST segment elevation acute coronary syndrome received immediate full reperfusion therapy (thrombolysis and stenting). It was performed early in the course of the disease and demonstrated good angiographic result. Postoperatively there were no typical evolution of ECG signs of AMI. By the end of the first day we registered stent thrombosis with fatal outcome. Cause of death: acute left ventricular failure. The area of infarcted cardiac muscle was about 40 %, in the projection of the apex of the left ventricle the acute aneurysm was formed. Perhaps this situation has been associated with disorders of microcirculation in the infarcted area, which can be potentially neutralized by inhibitors 2b/3a receptors of platelets. This drug was given to this patient too late (during rethrombosis). In another observation (with the same circumstances) the inhibitor of IIb/IIIa GP receptors was given during the early postoperative period, what was followed by the natural course of AMI. Conclusion. These examples demonstrate the need of additional antiplatelet support (inhibitor IIb/IIIa GP receptors) in such clinical situations.

scholarly journals Can inflammatory biomarkers play a role in the inclusion of patients with acute myocardial infarction in cardiac rehabilitation programs?

2021 ◽  
Vol 12 (3) ◽  
pp. 255-260
Author(s):  
Alexandra DĂDÂRLAT-POP ◽  
Horea ROȘIANU ◽  
Renaldo POPTILE ◽  
Raluca TOMOAIA ◽  
Ruxandra BEYER ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Acute Myocardial Infarction ◽  
Cardiac Rehabilitation ◽  
Systolic Function ◽  
Laboratory Data ◽  
Inflammatory Biomarkers ◽  
St Segment Elevation ◽  
Coronary Syndrome ◽  
Rehabilitation Programs ◽  
St Segment

Introduction: In spite of the enormous progress made over the last decades, acute coronary syndromes remain the leading cause of death globally. Inflammation plays an important role in coronary artery disease development. Although the role of inflammatory biomarkers in acute obstructive myocardial infarction is well established, there is no data regarding the potential differences between acute myocardial infarction (AMI) with ST segment elevation, AMI without ST segment elevation (NON-STEMI) and non-obstructive acute myocardial infarction (MINOCA), respectively. Also, it is well known that cardiac rehabilitation of acute myocardial infarction survivors significantly improves their long-term prognosis. Aim of the study: To asses the possible existing differences between patients with STEMI, NON-STEMI and MINOCA in terms of clinical and paraclinical parameters, especially inflammatory biomarkers. A second objective of our study was to describe the relationship between inflammatory, cardiac necrosis enzymes and left ventricle systolic function. Material and methods: The study included 35 adult patients admitted in the Cardiology service of the Niculae Stăncioiu Heart Institute, Cluj-Napoca with acute myocardial infarction. Demographic, clinical, echocardiographic and laboratory data were analyzed. Patients were divided into 3 groups, 19 patients (54.2%) were diagnosed with STEMI- group 1, 9 patients (25.7%) with NON-STEMI- group 2 and 7 patients (20%) with MINOCA- group 3, respectively. Dosage of serum inflammatory markers was performed on the day of admission. Results and conclusion: The most common associated cardiovascular risk factor was arterial hypertension (65.7% of patients). Markers of myocardial necrosis (CK, CK-MB, hs Troponin) were significantly higher in patients with STEMI (p <0.05) in comparison with NON-STEMI and MINOCA patients. Congestive heart failure was most frequently encountered in STEMI patients. hsCRP value was higher among patients with STEMI. The value of ESR was significantly higher among patients with NON-STEMI. Serial dosage of inflammation biomarkers in patients with recent acute myocardial infarction may serve as valuable risk stratification instruments and also for functional capacity and recovery status assessment in patients included in cardiac rehabilitation programs. Keywords: acute coronary syndrome; inflammatory biomarkers; non-obstructive acute myocardial infarction,

scholarly journals Outcomes in nonagenarians with acute coronary syndrome. Is medical treatment important?

2021 ◽  
Vol 28 (Supplement_1) ◽  
Author(s):  
JULIO Echarte-Morales ◽  
ELENA Tundidor Sanz ◽  
E Martinez Gomez ◽  
PEDRO Cepas-Guillen ◽  
JAVIER Borrego Rodriguez ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Acute Myocardial Infarction ◽  
Acute Coronary Syndrome ◽  
Secondary Prevention ◽  
Dual Antiplatelet Therapy ◽  
St Segment Elevation ◽  
Coronary Syndrome ◽  
Segment Elevation Myocardial Infarction ◽  
St Segment

Abstract Funding Acknowledgements Type of funding sources: None. Introduction  Nonagenarians have a high rate of comorbidities and are underrepresented in studies of ischemic heart disease. It is unknown whether treatment at discharge is useful in preventing adverse events at follow up.  Purpose  The aim of this study is to evaluate the secondary prevention with medical treatment in nonagenarians with acute myocardial infarction. Methods A multicenter, observational and retrospective study was carried out in nonagenarians admitted by acute coronary syndrome (ACS) between January 2005 and December 2018. Baseline characteristics, interventional procedures, treatment at discharge and outcomes at 1 year were evaluated. Patients with type 2 acute myocardial infarction were excluded.  Results  680 patients (92,6 ± 2,4 years old) were included. Hypertension was present in 79.4% of the entire population. Percutaneous coronary intervention (PCI) was performed in 32.1% of patients, and this group had a higher GRACE score compared to the conservative treatment group (177 versus 172; p = 0.001). Patients with ST-segment elevation myocardial infarction (STEMI) were more likely to receive an invasive strategy than the non-ST segment elevation myocardial infarction (NSTEMI) (61.5% versus 41.5%; p= 0.001). 263 patients died at 1 year follow up with in-hospital mortality of 17%. In STEMI group, patients with statins and dual antiplatelet therapy at discharge had lower mortality during follow up compared to those who did not received (26.7 % versus 41.5%; p = 0.001 and 31% versus 22%; p = 0.02, respectively) (Image 1).  Conclusions Nonagenarian patients with ACS have a high prevalence of hypertension and ICP procedures are not performed frequently. They also have a high mortality rate, although statins and dual antiplatelet therapy could be an effective secondary prevention. Abstract Figure.

scholarly journals Acute Coronary Syndrome and Ischemic Heart Disease in Pregnancy: Data From the EURObservational Research Programme‐European Society of Cardiology Registry of Pregnancy and Cardiac Disease

2020 ◽  
Vol 9 (15) ◽  
Author(s):  
Lucia Baris ◽  
Abdul Hakeem ◽  
Tabitha Moe ◽  
Jérôme Cornette ◽  
Nasser Taha ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Acute Coronary Syndrome ◽  
Heart Disease ◽  
Cardiac Disease ◽  
Research Programme ◽  
St Segment Elevation ◽  
Coronary Syndrome ◽  
Segment Elevation Myocardial Infarction ◽  
St Segment ◽  
European Society Of Cardiology

Background The prevalence of ischemic heart disease (IHD) in women of child‐bearing age is rising. Data on pregnancies however are scarce. The objective is to describe the pregnancy outcomes in these women. Methods and Results The European Society of Cardiology‐EURObservational Research Programme ROPAC (Registry of Pregnancy and Cardiac Disease) is a prospective registry in which data on pregnancies in women with heart disease were collected from 138 centers in 53 countries. Pregnant women with preexistent and pregnancy‐onset IHD were included. Primary end point were maternal cardiac events. Secondary end points were obstetric and fetal complications. There were 117 women with IHD, of which 104 had preexisting IHD. Median age was 35.5 years and 17.1% of women were smoking. There was no maternal mortality, heart failure occurred in 5 pregnancies (4.8%). Of the 104 women with preexisting IHD, 11 women suffered from acute coronary syndrome during pregnancy. ST‐segment‒elevation myocardial infarction were more common than non‒ST‐segment‒elevation myocardial infarction, and atherosclerosis was the most common etiology. Women who had undergone revascularization before pregnancy did not have less events than women who had not. There were 13 women with pregnancy‐onset IHD, in whom non‒ST‐segment‒elevation myocardial infarction was the most common. Smoking during pregnancy was associated with acute coronary syndrome. Caesarean section was the primary mode of delivery (55.8% in preexisting IHD, 84.6% in pregnancy‐onset IHD) and there were high rates of preterm births (20.2% and 38.5%, respectively). Conclusions Women with IHD tolerate pregnancy relatively well, however there is a high rate of ischemic events and these women should therefore be considered moderate‐ to high‐risk. Ongoing cigarette smoking is associated with acute coronary syndrome during pregnancy.

scholarly journals Assessment of quality indicators for acute myocardial infarction management in 28 countries and use of composite quality indicators for benchmarking

2020 ◽  
Vol 9 (8) ◽  
pp. 911-922 ◽  
Author(s):  
Xavier Rossello ◽  
Jesús Medina ◽  
Stuart Pocock ◽  
Frans Van de Werf ◽  
Chee Tang Chin ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Acute Myocardial Infarction ◽  
Quality Indicators ◽  
European Society ◽  
Prognostic Value ◽  
St Segment Elevation ◽  
Coronary Syndrome ◽  
St Segment ◽  
European Society Of Cardiology ◽  
Elevation Acute Myocardial Infarction

Background: The European Society of Cardiology established a set of quality indicators for the management of acute myocardial infarction. Our aim was to evaluate their degree of attainment, prognostic value and potential use for centre benchmarking in a large international cohort. Methods: Quality indicators were extracted from the long-tErm follow-uP of antithrombotic management patterns In acute CORonary syndrome patients (EPICOR) (555 hospitals, 20 countries in Europe and Latin America, 2010–2011) and EPICOR Asia (218 hospitals, eight countries, 2011–2012) registries, including non-ST-segment elevation acute myocardial infarction ( n=6558) and ST-segment elevation acute myocardial infarction ( n=11,559) hospital survivors. The association between implementation rates for each quality indicator and two-year adjusted mortality was evaluated using adjusted Cox models. Composite quality indicators were categorized for benchmarking assessment at different levels. Results: The degree of attainment of the 17 evaluated quality indicators ranged from 13% to 100%. Attainment of most individual quality indicators was associated with two-year survival. A higher compliance with composite quality indicators was associated with lower mortality at centre-, country- and region-level. Moreover, the higher the risk for two-year mortality, the lower the compliance with composite quality indicators. Conclusions: When EPICOR and EPICOR Asia were conducted, the European Society of Cardiology quality indicators would have been attained to a limited extent, suggesting wide room for improvement in the management of acute myocardial infarction patients. After adjustment for confounding, most quality indicators were associated with reduced two-year mortality and their prognostic value should receive further attention. The two composite quality indicators can be used as a tool for benchmarking either at centre-, country- or world region-level.

scholarly journals Kounis syndrome – an unusual etiology of acute myocardial infarction

2015 ◽  
Vol 10 (3) ◽  
pp. 295-299
Author(s):  
Vlad BĂTĂILĂ ◽  
◽  
Aura VÎJÎIAC ◽  
Lucian CÂLMÂC ◽  
Maria DOROBANŢU ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Acute Myocardial Infarction ◽  
Conservative Approach ◽  
Inferior Myocardial Infarction ◽  
Kounis Syndrome ◽  
Wasp Sting ◽  
St Segment Elevation ◽  
Coronary Syndrome ◽  
Vasoactive Mediators ◽  
St Segment

Kounis syndrome is defined as an association between an acute coronary syndrome and acute systemic allergy involving vasoactive mediators released during the activation of the mast cells. A 79 year old woman arrives at the emergency department with syncope; she was stung by a wasp an hour before symptoms’ onset. Clinical examination was normal, excepet her left upper limb which had important edema. The ECG revealed ST-segment elevation in the inferior leads and negative T waves in the anterior leads. Emergency coronary angiography was performed, which revealed a 40% stenotic plaque on the mid LAD. A conservative approach was decided. The patient received standard anti-ischemic treatment and she was safely discharged after 6 days. We considered this case a Kounis syndrome induced by a wasp sting associated with a silent inferior myocardial infarction.

scholarly journals Ventricular Septal Rupture after Acute Coronary Syndrome

2019 ◽  
Vol 4 (10) ◽  
Author(s):  
Pedro Rafael de Oliveira Nascimento ◽  
Gustavo Henrique Belarmino Góes ◽  
Caroline Bernardi Fabro ◽  
Mateus Lopes Barreto de Sousa ◽  
Diana Patricia Lamprea Sepulveda ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Acute Myocardial Infarction ◽  
Acute Coronary Syndrome ◽  
Emergency Room ◽  
Mechanical Complication ◽  
Ventricular Septal Rupture ◽  
Early Therapy ◽  
St Segment Elevation ◽  
Coronary Syndrome ◽  
St Segment

Objective: Ventricular septal rupture (VSR) is a rare but serious complication of acute myocardial infarction, which occurs in about 0.2 to 0.3% of patients with myocardial ischemia. If early therapy is not initiated, 90% of patients with VSR will die within the first month. This study aimed to evaluate the epidemiological and clinical characteristics of patients with VSR as a mechanical complication of acute myocardial infarction. Methods: A prospective study was conducted among nine patients who presented to the Cardiovascular Emergency Room of Pernambuco with acute coronary syndrome with ST segment elevation and VSR complications. Results: There were five women and 4 men, and the mean age of the patients was 72.5 years. The median time from the onset of the symptoms of acute coronary syndrome with ST segment elevation to the diagnosis of VSR was 3.5 days. Among the nine patients included in the study, three were treated surgically. Of all the patients, including those who underwent corrective surgery, eight patients died, 44.4% (N = 4), in the first four days after AMI. Conclusion: VSR occurs more frequently among elderly patients with multi-arterial involvement, lower wall infarction, and involvement of the right coronary artery. The prognosis is extremely limited, especially in patients who are already admitted to the cardiac emergency room with Killip IV, with > 24 hours of clinical evolution, and do not require surgical correction.

Sign in / Sign up

Export Citation Format

Share Document