scholarly journals TOPICAL DIAGNOSTICS OF SINGLE CORONARY ARTERY OCCLUSION IN ST ELEVATION MYOCARDIAL INFARCTION PATIENTS

Author(s):  
R. R. Khafizov ◽  
B. I. Zagidullin ◽  
I. A. Lakman ◽  
I. А. Mustafina ◽  
N. Sh. Zagidullin
2012 ◽  
Vol 76 (2) ◽  
pp. 414-422 ◽  
Author(s):  
Simcha R. Meisel ◽  
Michael Shochat ◽  
Aaron Frimerman ◽  
Aya Asif ◽  
David S. Blondheim ◽  
...  

2021 ◽  
Vol 2 (5) ◽  
pp. 152-154
Author(s):  
Bruno Minotti ◽  
Jörg Scheler ◽  
Robert Sieber ◽  
Eva Scheler

Introduction: The “spiked helmet” sign was first described in 2011 by Littmann and Monroe in a case series of eight patients. This sign is characterized by an ST-elevation atypically with the upward shift starting before the onset of the QRS complex. Nowadays the sign is associated with critical non-cardiac illness. Case Report: An 84-year-old man with a history of three-vessel disease presented to the emergency department with intermittent pain in the upper abdomen. The electrocardiogram revealed the “spiked helmet” sign. After ruling out non-cardiac conditions the catherization lab was activated. The coronary angiography revealed an acute occlusion of the right coronary artery, which was balloon-dilated followed by angioplasty. The first 24 hours went uneventfully with resolution of the “spiked helmet” sign. On the second day, however, the patient died suddenly and unexpectedly. Conclusion: Despite the association with non-cardiac illness, the “spiked helmet” sign can be seen by an acute coronary artery occlusion as an ST-elevation myocardial infarction (STEMI). Reciprocal ST-depression in these cases should raise the suspicion of STEMI.


Angiology ◽  
2021 ◽  
pp. 000331972110313
Author(s):  
Erdoğan Yaşar ◽  
Adil Bayramoğlu ◽  
Yasin Karakuş ◽  
Tolga Çakmak

Early detection of total coronary artery occlusion (TO) in non-ST elevation myocardial infarction (NSTEMI) patients may be beneficial since invasive treatments are initiated more rapidly in appropriate patients. Previous studies have shown that the CHA2DS2-VASc (congestive heart failure, hypertension, age ≥75 years, diabetes mellitus, previous stroke, vascular disease, age between 65 and 74 years, female gender) score is associated with thrombus burden in acute coronary syndromes. We investigated the association between the CHA2DS2-VASc risk score and TO in patients with NSTEMI who underwent coronary angiography. TIMI (thrombolysis in myocardial infarction) flow 0 was defined as TO and TIMI flow 1-3 was defined as non-total occlusion (non-TO). The NSTEMI patients (n = 400) included were separated into two groups: those with (n = 138) and without (n = 262) TO. We observed that the CHA2DS2-VASc score was higher in the TO group (3.86 ± 2.32 vs 2.15 ± 1.79, P <.001). The Global Registry of Acute Coronary Events (GRACE) score ( P = .002) and the CHA2DS2-VASc score ( P < .001) were also found to be significant independent predictors for total occlusion in multiple regression analysis. A CHA2DS2-VASc score ≥3 had 68.1% sensitivity and 64.0% specificity (area under the curve (AUC): 0.657, 95% CI: 0.585-0.725, P < .001) for predicting TO. The CHA2DS2-VASc score was an effective tool that predicted TO in patients with NSTEMI.


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