scholarly journals A History of Kawasaki Disease From Childhood and Coronary Artery Ectasia With Recurrent ST Elevation Myocardial Infarction: A Therapeutic Challenge

2017 ◽  
Vol 8 (6) ◽  
pp. 344-348
Author(s):  
Ashraf Abugroun ◽  
Daniel Vilchez ◽  
Osama Hallak ◽  
Anahita Shahrrava
Keyword(s):  
Myocardial Infarction ◽  
Coronary Artery ◽  
Kawasaki Disease ◽  
St Elevation Myocardial Infarction ◽  
Coronary Artery Ectasia ◽  
Therapeutic Challenge ◽  
History Of ◽  
St Elevation

scholarly journals Romanian Patients Who Experience in-Stent Restenosis After St-Elevation Myocardial Infarction: The Experience of a Tertiary Center

2021 ◽  
Vol 18 (2) ◽  
pp. 7-13
Author(s):  
Alice Elena Munteanu ◽  
Liviu Chiriac ◽  
Filip Romi Bolohan ◽  
Daniel Niţă ◽  
Ruxandra Constantinescu ◽  
...  
Keyword(s):  
Risk Factors ◽  
Myocardial Infarction ◽  
Coronary Artery ◽  
St Elevation Myocardial Infarction ◽  
Warning Sign ◽  
Stent Restenosis ◽  
Tertiary Center ◽  
History Of ◽  
St Elevation ◽  
In Stent Restenosis

Abstract Background and aim. Coronary artery disease (CAD) is one of the most important causes of death worldwide. ST-elevation myocardial infarction (STEMI) is an acute form of presentation in patients with CAD. Percutaneous coronary intervention (PCI) is the treatment of choice in STEMI patients. Generally, a stent is placed after the culprit lesion is dilated in order to ensure the patency of the coronary artery. In-stent restenosis (ISR) is a possible chronic complication in this setting. The following study is one of the few of its kind, since it investigates ISR in a cohort of Romanian patients who underwent PCI in the setting of STEMI. Our current descriptive study aims at highlighting the characteristics of these patients and identifying potential risk factors in this specific population, which could be validated by a further larger study. Methods. We studied 68 patients from “Dr. Carol Davila” Central Military Emergency University Hospital in Bucharest, Romania, who presented with STEMI in 2016. The mean time for angiographic reevaluation was 111 days. Results. 94% (64) of the patients underwent primary PCI, while in 6% (4) of the cases thrombolysis was initially attempted before PCI. The most prevalent risk factors that we identified were: arterial hypertension (61%), dyslipidemia (60%) and smoking or history of smoking (47%). The anterior myocardial infarction was the most prevalent (49%). Only 6% of the patients had a documented history of CAD, while on the other hand chronic occlusions were observed in most patients (85%). Of note is that only 11% of the patients reported recurrent angina before the angiographic reevaluation. Conclusion. Common cardiovascular risk factors are also involved in ISR. Their poor management in the case of Romanian patients with STEMI increases the risk of ISR. The lack of symptoms in patients with ISR constitutes a warning sign for clinicians and shows that ISR is a complication which can be easily omitted. Therefore, its incidence is probably underestimated.

scholarly journals Usefulness of multimodality cardiac imaging in a patient with ST elevation myocardial infarction caused by two giant coronary artery aneurysms

2019 ◽  
Vol 12 (8) ◽  
pp. e229995
Author(s):  
Satoshi Hayashida ◽  
Tsukasa Yagi ◽  
Yasuyuki Suzuki ◽  
Eizo Tachibana
Keyword(s):  
Myocardial Infarction ◽  
Coronary Artery ◽  
Cardiac Imaging ◽  
Artery Aneurysm ◽  
Coronary Intervention ◽  
Structural Features ◽  
St Elevation Myocardial Infarction ◽  
History Of ◽  
St Elevation ◽  
The Right

Coronary artery aneurysm (CAA) is a rare cause of myocardial infarction. However, only a few studies have investigated this aspect. An 84-year-old woman with a history of hypertension presented with nausea. showed ST elevation in the inferior leads, and coronary angiography revealed two giant CAAs in the right coronary artery. Percutaneous coronary intervention was difficult because of risk of CAA rupture. Thus, these aneurysms were further evaluated using multimodality cardiac imaging to determine the treatment. MRI using late gadolinium enhancement revealed structural features of the aneurysms and the viability of the myocardium. Only antithrombotic medication was administered on the basis of the results of the multimodality cardiac imaging. Here, we report a rare case of a patient diagnosed with ST elevation myocardial infarction caused by thrombosis in giant CAAs using multimodality cardiac imaging, particularly MRI.

scholarly journals Clinical outcome of patients with ST-elevation myocardial infarction and angiographic evidence of coronary artery ectasia

2020 ◽  
Vol 41 (Supplement_2) ◽  
Author(s):  
A Silverio ◽  
L Esposito ◽  
G Fierro ◽  
M Di Maio ◽  
F Di Feo ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Coronary Artery ◽  
Coronary Angiography ◽  
St Elevation Myocardial Infarction ◽  
Coronary Artery Ectasia ◽  
Comparable Rate ◽  
Long Term Outcome ◽  
Angiographic Evidence ◽  
St Elevation

Abstract Background Coronary artery ectasia (CAE) is a relatively frequent finding in patient with ST-elevation myocardial infarction (STEMI) who undergo emergent coronary angiography. However, the long-term outcome of STEMI patients with CAE as compared to Non-CAE has been poorly investigated. Purpose To compare the baseline features and outcome of patients with and without CAE in the clinical setting of STEMI. Methods All patients with STEMI who underwent emergent coronary angiography from January 2012 to December 2017 at our Institution were retrospectively enrolled. Baseline demographic, clinical, instrumental, angiographic and percutaneous coronary intervention (PCI) findings were collected for patients with and without CAE. The study outcome measures were recurrent myocardial infarction (MI) and all-cause death. The propensity score weighting (PSW) technique was used to take into account for potential selection bias in treatment assignment between CAE and Non-CAE groups. Results The study included 534 patients with STEMI (mean age 62.9±12.0 years), 154 were CAE and 380 Non-CAE. The two groups were significantly different in terms of sex (90.9% in CAE vs 72,6% in Non-CAE, p<0.001), diabetes (11.7% vs. 25.8%; p=0.009) and smoking status (72.1% vs. 62.4%; p=0.042). The right coronary artery was more commonly treated in CAE patients (41.6% vs. 30.8%, p=0.023) and, as expected, the stent diameter (p<0.001) and the TIMI frame count (p<0.001) were significantly higher in CAE group. The myocardial blush grade was higher in Non-CAE (p<0.001). The Kaplan-Meyer analysis showed a comparable rate of all-cause death among the two groups (3.4/100 person/years in CAE vs. 3.5 per 100 person/years in Non-CAE, Log-Rank = 0.86). The survival free from recurrent MI was lower, although not statistically significant, in CAE vs. Non-CAE patients (3.1/100 person/years vs. 4.8/100 person/years; Log-Rank = 0.068). After PSW, an optimal balance was obtained as demonstrated by a standardized mean difference <0.1 for all the variables included in the model. The adjusted Cox regression analysis showed a significantly higher risk of recurrent MI in CAE vs. Non-CAE groups (HR = 1.93; p=0.009). No difference in the risk of all-cause death was observed (HR = 0.83, p=0.501). Conclusions Patient with STEMI and angiographic evidence of CAE have a different clinical profile compared to Non-CAE. In this analysis focused on STEMI patients, CAE was associated with a higher risk of recurrent MI at long-term follow-up. Funding Acknowledgement Type of funding source: None

scholarly journals Primary Percutaneous Coronary Intervention in the Left Main ST-Elevation Myocardial Infarction and Cardiogenic Shock on Octogenarian Patient with Single Remaining Vessel

2021 ◽  
Vol 9 (B) ◽  
pp. 363-366
Author(s):  
Mochamad Yusuf Alsagaff ◽  
Kandita Arjani ◽  
Yudi Oktaviono ◽  
Sondang Sitorus
Keyword(s):  
Myocardial Infarction ◽  
Coronary Artery ◽  
Cardiogenic Shock ◽  
Left Main Coronary Artery ◽  
Coronary Intervention ◽  
St Elevation Myocardial Infarction ◽  
Left Main ◽  
Percutaneous Coronary ◽  
History Of ◽  
St Elevation

The left main coronary artery (LMCA) ST-elevation myocardial infarction has been associated with significant morbidity and mortality. Older age and cardiogenic shock are independent predictors for in-hospital mortality. Here, we report a case of an 89-year-old Javanese man with a history of smoking presented with total LMCA occlusion complicated by cardiogenic shock in an octogenarian that was saved by stenting in thrombolysis in myocardial Infarction Flow III right coronary artery.

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