scholarly journals An unusual myocardial infarction

2014 ◽  
Vol 1 (2) ◽  
pp. K9-K12 ◽  
Author(s):  
Sara Di Michele ◽  
Francesca Mirabelli ◽  
Domenico Galzerano ◽  
Sunil Mankad
Keyword(s):  
Myocardial Infarction ◽  
Heart Diseases ◽  
Cardiac Tumors ◽  
List Type ◽  
Transthoracic Echocardiogram ◽  
Cardiac Apex ◽  
The Right ◽  
Electrocardiogram Ecg ◽  
Learning Points ◽  
Chest Ct Scan

Summary We present a 74-year-old male with a chondrosarcoma, who presented with chest pain. The history, electrocardiogram (ECG), and biomarkers established the diagnosis of myocardial infarction (MI); angiography did not show coronary atherosclerosis and, both initial transthoracic echocardiogram and chest computed tomography (CT), did not demonstrate any cardiac abnormalities. A second echocardiogram following a routine ECG showed presence of a mass involving the right ventricle and the cardiac apex that was confirmed by chest CT scan. We underline the importance of considering cardiac tumors in the clinical arena of MI management. Learning points Cardiac tumors cause ECG changes similar to ischemic heart diseases. Keep in mind cardiac tumors when performing transthoracic echocardiogram (TTE) in the setting of suspected MI. TTE is the technique of choice in detecting cardiac tumors.

A 42-year-old woman with acute myocardial infarction

Heart ◽  
2018 ◽  
Vol 104 (19) ◽  
pp. 1607-1607 ◽  
Author(s):  
James K Fahey ◽  
Abdul Rahman Ihdayhid ◽  
Anthony John White
Keyword(s):  
Myocardial Infarction ◽  
Coronary Artery ◽  
Iliac Artery ◽  
Fibromuscular Dysplasia ◽  
External Iliac Artery ◽  
List Type ◽  
System A ◽  
Invasive Angiography ◽  
St Elevation ◽  
The Right

Clinical introductionA 42-year-old woman presented with anterior ST elevation myocardial infarction. Urgent coronary angiography revealed tapering then occlusion of the distal left anterior descending (LAD) coronary artery with no flow in the distal LAD (figure 1A). Balloon angioplasty with a 2.0×8 mm balloon re-established flow into the distal LAD. An angiogram of the right external iliac artery was also performed (figure 1B).Figure 1Invasive angiography of the left coronary system (A) and the right external iliac artery (B). The coronary angiogram (A) shows tapering and then occlusion (arrow) of the distal left anterior descending coronary artery.QuestionWhich of the following explains the abnormal appearance of the external iliac artery (figure 1B)?Atherosclerosis.Concertina effect.Fibromuscular dysplasia.Perforation.Multiple aneurysms.

scholarly journals Successful use of cinacalcet to treat parathyroid-related hypercalcemia in two pediatric patients

2018 ◽  
Vol 2018 ◽  
Author(s):  
E Mogas ◽  
A Campos-Martorell ◽  
M Clemente ◽  
L Castaño ◽  
A Moreno-Galdó ◽  
...  
Keyword(s):  
Pediatric Patients ◽  
Receptor Gene ◽  
Gene Mutations ◽  
Rare Condition ◽  
List Type ◽  
Calcium Sensing Receptor ◽  
Calcium Sensing ◽  
Severe Hypercalcemia ◽  
The Right ◽  
Learning Points

Summary Two pediatric patients with different causes of hyperparathyroidism are reported. First patient is a 13-year-old male with severe hypercalcemia due to left upper parathyroid gland adenoma. After successful surgery, calcium and phosphate levels normalized, but parathormone levels remained elevated. Further studies revealed a second adenoma in the right gland. The second patient is a 13-year-old female with uncommon hypercalcemia symptoms. Presence of pathogenic calcium-sensing receptor gene (CASR) mutation was found, resulting in diagnosis of symptomatic familial hypocalciuric hypercalcemia. Cinacalcet, a calcium-sensing agent that increases the sensitivity of the CASR, was used in both patients with successful results. Learning points: Hyperparathyroidism is a rare condition in pediatric patients. If not treated, it can cause serious morbidity. Genetic tests searching for CASR or MEN1 gene mutations in pediatric patients with primary hyperparathyroidism should be performed. Cinacalcet has been effective for treating different causes of hyperparathyroidism in our two pediatric patients. Treatment has been well tolerated and no side effects have been detected.

scholarly journals Digital And Palmar Dermatoglyphics In Myocardial Infarction

2012 ◽  
Vol 7 (2) ◽  
pp. 4-8
Author(s):  
A Manara ◽  
MA Habib ◽  
MA Rahman ◽  
M Ayub ◽  
N Begum ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Heart Diseases ◽  
Normal Male ◽  
Ridge Count ◽  
Coronary Heart Diseases ◽  
Ulnar Loop ◽  
Ridge Pattern ◽  
Significant Difference ◽  
Bangladeshi Population ◽  
The Right

Introduction: Dermatoglyphics pattern is feature with which human takes birth. As a diagnostic aid, it is now well established in a number of diseases which have a strong hereditary basis. The aetiology of coronary heart diseases is believed to be multi-factorial with genetics playing an important role. Objective: The present study was designed to make an observation of the usefulness of dermatoglyphic pattern in serving as a predictor for myocardial infarction among Bangladeshi male who were non relative to each other. Place of study: The study was conducted in the Department of Anatomy, Bangabandhu Sheikh Mujib Medical University (BSMMU), Dhaka, Bangladesh, between October 2003 and February 2005. Method: Inking method was used for taking finger and palm prints. Dermatoglyphic prints of five fingers and palm of both hands of sixty individuals were collected. Of them dermatoglyphic prints of both hands of 30 myocardial infarction (MI) male patients non relative to each other were selected as patients and same of 30 normal male having no myocardial infarction and having no family history of MI were selected as control. The dermatoglyphics of each hand of the patients were compared with those of the controls for: a) frequencies of different finger ridge patterns of the five fingers; b) total finger ridge count (TFRC); c) a-b, b-c, and c-d ridge counts of each hand; d) a-t-d angle; e) frequency of palmar ridge pattern and f) frequencies of different palmar creases. Result: The results of the controls confirmed more or less to the ethnic trends of the normal Bangladeshi. In case of finger dermatoglyphics, the MI patients showed higher frequencies of whorl patterns but lower frequencies of ulnar loop, radial loop and arch patterns than the controls. The mean total finger ridge count of the MI patients was lower than that of the controls (p>0.05). In case of palmar dermatoglyphics a-b, c-d ridge counts was higher and b-c ridge counts was lower in the MI patients than in the controls. Mean a-t-d angle was wider in the MI patients than that of the controls. Palmar patterns and creases showed no significant difference except transitional crease of the right hand that was significantly lower in MI patients than controls. Conclusion: Result of this study may be used to standardize the dermatoglyphic pattern of Bangladeshi population and to identify person susceptible to MI. DOI: http://dx.doi.org/10.3329/jafmc.v7i2.10386 JAFMC 2011; 7(2): 4-8

scholarly journals Pheochromocytomatosis associated with a novel TMEM127 mutation

2017 ◽  
Vol 2017 ◽  
Author(s):  
Run Yu ◽  
Danielle Sharaga ◽  
Christopher Donner ◽  
M Fernando Palma Diaz ◽  
Masha J Livhits ◽  
...  
Keyword(s):  
Surgical Resection ◽  
Rare Complication ◽  
List Type ◽  
Open Resection ◽  
Rare Form ◽  
Tumor Capsule ◽  
The Right ◽  
Learning Points ◽  
Generation Sequencing ◽  
Capsule Rupture

Summary Pheochromocytomatosis, a very rare form of pheochromocytoma recurrence, refers to new, multiple, and often small pheochromocytomas growing in and around the surgical resection bed of a previous adrenalectomy for a solitary pheochromocytoma. We here report a case of pheochromocytomatosis in a 70-year-old female. At age 64 years, she was diagnosed with a 6-cm right pheochromocytoma. She underwent laparoscopic right adrenalectomy, during which the tumor capsule was ruptured. At age 67 years, CT of abdomen did not detect recurrence. At age 69 years, she began experiencing episodes of headache and diaphoresis. At age 70 years, biochemical markers of pheochromocytoma became elevated with normal calcitonin level. CT revealed multiple nodules of various sizes in the right adrenal fossa, some of which were positive on metaiodobenzylguanidine (MIBG) scan. She underwent open resection of pheochromocytomatosis. Histological examination confirmed numerous pheochromocytomas ranging 0.1–1.2 cm in size. Next-generation sequencing of a panel of genes found a novel heterozygous germline c.570delC mutation in TMEM127, one of the genes that, if mutated, confers susceptibility to syndromic pheochromocytoma. Molecular analysis showed that the c.570delC mutation is likely pathogenic. Our case highlights the typical presentation of pheochromocytomatosis, a rare complication of adrenalectomy for pheochromocytoma. Previous cases and ours collectively demonstrate that tumor capsule rupture during adrenalectomy is a risk factor for pheochromocytomatosis. We also report a novel TMEM127 mutation in this case. Learning points: Pheochromocytomatosis is a very rare form of pheochromocytoma recurrence. Pheochromocytomatosis refers to new, multiple and often small pheochromocytomas growing in and around the surgical resection bed of a previous adrenalectomy for a solitary pheochromocytoma. Tumor capsule rupture during adrenalectomy predisposes a patient to develop pheochromocytomatosis. Surgical resection of the multiple tumors of pheochromocytomatosis is recommended. Pheochromocytoma recurrence should prompt genetic testing for syndromic pheochromocytoma.

Seventy-six-year-old man with progressive dyspnoea

Heart ◽  
2018 ◽  
Vol 105 (1) ◽  
pp. 74-88 ◽  
Author(s):  
Juan Martínez-Milla ◽  
Ángel José Maestre Bastardo ◽  
Marcelino Cortés
Keyword(s):  
Cardiac Myxoma ◽  
Usual Interstitial Pneumonia ◽  
Smoking History ◽  
List Type ◽  
Transthoracic Echocardiogram ◽  
Chamber View ◽  
Radiological Data ◽  
Chest X Ray ◽  
St Elevation ◽  
The Right

Clinical introductionA 76-year-old man with 50 years of smoking history was diagnosed in 2012 with diffuse interstitial lung disease, with radiological data of usual interstitial pneumonia. He came to the emergency room presenting with progression of dyspnoea for 1 week, concomitant with loss of 5 kg of weight, anorexia and poor general condition. He had tachypnoea at rest (30 breaths/min), peripheral cyanosis, speech interfered by cough and breathlessness, baseline oxygen saturation 90%, heart rate 40 beats/min and blood pressure 130/70 mm Hg. Chest X-ray was performed and there was basal atelectasia of the right lung. ECG and urgent echocardiogram (transthoracic echocardiogram, TTE) were also performed (figure 1).QuestionWhich of the following best explains the patient’s situation?Figure 1(A) ECG. (B) Long-axis parasternal view from the transthoracic echocardiogram (TTE). (C) Four-chamber view from the TTE.Acute pulmonary embolismNon-ST elevation myocardial infarctionCardiac lymphomaCardiac myxomaMobitz type II AV block

Identification of myocardial infarction from analysis of ECG signal

2020 ◽  
Vol 24 (3) ◽  
pp. 217-226
Author(s):  
D.B.V. Jagannadham ◽  
D.V. Sai Narayana ◽  
P. Ganesh ◽  
D. Koteswar
Keyword(s):  
Myocardial Infarction ◽  
Feature Extraction ◽  
Early Stage ◽  
Heart Diseases ◽  
Ecg Signal ◽  
St Segment Elevation ◽  
T Wave ◽  
European Database ◽  
St Segment ◽  
Electrocardiogram Ecg

Many heart diseases can be identified and cured at an early stage by studying the changes in the features of electrocardiogram (ECG) signal. Myocardial Infarction (MI) is the serious cause of death worldwide. If MI can be detected early, the death rate will reduce. In this paper, an algorithm to detect MI in an ECG signal using Daubechies wavelet transform technique is developed. The ECG signal-denoising is performed by removing the corresponding wavelet coefficients at higher scale. After denoising, an important step towards identifying an arrhythmia is the feature extraction from the ECG. Feature extraction is carried out to detect the R peaks of the ECG signal. Since as R peak is having the highest amplitude, and therefore it is detected in the first round, subsequently location of other peaks are determined. Having completed the preprocessing and the feature extraction the MI is detected from the ECG based on inverted T wave logic and ST segment elevation. The algorithm was evaluated using MIT-BIH database and European database satisfactorily.

scholarly journals Uneventful survival of a rural child after penetrating cardiac injury by a thorn: a case report

2019 ◽  
Vol 3 (3) ◽  
Author(s):  
Rik De Decker ◽  
Yifan Joshua Li ◽  
Dirk von Delft ◽  
Heidi Meyer ◽  
Alfred Mureko
Keyword(s):  
Cardiac Injury ◽  
Median Sternotomy ◽  
Management Guidelines ◽  
Pulsatile Mass ◽  
Cardiac Apex ◽  
Definition Of ◽  
The Right ◽  
Penetrating Cardiac Injury ◽  
Learning Points

Abstract Background Paediatric penetrating cardiac injury is extremely rare, precluding published management guidelines, therefore warranting a case-by-case approach with learning points gleaned from each case. Case summary A 7-year-old boy presented to a rural hospital with a stab wound to the chest by a Withaak (Vachellia tortilis) thorn. The patient was haemodynamically stable on presentation, but a 2 cm subcutaneous, pulsatile mass was present at the cardiac apex. Echocardiography revealed a foreign body penetrating from the apex into the heart, with evidence for a fistula between a cardiac chamber and the pulsatile mass. Angiography confirmed the existence of the fistula between the right ventricle (RV) and the pulsatile mass. A controlled extraction under general anaesthaesia via median sternotomy was performed in-theatre, with blood products and cardiac bypass on standby. The patient recovered without complications and was discharged after 4 days. Discussion Our case illustrates the limitations of echocardiography in identifying the precise anatomical definition of penetrating cardiac injuries. Angiography is therefore indicated in such cases. The injury to the RV and the haemostatic effects of the in situ thorn were favourable prognostic factors. We believe that the mortality risk reduction of extraction under full control warrants the minor morbidity of a median sternotomy.

Off-Pump Supraarterial Decompression Myotomy for Myocardial Bridging

2005 ◽  
Vol 8 (1) ◽  
pp. 49 ◽  
Author(s):  
Mersa M. Baryalei ◽  
Theodorus Tirilomis ◽  
Wolfgang Buhre ◽  
Stephan Kazmaier ◽  
Friedrich A. Schoendube ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Exercise Testing ◽  
Clinical Symptoms ◽  
Therapeutic Option ◽  
Median Sternotomy ◽  
Myocardial Bridging ◽  
Off Pump ◽  
Hemodynamic Compromise ◽  
Artery Disease ◽  
The Right

Background: Myocardial bridging of the left anterior descending (LAD) artery may result in clinical symptoms. Surgery with cardiopulmonary bypass (CPB) is a therapeutic option with considerable risk. We hypothesized that off-pump supraarterial myotomy could be an effective treatment modality. Methods: Between October 1998 and May 2000, 13 patients were referred for surgery. All were symptomatic despite medical therapy. Anteroseptal ischemia had been proven by thallium scintigraphy in all 13 patients, exercise testing was positive in 11. All patients were operated on with an off-pump approach after median sternotomy. Results: Mean patient age was 61 8 years (range, 43-71 years). Coronary artery disease mandating additional bypasses was present in 3 patients. The bypasses were done off pump in 2 patients. Conversion to on-pump surgery was necessary in 3 of 13 patients (23%) because of hemodynamic compromise (1 patient), opening of the right ventricle (1 patient), and injury to the LAD (1 patient). Supraarterial myotomy was performed in all patients. One patient who underwent surgery with CPB developed postoperative anteroseptal myocardial infarction. Postoperative exercise testing was performed in all patients and did not reveal any persistent ischemia. Mortality was 0%. All patients were free from symptoms and had not undergone repeat interventions after an average of 51 7 months of follow-up. Conclusions: Off-pump supraarterial myotomy effectively relieves coronary obstruction but has a certain periprocedural risk as evidenced by 1 myocardial infarction, 1 right ventricular injury, and 1 LAD injury. Long-term freedom from symptoms and from reintervention favor further investigation of this surgical therapy.

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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