Myocardial infarction (clinic, diagnostic features, complications, treatment)

1997 ◽  
Vol 78 (2) ◽  
pp. 120-128
Author(s):  
I. A. Latfullin
Keyword(s):  
Myocardial Infarction ◽  
Blood Supply ◽  
Coronary Arteries ◽  
Heart Muscle ◽  
Oxygen Demand ◽  
Myocardial Oxygen Demand ◽  
Ischemic Necrosis ◽  
Diagnostic Features

Myocardial infarction (MI) occurs due to an acute mismatch between myocardial oxygen demand and its blood supply through the coronary arteries of the heart, which results in the development of ischemic necrosis of the heart muscle with subsequent topical changes on ECG.

scholarly journals Repetitive Myocardial Infarctions Secondary to Delirium Tremens

2014 ◽  
Vol 2014 ◽  
pp. 1-3
Author(s):  
David Schwartzberg ◽  
Adam Shiroff
Keyword(s):  
Myocardial Infarction ◽  
Myocardial Ischemia ◽  
Alcohol Withdrawal ◽  
Delirium Tremens ◽  
Oxygen Demand ◽  
Myocardial Infarctions ◽  
Myocardial Oxygen Demand ◽  
Significant Morbidity ◽  
St Segment ◽  
Patients Experience

Delirium tremens develops in a minority of patients undergoing acute alcohol withdrawal; however, that minority is vulnerable to significant morbidity and mortality. Historically, benzodiazepines are given intravenously to control withdrawal symptoms, although occasionally a more substantial medication is needed to prevent the devastating effects of delirium tremens, that is, propofol. We report a trauma patient who required propofol sedation for delirium tremens that was refractory to benzodiazepine treatment. Extubed prematurely, he suffered a non-ST segment myocardial infarction followed by an ST segment myocardial infarction requiring multiple interventions by cardiology. We hypothesize that his myocardial ischemia was secondary to an increased myocardial oxygen demand that occurred during his stress-induced catecholamine surge during the time he was undertreated for delirium tremens. This advocates for the use of propofol for refractory benzodiazepine treatment of delirium tremens and adds to the literature on the instability patients experience during withdrawal.

scholarly journals KNOWLEDGE AND AWARENESS ABOUT ANGINA PECTORIS AMONG PHARMACY STUDENTS

2014 ◽  
Vol 4 ◽  
pp. 81
Author(s):  
Humera Khatoon ◽  
Keyword(s):  
Myocardial Infarction ◽  
Angina Pectoris ◽  
Blood Supply ◽  
Heart Muscle ◽  
Heart Attack ◽  
Pharmacy Students ◽  
Warning Sign ◽  
Chest Discomfort ◽  
Adequate Blood Supply ◽  
Disease Sign

Objective of this study is to determine the awareness among student of Pharm D with Angina Pectoris (AP) regarding the disease, sign & symptoms and treatment.The term Angina Pectoris is applied to varying forms of transient chest discomfort that are attributable to insufficient myocardial oxygen. The classic description of angina is a crushing pain that radiates through the chest and sometimes down the arm, neck, teeth /jaw or into the back, which is usually aggravated by exertion or stress. Angina is a warning sign that the heart muscle is not getting adequate blood supply and specially oxygen and it may lead to myocardial infarction or a heart attack

scholarly journals From bedside to bench and back again: translational studies of mechanical unloading of the left ventricle to promote recovery after acute myocardial infarction

F1000Research ◽  
2018 ◽  
Vol 7 ◽  
pp. 1852 ◽  
Author(s):  
Navin K. Kapur ◽  
Shiva Annamalai ◽  
Lara Reyelt ◽  
Samuel J. Karmiy ◽  
Allen A. Razavi ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Heart Failure ◽  
Acute Myocardial Infarction ◽  
Pilot Trial ◽  
Oxygen Demand ◽  
Myocardial Damage ◽  
Reperfusion Therapy ◽  
Circulatory Support ◽  
Myocardial Oxygen Demand ◽  
St Segment Elevation

Heart failure is a major cause of global morbidity and mortality. Acute myocardial infarction (AMI) is a primary cause of heart failure due in large part to residual myocardial damage despite timely reperfusion therapy. Since the 1970’s, multiple preclinical laboratories have tested whether reducing myocardial oxygen demand with a mechanical support pump can reduce infarct size in AMI. In the past decade, this hypothesis has been studied using contemporary circulatory support pumps. We will review the most recent series of preclinical studies in the field which led to the recently completed Door to Unload ST-segment Elevation Myocardial Infarction (DTU-STEMI) safety and feasibility pilot trial.

scholarly journals Pathophysiological aspects of development myocardial infarction type 2 in subclinical hypothyroidism

2021 ◽  
pp. 34-41
Author(s):  
A. A. Ivannikov ◽  
A. A. Kanibolotsky ◽  
Kh. G. Alidzhanova ◽  
I. V. Bratischev
Keyword(s):  
Myocardial Infarction ◽  
Coronary Artery ◽  
Subclinical Hypothyroidism ◽  
Hormone Replacement ◽  
Myocardial Revascularization ◽  
Oxygen Demand ◽  
Cardiomyocyte Hypertrophy ◽  
Myocardial Oxygen Demand ◽  
Atherosclerotic Stenosis

The main purpose of the following article is to highlight one of the most pressing and poorly studied issues both for cardiology and endocrinology – treatment and prognosis for patients with severe coronary pathology and subclinical hypothyroidism (SH). Pathophysiological mechanisms of type 2 myocardial infarction (MI) development with SH as a background and hormone replacement therapy issues are considered. SH is a modifiable risk factor (RF) for cardiovascular diseases (CVD) and mortality that does not depend on traditional cardiovascular RF. SH is associated with high risk of developing coronary artery disease, MI, heart failure, and CVD mortality. SH incidence of morbidity increases with age, usually the course is oligo- or asymptomatic. SH leads to a number of pathological conditions that cause an imbalance between the myocardial oxygen demand and delivery with a possible development of type 2 MI. Clinical case of type 2 MI development in a patient with severe coronary atherosclerosis and SH is presented. The key point of type 2 MI development mechanism is insufficient oxygen (O2) supply to cardiomyocytes due to multivessel coronary artery atherosclerotic stenosis and sharp increase in O2 demand as a result of cardiomyocyte hypertrophy. Older patients with severe cardiac pathology and SH should refrain from treatment with levothyroxine or start treatment after myocardial revascularization, selecting the dose of the drug individually.

scholarly journals The artery of Mouchet: blood supply of the septomarginal trabecula in 50 human hearts

2018 ◽  
Vol 64 (10) ◽  
pp. 916-921
Author(s):  
Carlos Chagas ◽  
Lucas Pires ◽  
Tulio Leite ◽  
Marcio Babinski
Keyword(s):  
Myocardial Infarction ◽  
Blood Supply ◽  
Coronary Arteries ◽  
Muscular Structure ◽  
Atrioventricular Bundle ◽  
The Right ◽  
Clinical Conditions ◽  
Arterial Branch

SUMMARY The septomarginal trabecula is a muscular structure which transmits the right branch of the atrioventricular bundle. It is usually supplied by a branch from the second anterior septal artery. Anastomoses between the right and left coronary arteries may happen on the septomarginal trabecula. They are of great significance in order to prevent ischemia during a myocardial infarction. Surgeries such as Konno's and Ross' procedures implies in knowledge of these vessels anatomy. The coronary arteries of 50 human hearts were injected with latex and subsequentely dissected with the purpose of identifying the arterial branch that supplied the septomarginal trabecula. The trabecular branch arose from the second anterior septal artery in 38% of cases, and the branch arose from the first anterior septal artery in 26%. One of the hearts had its septomarginal trabecula supplied by the conus arteriosus arteryliterature. Anastomoses between the right and left coronary arteries were found inside the septomarginal trabecula. The right branch of the atrioventricular bundle is subject to a great number of clinical conditions and is often manipulated during surgery, thus, the study of the septal branches of the coronary arteries and the trabecular branch is essential.

scholarly journals Characteristics of clinical signs, laboratory and instrumental examinations in various mechanisms of development of type 2 myocardial infarction

2021 ◽  
Vol 12 (3) ◽  
pp. 132-138
Author(s):  
Dmitrii V. Oblavatckii ◽  
Svetlana A. Boldueva
Keyword(s):  
Myocardial Infarction ◽  
Hypertensive Crisis ◽  
Clinical Signs ◽  
Clinical Manifestations ◽  
Oxygen Demand ◽  
Microvascular Dysfunction ◽  
Myocardial Oxygen Demand ◽  
Pathogenic Variants ◽  
Severe Pathology

Aim. To identify different pathogenetic variants of myocardial infarction type 2 (MI-2). Material and methods. Reviewed 4168 cases of MI admitted in multidisciplinary hospital for 10 years. 353 patients met the criteria for MI-2 without signs of coronary atherothrombosis (CA). In the study group, the features of clinical and laboratory-instrumental manifestations were evaluated. Results. Cases of IM-2 were subdivided into 4 clinical-pathogenic variants (CPV): 1-CPV developed due an increasing in myocardial oxygen demand; 2-CPV, arising from a decrease in the supply of oxygen; 3-CPV associated with local coronary circulation disorder; 4-CPV developed due to the combined oxygen-energy imbalance. In 72 (20.4%) cases, 1-CPV was detected, caused by a hypertensive crisis and/or tachyarrhythmias; 2-CPV observed in 73 (20.68%) patients with hypotension, anemia, microvascular dysfunction, respiratory failure; 3-CPV caused by spasm and embolism of CA was detected in 47 (13.31%) cases; in 161 (45.61%) patients, IM-2 is associated with increased myocardial oxygen demand with reduced oxygen delivery. The gender and risk factors in groups are comparable. The average age of 1-CPV- and 3-CPV-patients was less and amounted to 65.7 and 56.5 versus 70.2 and 73.8 years in the 2-CPV and 4-CPV. Typical clinical and laboratory-instrumental signs of MI were common for patients with 1-CPV and 3-CPV, while 2-CPV and 4-CPV more often had chronic severe pathology, multivessel coronary disorder, and the clinical presentation and ischemic signs were less common. Conclusion. Clinical manifestations and results of examination of patients with MI-2 depend on the mechanism of its development.

Effects of relaxing music on cardiac autonomic balance and anxiety after acute myocardial infarction

1999 ◽  
Vol 8 (4) ◽  
pp. 220-230 ◽  
Author(s):  
JM White
Keyword(s):  
Myocardial Infarction ◽  
Acute Myocardial Infarction ◽  
Heart Rate ◽  
Respiratory Rate ◽  
Oxygen Demand ◽  
Control Group ◽  
Myocardial Oxygen Demand ◽  
Treatment As Usual ◽  
Physiological Indicators ◽  
Experimental Group

BACKGROUND: Acute myocardial infarction places additional demands on an already compromised myocardium. Relaxing music can induce a relaxation response, thereby reversing the deleterious effects of the stress response. OBJECTIVES: To compare the effects of relaxing music; quiet, uninterrupted rest; and "treatment as usual" on anxiety levels and physiological indicators of cardiac autonomic function. METHODS: A 3-group repeated measures experimental design was used. Forty-five patients, 15 per group, with acute myocardial infarction were assigned randomly to 20 minutes of (1) music in a quiet, restful environment (experimental group); (2) quiet, restful environment without music (attention); or (3) treatment as usual (control). Anxiety levels and physiological indicators were measured. RESULTS: Immediately after the intervention, reductions in heart rate, respiratory rate, and myocardial oxygen demand were significantly greater in the experimental group than in the control group. The reductions in heart rate and respiratory rate remained significantly greater 1 hour later. Changes in heart rate, respiratory rate, and myocardial oxygen demand in the attention group did not differ significantly from changes in the other 2 groups. The 3 groups did not differ with respect to systolic blood pressure. Increases in high-frequency heart rate variability were significantly greater in the experimental and attention groups than in the control group immediately after the intervention. State anxiety was reduced in the experimental group only; the reduction was significant immediately and 1 hour after the intervention. CONCLUSIONS: Patients recovering from acute myocardial infarction may benefit from music therapy in a quiet, restful environment.

Studies on the Functionality of Newly Synthesized Fibrinogen after Treatment of Acute Myocardial Infarction with Streptokinase, Increase in the Rate of Fibrinopeptide Release

1993 ◽  
Vol 70 (06) ◽  
pp. 0978-0983 ◽  
Author(s):  
Edelmiro Regano ◽  
Virtudes Vila ◽  
Justo Aznar ◽  
Victoria Lacueva ◽  
Vicenta Martinez ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Acute Myocardial Infarction ◽  
Molecular Weight ◽  
Steady State ◽  
High Molecular Weight ◽  
Coronary Arteries ◽  
Risk Index ◽  
Weight Fraction ◽  
High Molecular Weight Fraction ◽  
Fibrinopeptide A

SummaryIn 15 patients with acute myocardial infarction who received 1,500,000 U of streptokinase, the gradual appearance of newly synthesized fibrinogen and the fibrinopeptide release during the first 35 h after SK treatment were evaluated. At 5 h the fibrinogen circulating in plasma was observed as the high molecular weight fraction (HMW-Fg). The concentration of HMW-Fg increased continuously, and at 20 h reached values higher than those obtained from normal plasma. HMW-Fg represented about 95% of the total fibrinogen during the first 35 h. The degree of phosphorylation of patient fibrinogen increased from 30% before treatment to 65% during the first 5 h, and then slowly declined to 50% at 35 h.The early rates of fibrinopeptide A (FPA) and phosphorylated fibrinopeptide A (FPAp) release are higher in patient fibrinogen than in isolated normal HMW-Fg and normal fibrinogen after thrombin addition. The early rate of fibrinopeptide B (FPB) release is the same for the three fibrinogen groups. However, the late rate of FPB release is higher in patient fibrinogen than in normal HMW-Fg and normal fibrinogen. Therefore, the newly synthesized fibrinogen clots faster than fibrinogen in the normal steady state.In two of the 15 patients who had occluded coronary arteries after SK treatment the HMW-Fg and FPAp levels increased as compared with the 13 patients who had patent coronary arteries.These results provide some support for the idea that an increased synthesis of fibrinogen in circulation may result in a procoagulant tendency. If this is so, the HMW-Fg and FPAp content may serve as a risk index for thrombosis.

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