scholarly journals Repetitive Myocardial Infarctions Secondary to Delirium Tremens

2014 ◽  
Vol 2014 ◽  
pp. 1-3
Author(s):  
David Schwartzberg ◽  
Adam Shiroff
Keyword(s):  
Myocardial Infarction ◽  
Myocardial Ischemia ◽  
Alcohol Withdrawal ◽  
Delirium Tremens ◽  
Oxygen Demand ◽  
Myocardial Infarctions ◽  
Myocardial Oxygen Demand ◽  
Significant Morbidity ◽  
St Segment ◽  
Patients Experience

Delirium tremens develops in a minority of patients undergoing acute alcohol withdrawal; however, that minority is vulnerable to significant morbidity and mortality. Historically, benzodiazepines are given intravenously to control withdrawal symptoms, although occasionally a more substantial medication is needed to prevent the devastating effects of delirium tremens, that is, propofol. We report a trauma patient who required propofol sedation for delirium tremens that was refractory to benzodiazepine treatment. Extubed prematurely, he suffered a non-ST segment myocardial infarction followed by an ST segment myocardial infarction requiring multiple interventions by cardiology. We hypothesize that his myocardial ischemia was secondary to an increased myocardial oxygen demand that occurred during his stress-induced catecholamine surge during the time he was undertreated for delirium tremens. This advocates for the use of propofol for refractory benzodiazepine treatment of delirium tremens and adds to the literature on the instability patients experience during withdrawal.

The Electrocardiogram during Myocardial Infarction

1992 ◽  
Vol 3 (1) ◽  
pp. 190-202
Author(s):  
Linda K. Menzel
Keyword(s):  
Myocardial Infarction ◽  
Myocardial Ischemia ◽  
Myocardial Infarctions ◽  
Qrs Complex ◽  
Physical Assessment ◽  
T Wave ◽  
St Segment ◽  
Patient’S History

The electrocardiogram during myocardial ischemia, injury, and infarction produces classic changes in the QRS complex, ST segment, and T wave. These changes arc easily recognized and, with results of serum isoenzymes, physical assessment, and the patient’s history, aid in diagnosis. This article reviews the changes that occur on the electrocardiogram beginning with a brief review of normal depolarization and repolarization and ending with changes seen in various types of myocardial infarctions

scholarly journals Stent Embolization Mimicking Acute Myocardial Infarction

2021 ◽  
Vol 9 ◽  
pp. 232470962110365
Author(s):  
Syed Arqum Huda ◽  
Sara Akram Kahlown ◽  
Anojan Pathmanathan ◽  
Muhammad Saad Farooqi ◽  
Mark Charlamb
Keyword(s):  
Myocardial Infarction ◽  
Acute Myocardial Infarction ◽  
Stent Migration ◽  
Safe Procedure ◽  
Significant Morbidity ◽  
Fatal Complication ◽  
St Segment Elevation ◽  
Segment Elevation Myocardial Infarction ◽  
St Segment ◽  
Venous Stents

Venous thromboembolism is associated with significant morbidity and mortality if left untreated. Anticoagulation is the cornerstone of treatment. Venous stents are a relatively newer entity that are increasingly being used to treat venous stenosis/occlusion. It is a safe procedure, but complications include vein rupture, arterial puncture, retroperitoneal bleeding, and in-stent thrombosis. Stent migration is a rare but potentially fatal complication. We present a case of venous stent embolization to the heart that presented as a non-ST segment elevation myocardial infarction.

scholarly journals Pseudoaneurysm Development after Free Wall Rupture Post Myocardial Infarction

2020 ◽  
Vol 7 (3) ◽  
pp. 34
Author(s):  
Steven Douedi ◽  
Nasam Alfraji ◽  
Vandan D. Upadhyaya ◽  
Mihir Odak ◽  
Matthew Meleka ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Coronary Intervention ◽  
Left Ventricular ◽  
World Health ◽  
Myocardial Infarctions ◽  
Elderly Male ◽  
Left Ventricular Pseudoaneurysm ◽  
St Segment ◽  
High Operative Risk ◽  
Health Organization

Background: According to the World Health Organization, cardiovascular disease is the number one cause of death globally, claiming millions of lives each year with an increasing prevalence. Myocardial infarction (MI) makes up a large sum of these deaths each year. While MI in itself is lethal, there are several complications that can increase the morbidity and mortality of an MI, such as left ventricular wall rupture and aneurysms. Case Presentation: We present a case of an elderly male with an extensive cardiac history who presented with a non-ST segment myocardial infarction (NSTEMI) managed with percutaneous coronary intervention. Hours after, he became hemodynamically unable and was found to have a pseudoaneurysm of the left ventricle. Despite aggressive efforts, his pseudoaneurysm ruptured and he ultimately succumbed to his condition. Conclusions: Left ventricular pseudoaneurysm is usually seen after myocardial infarctions with a rupture rate of up to 45% leading to a mortality rate of about 50%. While cardiac catheterization with left ventriculography is the gold standard for diagnosis, echocardiography can also be used as an alternative. Treatment is emergent cardiac surgery but still holds a high operative risk. Therefore, patients may be medically stabilized and managed prior to ultimate surgical intervention.

Unstable angina: The significance of ST segment elevation or depression in patients without evidence of increased myocardial oxygen demand

1986 ◽  
Vol 112 (3) ◽  
pp. 463-467 ◽  
Author(s):  
Samuel Sclarovsky ◽  
Ehud Davidson ◽  
Boris Strasberg ◽  
Ruben F Lewin ◽  
Alexander Arditti ◽  
...  
Keyword(s):  
Unstable Angina ◽  
Oxygen Demand ◽  
Myocardial Oxygen Demand ◽  
St Segment Elevation ◽  
St Segment

scholarly journals Impact of ST‐Segment–Elevation Myocardial Infarction Regionalization Programs on the Treatment and Outcomes of Patients Diagnosed With Non–ST‐Segment–Elevation Myocardial Infarction

2021 ◽  
Vol 10 (3) ◽  
Author(s):  
Juan Carlos C. Montoy ◽  
Yu‐Chu Shen ◽  
Ralph G. Brindis ◽  
Harlan M. Krumholz ◽  
Renee Y. Hsia
Keyword(s):  
Myocardial Infarction ◽  
Myocardial Infarctions ◽  
St Segment Elevation ◽  
Risk Of Death ◽  
Segment Elevation Myocardial Infarction ◽  
Risk Of Mortality ◽  
St Segment ◽  
Changes In Risk ◽  
The Impact ◽  
Improve Access

Background Many communities have implemented systems of regionalized care to improve access to timely care for patients with ST‐segment–elevation myocardial infarction. However, patients who are ultimately diagnosed with non–ST‐segment–elevation myocardial infarctions (NSTEMIs) may also be affected, and the impact of regionalization programs on NSTEMI treatment and outcomes is unknown. We set out to determine the effects of ST‐segment–elevation myocardial infarction regionalization schemes on treatment and outcomes of patients diagnosed with NSTEMIs. Methods and Results The cohort included all patients receiving care in emergency departments diagnosed with an NSTEMI at all nonfederal hospitals in California from January 1, 2005 to September 30, 2015. Data were analyzed using a difference‐in‐differences approach. The main outcomes were 1‐year mortality and angiography within 3 days of the index admission. A total of 293 589 patients with NSTEMIs received care in regionalized and nonregionalized communities. Over the study period, rates of early angiography increased by 0.5 and mortality decreased by 0.9 percentage points per year among the overall population (95% CI, 0.4–0.6 and −1.0 to −0.8, respectively). Regionalization was not associated with early angiography (−0.5%; 95% CI, −1.1 to 0.1) or death (0.2%; 95% CI, −0.3 to 0.8). Conclusions ST‐segment–elevation myocardial infarction regionalization programs were not statistically associated with changes in guideline‐recommended early angiography or changes in risk of death for patients with NSTEMI. Increases in the proportion of patients with NSTEMI who underwent guideline‐directed angiography and decreases in risk of mortality were accounted for by secular trends unrelated to regionalization policies.

scholarly journals Postoperative Cardiac Ischemic Complications in Lung Cancer Patients

2019 ◽  
Vol 4 (5) ◽  
pp. 91-97 ◽  
Author(s):  
O. A. Bolshedvorskaya ◽  
K. V. Protasov ◽  
Yu. K. Batoroev ◽  
P. S. Ulybin ◽  
V. V. Dvornichenko
Keyword(s):  
Myocardial Infarction ◽  
Lung Cancer ◽  
Myocardial Ischemia ◽  
Small Cell Lung Cancer ◽  
Small Cell ◽  
Small Cell Lung ◽  
St Segment Elevation ◽  
St Segment ◽  
Ischemic Complications ◽  
Ischemic Events

Background. Perioperative myocardial ischemia often complicates extracardiac surgery. The problems of its prediction, diagnostics, treatment and prevention are not solved. Frequency, structure and clinical features of cardiac ischemic complications of surgical treatment of lung cancer are not well understood.The aim of the study was to investigate the frequency of postoperative myocardial infarction and myocardial ischemia in the surgical treatment of patients with non-small cell lung cancer.Methods. The frequency (%) of myocardial infarction (MI) with and without ST segment elevation of electrocardiogram, acute myocardial ischemia in a complete sample of cancer patients (n = 2051) who underwent treatment for non-small cell lung cancer for the last 10 years was calculated. By comparing the relative indicators and calculating the Odds Ratio (OR), we studied the relationship between the cardiac ischemic events with age, type of surgery, prevalence and localization of the tumour. The clinical manifestations and pathomorphology of postoperative myocardial infarction were analysed.Results. Cardiac ischemic complications of thoracotomy for lung cancer occurred in 2.73 % (95% CI 1.98–3.48) cases. Myocardial infarction with ST segment elevation was recorded in 1.07 % (95% CI 0.58–1.57) patients, MI without ST segment elevation – in 0.54 % (95% CI 0.17–0.9), myocardial ischemia – in 1.12 % (95% CI 0.62–1.63). An increase in the frequency of ischemic events after pneumonectomy was observed compared with lobectomy (OR 6.5, 95% CI 3.5–12.2) and after right-sided pneumonectomy compared with left-sided one (OR 3.2, 95% CI 1.6–6.3), and also the age over 70. Hospital mortality from MI was 39.3 %. According to autopsies of patients who died of МI, coronary atherothrombosis was detected in 2 of 22 cases.Conclusion. In the surgical treatment of non-small cell lung cancer, cardiac ischemic events develop in 2.73 % of patients. The greatest risk is associated with right-sided pneumonectomy.

scholarly journals Protective Effect of Shexiang Baoxin Pill on Myocardial Ischemia/Reperfusion Injury in Patients With STEMI

2021 ◽  
Vol 12 ◽  
Author(s):  
Haixia Qin ◽  
Siyuan Li ◽  
Zhenbing Liu
Keyword(s):  
Myocardial Infarction ◽  
Myocardial Ischemia ◽  
Protective Effect ◽  
Ischemia Reperfusion ◽  
Left Ventricular ◽  
Left Ventricular Ejection ◽  
St Segment ◽  
Myocardial Ischemia Reperfusion ◽  
Shexiang Baoxin Pill ◽  
Peak Value

Background: There is no definite effect in the treatment of myocardial ischemia/reperfusion (I/R) injury in patients with acute ST-segment elevation myocardial infarction (STEMI). We evaluated the protective effect of Shexiang Baoxin Pill (SBP) on I/R injury in STEMI patients.Methods: STEMI patients were randomly divided into a primary percutaneous coronary intervention (PPCI) group (n = 52) and a PPCI + SBP group (n = 51). The area at risk of infarction (AAR) and final infarct size (FIS) were examined by single-photon emission computed tomography (SPECT). I/R injury was assessed using myocardial salvage (MS) and salvage index (SI) calculated from AAR and FIS.Results: The ST-segment resolution (STR) in the PPCI + SBP group was significantly higher than that in the PPCI group (p = 0.036), and the peak value of high-sensitivity troponin T (hsTNT) was lower than that in the PPCI group (p = 0.048). FIS in the PPCI + SBP group was smaller than that in the PPCI group (p = 0.047). MS (p = 0.023) and SI (p = 0.006) in the PPCI + SBP group were larger than those in the PPCI group. The left ventricular ejection fraction (LVEF) in the PPCI + SBP group was higher than that in the PPCI group (p = 0.049), and N-terminal pro-B type natriuretic peptide (NT-proBNP) level in the PPCI + SBP group was lower than that in the PPCI group (p = 0.048).Conclusions: SBP can alleviate I/R injury (MS and SI), decrease myocardial infarction area (peak value of hsTNT and FIS), and improve myocardial reperfusion (MBG and STR) and cardiac function (LVEF and NT-proBNP).

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