Diagnosis of Myocardial Damage upon the Frank Lead Electrocardiogram

In a review article based on my own clinical experience of managing patients with acute myocardial injury and fulminant myocarditis, taking into account expert recommendations on the clinical treatment of myocardial damage associated with novel coronavirus infection a National clinical geriatric medical research center, division of cardiovascular diseases, the Chinese geriatrics society, Department of cardiology, Beijing Medical Association and European clinics discusses the pathogenesis, diagnosis and treatment of myocardial damage and FM patients, infected with SARS-CoV-2 in the context of the COVID-19 pandemic. Clinical features and diagnostic criteria are presented, including screening tests of markers of myocardial damage in the form of a highly sensitive troponin test, a natriuretic peptide. The article discusses in detail the pathogenesis and mechanisms of myocardial damage, including immune mechanisms, cytokine storm, systemic inflammation with macro- and microvascular dysfunction and the development of myocardial dysfunction with acute heart failure, hypotension, cardiogenic shock and/or life-threatening heart rhythm disorders caused by hypoxia and metabolic disorders at the cellular level. Features of the clinical course of fulminant myocarditis in infected patients (SARS-CoV-2) in the conditions of the COVID-19 pandemic are presented. For the first time, a detailed histo-morphological analysis of pathological myocardial injuries and complications is presented on the basis of unique autopsy material on post-mortem diagnostics of various pathoanatomic autopsies of those who died from COVID-19 in Moscow. Based on the clinical, functional and morphological material, the Protocol of etiopathogenetic treatment is presented. The basis of standard therapy is considered antiviral drugs, immunoglobulin G, the use of monoclonal antibodies to interleukin-6, anticoagulants, glucocorticoids, depending on the clinical situation, cardioprotectors and symptomatic treatment are recommended to maintain the heart, which in combination can achieve a certain clinical effectiveness. As adjuvant cardioprotective targeted therapy, the sodium salt of phosphocreatine is considered in order to preserve the myocardium, maintain its contractility and vital activity.

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Estimation of the Safety of Intraoperative Fluid Therapy during Great Abdominal Surgery in Patients with Coronary Heart Disease

Ukraïnsʹkij žurnal medicini bìologìï ta sportu ◽

10.26693/jmbs05.05.158 ◽

2020 ◽

Vol 5 (5) ◽

pp. 158-163

Author(s):

V. I. Lysenko ◽

◽

E. A. Karpenko ◽

Ya. V. Morozova

Keyword(s):

Heart Failure ◽

Coronary Heart Disease ◽

Heart Disease ◽

Fluid Therapy ◽

Troponin I ◽

Significant Proportion ◽

Myocardial Damage ◽

Enzyme Linked Immunosorbent Assay ◽

Cardiac Complications ◽

Fluid Regimen

The study of intraoperative fluid therapy tactics has been of great interest over the past few years, especially in people with concomitant coronary heart disease, as they make up a significant proportion of all surgical patients. The purpose of our study was to assess the risk of intraoperative myocardial damage in patients with concomitant coronary heart disease depending on the fluid regimen used based on monitoring of hemodynamic parameters, electrocardiogram and biomarkers of myocardial damage. Material and methods. The study involved 89 patients, who were divided into two groups depending on the tactics of intraoperative fluid therapy – restrictive and liberal. In order to detect cardiac complications at different stages, we assessed biomarkers of myocardial damage Troponin I, NT-proBNP by solid-phase enzyme-linked immunosorbent assay (ELISA). Results and discussion. Analysis of the obtained data showed that MINS (myocardial injury in noncardiac surgery) incidents were diagnosed in 5 patients (11.1%) in the first group and in 6 patients (13.6%) in the second. In patients of both groups there was an increase in NT-proBNP in the dynamics at all stages, and in the 2nd group, with a liberal regimen of intraoperative fluid therapy, it was more pronounced. It should be noted that the obtained values of NT-proBNP in all patients did not differ significantly from those allowed for this age group; such dynamics of NT-proBNP may indicate a relative risk of complications of liberal fluid therapy in patients with baseline heart failure. One of the important points when choosing the mode of fluid therapy in patients with high cardiac risk is the assessment of the initial volemic status and careful monitoring of water balance in the perioperative period with the desire for "zero" balance. The obtained dynamics of laboratory markers of myocardial damage indicates that in patients with a significant reduction in cardiac reserves compensated for heart failure, a restrictive fluid regimen is preferable, which is also confirmed by slight changes in the concentration of biomarkers. Conclusion. Thus, the study demonstrated the relative safety of selected fluid regimens in patients with concomitant coronary heart disease without signs of congestive heart failure

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Detection of myocardial damage and cardiac dysfunction following ecstasy ingestion

Clinical Intensive Care ◽

10.3109/tcic.12.2.85.87 ◽

2001 ◽

Vol 12 (2) ◽

pp. 85-87 ◽

Cited By ~ 3

Author(s):

RA Harry ◽

R Sherwood ◽

J Wendon

Keyword(s):

Cardiac Dysfunction ◽

Myocardial Damage

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Faculty Opinions recommendation of Presentation, patterns of myocardial damage, and clinical course of viral myocarditis.

Faculty Opinions – Post-Publication Peer Review of the Biomedical Literature ◽

10.3410/f.1047966.497996 ◽

2006 ◽

Author(s):

Eike Nagel

Keyword(s):

Clinical Course ◽

Viral Myocarditis ◽

Myocardial Damage

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New Method to Delineate Myocardial Damage at Surgery

Circulation ◽

10.1161/01.cir.39.5s1.i-83 ◽

1969 ◽

Vol 39 (5s1) ◽

Cited By ~ 9

Author(s):

GERARD A. KAISER ◽

ALBERT L. WALDO ◽

PAUL D. HARRIS ◽

FREDERICK O. BOWMAN ◽

BRIAN F. HOFFMAN ◽

...

Keyword(s):

Myocardial Damage ◽

New Method

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Cytoprotective Potential of Aged Garlic Extract (AGE) and Its Active Constituent, S-allyl-l-cysteine, in Presence of Carvedilol during Isoproterenol-Induced Myocardial Disturbance and Metabolic Derangements in Rats

Molecules ◽

10.3390/molecules26113203 ◽

2021 ◽

Vol 26 (11) ◽

pp. 3203

Author(s):

Syed Mohammed Basheeruddin Asdaq ◽

Obulesu Challa ◽

Abdulhakeem S. Alamri ◽

Walaa F. Alsanie ◽

Majid Alhomrani ◽

...

Keyword(s):

Myocardial Dysfunction ◽

Combined Therapy ◽

Myocardial Damage ◽

Thiobarbituric Acid ◽

Significant Rise ◽

Garlic Extract ◽

High Dose ◽

Aged Garlic Extract ◽

Active Constituent ◽

Aged Garlic

This study was conducted to determine the potential interaction of aged garlic extract (AGE) with carvedilol (CAR), as well as to investigate the role of S-allyl-l-cysteine (SAC), an active constituent of AGE, in rats with isoproterenol (ISO)-induced myocardial dysfunction. At the end of three weeks of treatment with AGE (2 and 5 mL/kg) or SAC (13.1 and 32.76 mg/kg), either alone or along with CAR (10 mg/kg) in the respective groups of animals, ISO was administered subcutaneously to induce myocardial damage. Myocardial infarction (MI) diagnostic predictor enzymes, lactate dehydrogenase (LDH) and creatinine kinase (CK-MB), were measured in both serum and heart tissue homogenates (HTH). Superoxide dismutase (SOD), catalase, and thiobarbituric acid reactive species (TBARS) were estimated in HTH. When compared with other groups, the combined therapy of high doses of AGE and SAC given alone or together with CAR caused a significant decrease in serum LDH and CK-MB activities. Further, significant rise in the LDH and CK-MB activities in HTH was noticed in the combined groups of AGE and SAC with CAR. It was also observed that both doses of AGE and SAC significantly increased endogenous antioxidants in HTH. Furthermore, histopathological observations corroborated the biochemical findings. The cytoprotective potential of SAC and AGE were dose-dependent, and SAC was more potent than AGE. The protection offered by aged garlic may be attributed to SAC. Overall, the results indicated that a high dose of AGE and its constituent SAC, when combined with carvedilol, has a synergistic effect in preventing morphological and physiological changes in the myocardium during ISO-induced myocardial damage.

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