scholarly journals Diffuse ST-Segment Elevation With Idiopathic Malignant Ventricular Arrhythmia

Circulation ◽  
2021 ◽  
Vol 144 (5) ◽  
pp. 399-402
Author(s):  
Stefanie Cheang ◽  
Paul LeLorier ◽  
Kelly Gajewski
Keyword(s):  
Ventricular Arrhythmia ◽  
St Segment Elevation ◽  
St Segment ◽  
Malignant Ventricular Arrhythmia

Abstract 12815: Lambda-like St-segment Elevation in Acute Myocardial Infarction: May be a New Risk Predictor for Lethal Ventricular Arrhythmia

Circulation ◽  
2020 ◽  
Vol 142 (Suppl_3) ◽  
Author(s):  
Heng shee Kim ◽  
Gurudevan Mahadevan ◽  
Chuey Yan Lee ◽  
Hou Tee Lu
Keyword(s):  
Ventricular Arrhythmia ◽  
Hospital Mortality ◽  
Cardiogenic Shock ◽  
Early Recognition ◽  
High Risk Group ◽  
Total Occlusion ◽  
St Segment Elevation ◽  
St Segment ◽  
St Elevation ◽  
Risk Predictor

Introduction: Ventricular arrhythmia (VA) is the frequent most cause of SCD in AMI patients. Among, early VT and VF are associated with high in-hospital mortality. Certain ECG changes during AMI was reported to be associated with lethal VA. We described a case of lethal VA in AMI patient with a specific ECG sign - the Lambda ST elevation. Case Description: A 49 year old diabetic and hypertensive man presented with worse ever angina. Examination showed bilateral lung crepitation. ECG revealed wide spread Lambda shaped ST elevation over anteroinferior lead with reciprocal changes. He was treated as anteroinferior STEMI and planned for PPCI. During preparation, he developed VF and resuscitated with CPR and defibrillations. He was then intubated and BP supported with inotropes. Coronary angiogram showed acute total occlusion of RCA and LAD. We decided PCI to both vessels. Multiple white thrombus aspirated from RCA and successfully established TIMI II flow. Just before deployment of the stent, he developed VF again and resuscitated. RCA was stented after ROSC. Similarly, multiple red and white thrombus aspirated from LAD. After balloon dilatation, TIMI II flow re-established with no obvious lesion. Unfortunately, he developed VF storm in between and succumbed despite one hour of resuscitation effort with acceptable angiographic results. Discussion: The presence of elevated J-wave followed by a steep downsloping elevated ST segment that merges with the inverted T wave, forming a Lambda or shark fin shape, was reported to be associated with fatal VA, cardiogenic shock and in-hospital mortality. It is closely related to early abnormal ventricular repolarization, which involves acute myocardial ischemia and genetic abnormality. Conclusion: This case demonstrated that the presence of Lambda-like ST elevation in AMI may be a risk predictor for lethal VA and cardiogenic shock. Early recognition of this high risk group and prompt aggressive treatment strategies can be lifesaving.

scholarly journals Neuroleptic-Induced Brugada Syndrome - A Case Report

2018 ◽  
Vol 5 ◽  
Author(s):  
Fouad Laboudi ◽  
Ghizlane Slimani ◽  
Mohamed Essaid Gourani ◽  
Abderrazzak Ouanass
Keyword(s):  
Case Report ◽  
High Risk ◽  
Sudden Death ◽  
Ventricular Arrhythmia ◽  
Brugada Syndrome ◽  
Genetic Disease ◽  
Autosomal Dominant ◽  
Dominant Inheritance ◽  
St Segment Elevation ◽  
St Segment

Brugada syndrome is a rare genetic disease, of autosomal dominant inheritance with low penetrance, manifested by ST segment elevation at right precordial V1, V2 and V3, and right branch block aspect. to the electrocardiogram. It exposes to a high risk of ventricular arrhythmia that can cause syncope and even sudden death, on a structurally healthy heart.We report here the case of a young patient of 25 years who has a syndrome of Brugada induced by a neuroleptic. To our knowledge, this is the first reported case of Brugada syndrome induced by a neuroleptic Morocco. Therapeutic management is based on Amiodarone and betablockers. Regular monitoring of the ECG should, however, be performed on patients taking psychotropic drugs and also on associations.

Risk stratification for complex ventricular arrhythmia complicating ST-segment elevation myocardial infarction

2018 ◽  
Vol 29 (8) ◽  
pp. 681-686 ◽  
Author(s):  
Tomasz S. Podolecki ◽  
Radoslaw K. Lenarczyk ◽  
Jacek P. Kowalczyk ◽  
Ewa K. Jedrzejczyk-Patej ◽  
Piotr K. Chodor ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Ventricular Arrhythmia ◽  
Risk Stratification ◽  
St Segment Elevation ◽  
Segment Elevation Myocardial Infarction ◽  
St Segment

Implications of ventricular arrhythmia “bursts” with normal epicardial flow, myocardial blush, and ST-segment recovery in anterior ST-elevation myocardial infarction reperfusion: A biosignature of direct myocellular injury “downstream of downstream”

2014 ◽  
Vol 4 (1) ◽  
pp. 51-59 ◽  
Author(s):  
Mohamed Majidi ◽  
Andrzej S Kosinski ◽  
Sana M Al-Khatib ◽  
Lilian Smolders ◽  
Ecaterina Cristea ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Ventricular Arrhythmia ◽  
Cellular Response ◽  
Multivariable Analysis ◽  
Coronary Intervention ◽  
St Segment Elevation ◽  
St Segment ◽  
Percutaneous Coronary ◽  
St Elevation ◽  
Electrocardiogram Ecg

Aims: Establishing epicardial flow with percutaneous coronary intervention (PCI) for ST-segment elevation myocardial infarction (STEMI) is necessary but not sufficient to ensure nutritive myocardial reperfusion. We evaluated whether adding myocardial blush grade (MBG) and quantitative reperfusion ventricular arrhythmia “bursts” (VABs) surrogates provide a more informative biosignature of optimal reperfusion in patients with Thrombolysis in Myocardial Infarction (TIMI) 3 flow and ST-segment recovery (STR). Methods and results: Anterior STEMI patients with final TIMI 3 flow had protocol-blinded analyses of simultaneous MBG, continuous 12-lead electrocardiogram (ECG) STR, Holter VABs, and day 5–14 SPECT imaging infarct size (IS) assessments. Over 20 million cardiac cycles from >4500 h of continuous ECG monitoring in subjects with STR were obtained. IS and clinical outcomes were examined in patients stratified by MBG and VABs. VABs occurred in 51% (79/154) of subjects. Microcirculation (MBG 2/3) was restored in 75% (115/154) of subjects, of whom 53% (61/115) had VABs. No VABs were observed in subjects without microvascular flow (MBG of 0). Of 115 patients with TIMI 3 flow, STR, and MBG 2/3, those with VABs had significantly larger IS (median: 23.0% vs 6.0%, p=0.001). Multivariable analysis identified reperfusion VABs as a factor significantly associated with larger IS ( p=0.015). Conclusions: Despite restoration of normal epicardial flow, open microcirculation, and STR, concomitant VABs are associated with larger myocardial IS, possibly reflecting myocellular injury in reperfusion settings. Combining angiographic and ECG parameters of epicardial, microvascular, and cellular response to STEMI intervention provides a more predictive “biosignature” of optimal reperfusion than do single surrogate markers.

scholarly journals General Anesthetic Management for Patient with Brugada Syndrome: A Case Report

2020 ◽  
Vol 8 (6) ◽  
Author(s):  
Ji Won Bak ◽  
Se Jin Kim ◽  
Yeon Ji Roh ◽  
So Yeon Cho ◽  
Seongsik Kang
Keyword(s):  
Case Report ◽  
Ventricular Arrhythmia ◽  
General Anesthesia ◽  
Brugada Syndrome ◽  
Anesthetic Management ◽  
General Anesthetic ◽  
Bundle Branch Block ◽  
St Segment Elevation ◽  
St Segment ◽  
Block Pattern

Brugada syndrome is an arrhythmogenic cardiopathy characterized by electrocardiography (ECG) pattern of the presence of an atypical right bundle branch block pattern with ST segment elevation in the precordial leads (V1-V3). It is sometimes associated with sudden deaths caused by ventricular arrhythmia. Here, we are reporting a case of a 43-year-old male patient with Brugada syndrome who underwent a tonsillectomy under general anesthesia without any complications.

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