Acute Myocardial Infarction Secondary to Suspected Paradoxical Emboli through Patent Foramen Ovale in a Young Woman

2011 ◽  
Vol 9 (2) ◽  
pp. 122
Author(s):  
Mohammad Hassan Namazi ◽  
Marjan Biglari ◽  
Mohammad Khani ◽  
Vahid Eslami ◽  
Mohammad Reza Movahed ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Patent Foramen Ovale ◽  
Left Ventricular Systolic Dysfunction ◽  
Systolic Dysfunction ◽  
Anterior Wall ◽  
Left Ventricular ◽  
Foramen Ovale ◽  
Anterior Myocardial Infarction ◽  
Severe Left Ventricular Dysfunction ◽  
Paradoxical Embolus

A 40-year-old woman presented with an extensive anterior myocardial infarction. After initial thrombolytic therapy, coronary angiography was performed a few days later revealing normal coronaries with severe left ventricular dysfunction secondary to anterior wall akinesia. Echocardiography showed severe left ventricular systolic dysfunction and a patent foramen ovale (PFO). The patient had a history of long-term oral contraceptive consumption. A paradoxical embolus into the left coronary artery via a large PFO was suspected and was successfully treated with PFO closure.

scholarly journals Successful Medical Management of a Left Ventricular Thrombus and Aneurysm following Failed Thrombolysis in Myocardial Infarction

2013 ◽  
Vol 7 ◽  
pp. CMC.S10929 ◽  
Author(s):  
Adebayo T Oyedeji ◽  
Christopher Lee ◽  
Olukolade O Owojori ◽  
Olabanji J Ajegbomogun ◽  
Adeseye A Akintunde
Keyword(s):  
Myocardial Infarction ◽  
Left Ventricular Systolic Dysfunction ◽  
Systolic Dysfunction ◽  
Left Ventricular ◽  
Left Ventricular Aneurysm ◽  
Ventricular Systolic Dysfunction ◽  
Anterior Myocardial Infarction ◽  
Short Intervals ◽  
Ventricular Thrombus

We report the case of a patient with an extensive anterior myocardial infarction complicated by left ventricular systolic dysfunction, left ventricular apical thrombus and an apical left ventricular aneurysm following failed thrombolysis. We obtained serial two-dimensional echocardiograms at short intervals in the acute phase and also during the months of recovery and follow up. The patient was successfully and exclusively medically managed.

Abstract 16749: Prevalence, Predictors, and Prognostic Implications of Left Ventricular Systolic Dysfunction Among Patients With STEMI in India: The Prospective NORIN-STEMI Registry

Circulation ◽  
2020 ◽  
Vol 142 (Suppl_3) ◽  
Author(s):  
Ambarish Pandey ◽  
Shreya Rao ◽  
Girish MP ◽  
Puneet Gupta ◽  
Sameer Arora ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Left Ventricular Systolic Dysfunction ◽  
Systolic Dysfunction ◽  
Tertiary Care ◽  
Anterior Wall ◽  
Left Ventricular ◽  
Middle Income ◽  
Logistic Regression Models ◽  
Low Middle Income Countries ◽  
Prognostic Implications

Introduction: Left ventricular (LV) systolic dysfunction (LVSD) and HF are important complications of ST-elevation myocardial infarction (STEMI). The prevalence and prognostic implications of LVSD in patients with STEMI in low/middle-income countries such as India are not well established. Methods: The present analysis was performed using data from the ongoing , prospective NORIN-STEMI registry of patients presenting with STEMI to 2 tertiary care medical centers in New Delhi, India from January to November 2019. LV ejection fraction (EF) was assessed at STEMI presentation using transthoracic echocardiography. Covariate-adjusted logistic regression models were constructed to evaluate the association of LVSD (mild: EF = 40-50%; moderate/severe: EF<40%; ref: EF>50%) with risk of in-hospital and 30-day mortality. Results: Among 3,635 patients with STEMI (age: 55[45-62], 33%≤50 years, 16% women), 1,489 (41%) had mild and 1,675 (46%) had moderate/severe LVSD on presentation. Patients with greater LVSD more commonly presented with anterior wall STEMI and had more frequent involvement of the left anterior descending artery as the culprit vessel. Among those with no, mild or moderate/severe LVSD, PCI was performed in 70% and 62% of patients, respectively. Hypertension, prior myocardial infarction, physical inactivity, greater time since symptom onset, and lower literacy levels were each independently associated with higher likelihood of LVSD. In adjusted analysis, LVSD was significantly associated with higher likelihood of in-hospital but not 30-day mortality ( See Table ). Conclusion: Among patients presenting to tertiary care centers in India with STEMI, LVSD is common, with 87% demonstrating LVEF<50%. LVSD was significantly associated with higher risk of in-hospital and 30-day mortality. Future studies are needed to determine if quality improvement efforts to standardize pathways for primary PCI may lessen occurrence of LVSD.

Clinical, Electrocardiographic and Echocardiographic Profile of Ischemic Cardiomyopathy: An analysis of 100 cases.

2021 ◽  
Vol 35 (2) ◽  
pp. 121-127
Author(s):  
Mainul Islam ◽  
M Atahar Ali ◽  
Umme Habiba Ferdaushi ◽  
Shaila Nabi ◽  
Sayeedur Rahman Khan ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Data Analysis ◽  
Mitral Regurgitation ◽  
Ischemic Cardiomyopathy ◽  
Left Ventricular Systolic Dysfunction ◽  
Systolic Dysfunction ◽  
Left Ventricular ◽  
Left Ventricular Ejection ◽  
Anterior Myocardial Infarction ◽  
Ventricular Ejection Fraction

Background: Ischemic heart disease (IHD) is one of the leading cause of morbidity and mortality worldwide. Ischemic cardiomyopathy (ICM) is a delayed complication of IHD that arises as dilated cardiomyopathy with depressed ventricular function, which cannot be attributed entirely to coronary artery obstruction or ischemic injury. Objectives: To evaluate the clinical, electrocardiographic and echocardiographic profile of patients presenting with ischemic cardiomyopathy. Methods: In this cross sectional observational study 100 patients of ischemic cardiomyopathy admitted in hospital or visited OPD in NICVD, Dhaka from March’15 to Sept’15 were studied. Enrollment of the patients were done after fulfilling the inclusion and exclusion criteria. Clinical, electrocardiographic and echocardiographic data were collected then data analysis was done. Results: Data analysis of 100 patients was showed age range was 40-80 years and mean age was 61.4±7.9 years. 79% subjects were male. Most common symptoms were dyspnea (93%), chest pain(73%), palpitation (39%) and edema (23%). Most patients were in NYHA functional class lV (43%). 64% cases had history of anterior myocardial infarction (MI), 22% had inferior MI, 25% had H/O PTCA and 7% had CABG. 71% subjects had tachycardia, 65% had lungs basal rales, 56% had systolic blood pressure below 100 mmhg and 25% had edema. ECG findings was as follows sinus rhythm (85%), Sinus tachycardia 71%, AF 15%, LBBB 34%, RBBB 12%, pathological Q in anterior surface 65% and inferior surface 21%, non specific ST-T changes 41% and PVCs was found in 17%.On echocardiography ,anterior wall hypokinesia was seen in 52% and global hypokinesia in 43%. Mean left ventricular ejection fraction (LVEF) was 31±5.9% and mean left ventricular internal diastolic diameter (LVIDd) was 6.5±0.4 cm. (59%) subjects had mitral regurgitation (MR) grade-l and 20% had MR grade-ll. Conclusion: The clinical presentation of ischemic cardiomyopathy varies from patient to patient. Severity of symptoms correlates with severity of left ventricular systolic dysfunction, left ventricular diameter and mitral regurgitation grade . Anterior Myocardial infarction has more chance to develop ischemic cardiomyopathy. Bangladesh Heart Journal 2020; 35(2) : 121-127

scholarly journals Rare recurrence of apical ballooning (takotsubo) syndrome in an elderly man

2018 ◽  
pp. bcr-2017-222451
Author(s):  
Rosalyn Adigun ◽  
Samantha Morley ◽  
Abhiram Prasad
Keyword(s):  
Myocardial Infarction ◽  
Acute Myocardial Infarction ◽  
Left Ventricular Systolic Dysfunction ◽  
Systolic Dysfunction ◽  
Obstructive Coronary Artery Disease ◽  
Apical Ballooning ◽  
Left Ventricular ◽  
Major Surgery ◽  
Apical Ballooning Syndrome ◽  
Elderly Male

Apical ballooning syndrome (ABS) is an under recognised clinical entity characterised by acute reversible left ventricular systolic dysfunction that mimics acute myocardial infarction in the absence of obstructive coronary artery disease; typically occurring in the setting of profound stress.1 ABS disproportionately affects older women and recurrences are infrequent. We, hereby, describe a rare phenomenon of recurrent ABS in an elderly male patient, 10 years apart, presenting with the same left ventricular morphological appearance following non-cardiac surgeries. The case illustrates the importance of considering ABS in the differential diagnosis of perioperative acute myocardial infarction in older men undergoing major surgery.

Left ventricular apical mass after myocardial infarction—not always a thrombus: a diagnostic dilemma

2021 ◽  
Vol 14 (10) ◽  
pp. e245963
Author(s):  
Jayanty Venkata Balasubramaniyan ◽  
Judah Nijas Arul ◽  
Jebaraj Rathinasamy ◽  
Thangavel Periyasamy
Keyword(s):  
Myocardial Infarction ◽  
Systolic Dysfunction ◽  
Anterior Wall ◽  
Left Ventricular ◽  
Prior History ◽  
Surgical Removal ◽  
Diagnostic Dilemma ◽  
Echocardiographic Evaluation ◽  
Lv Mass ◽  
History Of

Myxomas arising from the left ventricle (LV) are extremely rare and can be easily mistaken for a thrombus. We report a case of a 35-year-old man who presented with an acute cerebrovascular accident, having had a prior history of an anterior wall myocardial infarction 2 years back with an echocardiographic evaluation showing mild LV systolic dysfunction. His present prothrombotic workup revealed hyperhomocystinaemia and elevated levels of factor VIII. Present echocardiography revealed a mass arising from a scarred LV wall. Considering the possibility of a thrombus, he was initially started on parenteral anticoagulation. Unfortunately, consequent echocardiogram evaluation showed no reduction in size of the LV mass hence surgical removal was done. Histopathological evaluation unveiled the mass to be a myxoma.

scholarly journals Diagnosis and Treatment of Asymptomatic Left Ventricular Systolic Dysfunction after Myocardial Infarction

2013 ◽  
Vol 2013 ◽  
pp. 1-7 ◽  
Author(s):  
Laura Ajello ◽  
Giuseppe Coppola ◽  
Egle Corrado ◽  
Eluisa La Franca ◽  
Antonino Rotolo ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Heart Failure ◽  
Acute Myocardial Infarction ◽  
Early Detection ◽  
Left Ventricular Systolic Dysfunction ◽  
Systolic Dysfunction ◽  
Left Ventricular ◽  
Diagnosis And Treatment ◽  
Ventricular Systolic Dysfunction

The increased survival after acute myocardial infarction induced an increase in heart failure with left ventricular systolic dysfunction. Early detection and treatment of asymptomatic left ventricular systolic dysfunction give the chance to improve outcomes and to reduce costs due to the management of patients with overt heart failure.

scholarly journals Improvements in Regional Left Ventricular Function Following Late Percutaneous Coronary Intervention for Anterior Myocardial Infarction

2017 ◽  
Vol 11 ◽  
pp. 117954681774663
Author(s):  
Srilakshmi M Adhyapak ◽  
Prahlad G Menon ◽  
Kiron Varghese ◽  
Abhinav Mehra ◽  
SB Lohitashwa ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Percutaneous Coronary Intervention ◽  
Cardiac Cycle ◽  
Coronary Intervention ◽  
Anterior Wall ◽  
Left Ventricular ◽  
Anterior Myocardial Infarction ◽  
Regional Left Ventricular Function ◽  
Percutaneous Coronary ◽  
Anterior Wall Myocardial Infarction

Background: Late revascularization following a myocardial infarction has questionable clinical benefit. Methods: We studied 13 patients with anterior wall myocardial infarction who underwent percutaneous coronary intervention within 2 weeks of the primary event, by quantitative analysis of 2-dimensional echocardiographic images. Endocardial segmentations of the left ventricular (LV) endocardium from the 4-chamber views were studied over time to establish cumulative wall displacements (CWDs) throughout the cardiac cycle. Results: Left ventricular end-systolic volume decreased to 42 ± 8 mL/body surface area ( P = .034) and LV ejection fraction improved to 52% ± 7% ( P = .04). Analysis of LV endocardial CWD demonstrated significant improvements in mid-systolic to late-systolic phases in the apical LV segments, from 3.5 ± 0.32 to 5.89 ± 0.43 mm ( P = .019). Improvements in CWD were also observed in the late-diastolic phase of the cardiac cycle, from 1.50 ± 0.42 to 1.76 ± 0.52 mm ( P = .04). Conclusions: In our pilot patient cohort, following late establishment of infarct-related artery patency following an anterior wall myocardial infarction, regional improvements were noted in the LV apical segments during systole and late diastole.

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