scholarly journals The Role of Coronary Computed Tomography Angiography and Cardiac Magnetic Resonance in STEMI Patients with Normal Coronary Angiography

2017 ◽  
Vol 2 (3) ◽  
pp. 254-257
Author(s):  
Elena Beganu ◽  
Ioana Rodean ◽  
Lehel Bordi ◽  
Daniel Cernica ◽  
Imre Benedek
Keyword(s):  
Myocardial Infarction ◽  
Computed Tomography ◽  
Magnetic Resonance ◽  
Coronary Angiography ◽  
Coronary Angiogram ◽  
St Segment Elevation ◽  
St Segment ◽  
Normal Coronary Angiography ◽  
Angiographic Examination

Abstract Usually, the diagnosis of myocardial infarction based on patient symptoms, electrocardiogram (ECG) changes, and cardiac enzymes, is not a challenge for cardiologists. The correlation between coronary anatomy and the ECG territories that present ischemic changes can help the clinician to estimate which coronary artery presents lesions upon performing a coronary angiogram. In certain situations, the diagnosis of myocardial infarction can be difficult due to the lack of correlations between the clinical and paraclinical examinations and the coronary angiogram. In some cases, patients with chest pain and ST-segment elevation on the ECG tracing present with a normal coronary angiography. In other cases, patients without important changes on the ECG can present critical lesions or even occlusions upon angiographic examination. The aim of this article is to highlight the role of noninvasive coronary magnetic resonance and multi-slice computed tomography in patients with ST-segment elevation myocardial infarction and normal coronary angiography.

scholarly journals ST Segment Elevation Is Not Always Myocardial Infarction: A Case of Focal Myopericarditis

2017 ◽  
Vol 2017 ◽  
pp. 1-4
Author(s):  
Cyrus M. Munguti ◽  
Samuel Akidiva ◽  
Jacob Wallace ◽  
Hussam Farhoud
Keyword(s):  
Myocardial Infarction ◽  
Coronary Artery Disease ◽  
Chest Pain ◽  
Coronary Artery ◽  
Coronary Angiography ◽  
Cardiac Mri ◽  
St Segment Elevation ◽  
St Segment ◽  
Normal Coronary Angiography ◽  
Artery Disease

Protocols exist on how to manage STEMI patients, with well-established timelines. There are times when patients present with chest pain, ST segment elevation, and biomarker elevation that are not due to coronary artery disease. These conditions usually present with normal coronary angiography. We present a case that was clinically indistinguishable from STEMI and that was diagnosed with focal myopericarditis on cardiac MRI.

scholarly journals Electroangiographic Correlation of Simultaneous ST-Segment Elevations of Anterior and Inferior Segment: Who Is the Culprit?

2021 ◽  
pp. 263246362110155
Author(s):  
Pankaj Jariwala ◽  
Shanehyder Zaidi ◽  
Kartik Jadhav
Keyword(s):  
Myocardial Infarction ◽  
Coronary Angiography ◽  
Coronary Arteries ◽  
Index Case ◽  
St Segment Elevation ◽  
Segment Elevation Myocardial Infarction ◽  
St Segment ◽  
Inferior Segment ◽  
The Right ◽  
Proximal Occlusion

Simultaneous ST-segment elevation (SST-SE) in anterior and inferior leads in the setting of ST-segment elevation myocardial infarction is often confounding for a cardiologist and further more challenging is the angiographic localization of the culprit vessel. SST-SE can be fatal as it jeopardizes simultaneously a larger area of myocardium. This phenomenon could be due to “one lesion, one artery,” “two lesions, one artery,” “two lesions, two arteries,” or combinations in two different coronary arteries. We have discussed an index case where we encountered a phenomenon of SST-SE and coronary angiography demonstrated “two lesions, one artery” (proximal occlusion and distal critical diffuse stenoses of the wrap-around left anterior descending [LAD] artery) and “two lesions, two (different coronary) arteries” (previously mentioned stenoses of the LAD artery and critical stenosis of the posterolateral branch of the right coronary arteries). We have also described in brief the possible causes of this phenomena and their electroangiographic correlation of the culprit vessels.

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