scholarly journals Case Report of the Patient with Acute Myocardial Infarction: “From Flatline to Stent Implantation”

2017 ◽  
Vol 34 (4) ◽  
pp. 329-337
Author(s):  
Dejan Petrović ◽  
Marina Deljanin Ilić ◽  
Bojan Ilić ◽  
Sanja Stojanović ◽  
Milovan Stojanović ◽  
...  

Summary Asystole is a rare primary manifestation in the development of sudden cardiac death (SCD), and survival during cardiac arrest as the consequence of asystole is extremely low. The aim of our paper is to illustrate successful cardiopulmonary resuscitation (CPR) in patients with acute myocardial infarction (AMI) and rare and severe form of cardiac arrest - asystole. A very short time between cardiac arrest in acute myocardial infarction, which was manifested by asystole, and the adequate CPR measures that have been taken are of great importance for the survival of our patient. After successful reanimation, the diagnosis of anterior wall AMI with ST segment elevation was established. The right therapeutic strategy is certainly the early primary percutaneous coronary intervention (PPCI). In less than two hours, after recording the “flatline” and successful reanimation, the patient was in the catheterization laboratory, where a successful PPCI of LAD was performed, after emergency coronary angiography. In the further treatment course of the patient, the majority of risk factors were corrected, except for smoking, which may be the reason for newly discovered lung tumor disease. Early recognition and properly applied treatment of CPR can produce higher rates of survival.

1970 ◽  
Vol 2 (2) ◽  
pp. 212-217 ◽  
Author(s):  
AQM Reza ◽  
AHMW Islam ◽  
S Munwar ◽  
S Talukder

Objective: Aim of our study was to evaluate the safety and survival outcome of Primary PCI (pPCI) in patients with Acute Myocardial infarction in our hospital setting. Methods: Total 30 (Female 5; Male 25) patients were enrolled in this study who were brought in to our hospital with STEMI. Average age was, Male 56, Female 52. Primary PCI was performed after transferring patient from Emergency Department (ED) to Cardiac Catheterization laboratory. Cardiovascular risk factors among the studied population were Dyslipidemia, Diabetes Mellitus, Hypertension, Smoking and Family History. Results: Primary PCI either with Bare Metal Stent (BMS) or Drug Eluting Stent (Sirolimus-eluting stent or Paclitaxel stent) were performed in total 13 LAD lesion and 15 RCA lesion and 2 LCX lesion. BMS used were 66.7%, Sirolimus 20% and Paclitaxel-eluting stent 13.3%. Total 2 patients expired but due to hemorrhagic CVA and refractory heart failure. At presentation, ECG evidenced diagnosis were Acute Anterior Wall MI : 12 (40%), Inferior MI: 16 (53%), Infero-Posterior MI: 2 (6.7%). Our study showed that Primary PCI increases the higher survival outcome 28 (93.3%) out of 30 patients with acute MI. Conclusion: Our present study revealed that revascularization by Primary PCI showed safety and better percentage of In-hospital and 30-days survival outcome in patients with Acute myocardial infarction in our hospital setting. Keywords: Primary PCI; STEMI. DOI: 10.3329/cardio.v2i2.6641Cardiovasc. j. 2010; 2(2) : 212-217


2016 ◽  
Vol 2 (4) ◽  
pp. 151-158
Author(s):  
Monica Marton-Popovici ◽  
Dietmar Glogar

Abstract Out-of-hospital cardiac arrest (OHCA) occurring as the first manifestation of an acute myocardial infarction is associated with very high mortality rates. As in comatose patients the etiology of cardiac arrest may be unclear, especially in cases without ST-segment elevation on the surface electrocardiogram, the decision to perform or not to perform urgent coronary angiography can have a significant impact on the prognosis of these patients. This review summarises the current knowledge and recommendations for treating patients with acute myocardial infarction presenting with OHCA. New therapeutic measures for the post-resuscitation phase are presented, such as hypothermia or extracardiac life support, together with strategies aiming to restore the coronary flow in the resuscitation phase using intra-arrest percutaneous revascularization performed during resuscitation. The role of regional networks in providing rapid access to the hospital facilities and to a catheterization laboratory for these critical cardiovascular emergencies is described.


2021 ◽  
Vol 10 (Supplement_1) ◽  
Author(s):  
M Thoegersen ◽  
M Frydland ◽  
O Helgestad ◽  
LO Jensen ◽  
J Josiassen ◽  
...  

Abstract Funding Acknowledgements Type of funding sources: Foundation. Main funding source(s): Lundbeck Foundation OnBehalf Critical Cardiac Care Research Group Background Approximately half of all patients with acute myocardial infarction complicated by cardiogenic shock (AMICS) present with out-of-hospital cardiac arrest (OHCA). Cardiogenic shock due to OHCA is caused by abrupt cessation of circulation, whereas AMICS without OHCA is due to cardiac failure with low cardiac output. Thus, there may also be differences between the two conditions in terms of blood borne biomarkers. Purpose To explore the potential differences in the admission plasma concentrations of biomarkers reflecting tissue perfusion (lactate), neuroendocrine response (mid-regional proadrenomedullin [MRproADM], Copeptin, pro-atrial natriuretic peptide [proANP]), endothelial damage (Syndecan-1, soluble thrombomodulin [sTM]), inflammation (soluble suppression of tumorigenicity 2 [sST2]) and kidney injury (neutrophil gelatinase-associated lipocalin [NGAL]), in patients with AMICS presenting with or without OHCA. Method Consecutive patients admitted for acute coronary angiography due to suspected ST-elevation myocardial infarction (STEMI) were enrolled during a 1-year period. A total of 2,713 patients were screened. In the present study 86 patients with confirmed STEMI and CS at admission were included. Results Patients with OHCA (had significantly higher median admission concentrations of Lactate (6,9 mmol/L vs. 3.4 mmol/L p <0.001), NGAL (220 ng/ml  vs 150 ng/ml p = 0.046), sTM (10 ng/ml vs. 8.0  ng/ml p = 0.026) and Syndecan-1 (160 ng/ml vs. 120 ng/ml p= 0.015) and significantly lower concentrations of MR-proADM (0.85 nmol/L  vs. 1.6 nmol/L p <0.001) and sST2 (39 ng/ml vs. 62 ng/ml p < 0.001).  After adjusting for age, sex, and time from symptom onset to coronary angiography, lactate (p = 0.008), NGAL (p = 0.03) and sTM (p = 0.011) were still significantly higher in patients presenting with OHCA while sST2 was still significantly lower (p = 0.029). There was very little difference in 30-day mortality between the OHCA and non-OHCA groups (OHCA 37% vs. non-OHCA 38%). Conclusion Patients with STEMI and CS at admission with or without concomitant OHCA had similar 30-day mortality but differed in terms of Lactate, NGAL, sTM and sST2 levels at the time of admission to catheterization laboratory. These findings propose that non-OHCA and OHCA patients with CS could be considered as two individual clinical entities. Abstract Figure. Level of biomarkers OHCA vs. non-OHCA


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