scholarly journals A Rare Presentation of Coeliac Disease; Intractable Itching with Recurrent Heart Attack and Dermatitis Herpetiformis

2021 ◽  
Vol 19 (3) ◽  
pp. 186-190
Author(s):  
Sumeyra ALAN YALIM ◽  
Betül DUMANOĞLU ◽  
Merve POYRAZ ◽  
Gulistan ALPAGAT ◽  
Ayse BAÇÇIOĞLU ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Coeliac Disease ◽  
Dermatitis Herpetiformis ◽  
Normal Population ◽  
Systemic Disease ◽  
Rare Presentation ◽  
St Segment Elevation ◽  
Increased Risk ◽  
Important Symptom ◽  
The Right

Coeliac disease (CD) is a systemic disease of the unwarranted immune reaction to gluten and is associated with a 10% increased risk of cardiovascular disease. Here we present a patient with recurrent myocardial ischemia and intractable itching who was eventually diagnosed with CD. A 53-year-old man presented to the allergy department due to intractable itching that was resistant to antihistamine therapy. In addition, despite successful percutaneous intervention with stent implantation to the right coronary artery, there was an ST segment elevation with myocardial infarction (MI) in the lower wall that had occurred three times. After dermatitis herpetiformis was reported as a result of the biopsy performed from the lesions, duodenal biopsy confirmed the diagnosis of CD. Diagnosis of CD with atypical presentation can be difficult. Cardiovascular risk is increased in patients with celiac disease compared to the normal population. Itching is an important symptom that needs to be evaluated in detail, even without the typical gastrointestinal manifestations of CD. Keywords: Allergy, coeliac disease, dermatitis herpetiformis, myocardial infarction, omalizumab, recurrent stenosis

scholarly journals Acute non-atherosclerotic ST-segment elevation myocardial infarction in an adolescent with concurrent hemoglobin H-Constant Spring disease and polycythemia vera

2015 ◽  
Vol 7 (3) ◽  
Author(s):  
Ekarat Rattarittamrong ◽  
Lalita Norasetthada ◽  
Adisak Tantiworawit ◽  
Chatree Chai-Adisaksopha ◽  
Sasinee Hantrakool ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Coronary Artery ◽  
Polycythemia Vera ◽  
Major Complication ◽  
Antiplatelet Agents ◽  
St Segment Elevation ◽  
Segment Elevation Myocardial Infarction ◽  
St Segment ◽  
Increased Risk ◽  
The Right

Thrombosis is a major complication of polycythemia vera (PV) and also a well-known complication of thalassemia. We reported a case of non-atherosclerotic ST-segment elevation myocardial infarction (STEMI) in a 17- year-old man with concurrent post-splenectomized hemoglobin H-Constant Spring disease and <em>JAK2</em> V617F mutation-positive PV. The patient initially presented with extreme thrombocytosis (platelet counts greater than 1,000,000/μL) and three months later developed an acute STEMI. Coronary artery angiography revealed an acute clot in the right coronary artery without atherosclerotic plaque. He was treated with plateletpheresis, hydroxyurea and antiplatelet agents. The platelet count decreased and his symptoms improved. This case represents the importance of early diagnosis, awareness of the increased risk for thrombotic complications, and early treatment of PV in patients who have underlying thalassemia with marked thrombocytosis.

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.

The ratio of circulating endothelin-1 to endothelin-3 associated with TIMI risk and dynamic TIMI risk score in ST elevation acute myocardial infarction

2020 ◽  
Vol 98 (9) ◽  
pp. 637-643 ◽  
Author(s):  
Anggoro Budi Hartopo ◽  
Ira Puspitawati ◽  
Hasanah Mumpuni
Keyword(s):  
Myocardial Infarction ◽  
Acute Myocardial Infarction ◽  
Risk Score ◽  
Multivariable Analysis ◽  
Primary Objective ◽  
St Segment Elevation ◽  
Timi Score ◽  
Increased Risk ◽  
Timi Risk Score ◽  
Elevation Acute Myocardial Infarction

In ST segment elevation acute myocardial infarction (STEMI), the endothelin (ET) system imbalance, reflected by the circulating ET-1:ET-3 ratio has not been investigated. This study’s primary objective was to measure the circulating ET-1:ET-3 ratio and correlate it with the risk stratification for 1 year mortality of STEMI based on TIMI score. On admission, the TIMI risk score and at discharge, the dynamic TIMI risk score were calculated in 68 consecutive subjects with STEMI. Subjects with high TIMI risk score were associated with higher mean ET-1 level and ET-1:ET-3 ratio. The ET-1:ET-3 ratio more accurately predicted the high on admission TIMI risk score than the ET-1 level. Subjects with high dynamic TIMI risk score were associated with higher mean ET-1 level and ET-1:ET-3 ratio. The ET-1:ET-3 ratio more accurately predicted the high at discharge dynamic TIMI risk score than ET-1 level. From multivariable analysis, the ET-1:ET-3 ratio was not independently associated with high on admission TIMI risk score but independently predicted high at discharge dynamic TIMI risk score (odds ratio = 9.186, p = 0.018). In conclusion, combining the ET-1 and ET-3 levels into the ET-1:ET-3 ratio provided a prognostic value by independently predicting the increased risk to 1 year mortality as indicated by at discharge dynamic TIMI risk score in patients with STEMI.

scholarly journals Association Between Smoking Status and Outcomes in ST-Segment Elevation and Non-ST-Segment Elevation Myocardial Infarction Patients Undergoing Percutaneous Coronary Intervention

2021 ◽  
Author(s):  
Ching-Hui Sia ◽  
Junsuk Ko ◽  
Huili Zheng ◽  
Andrew Ho ◽  
David Foo ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Percutaneous Coronary Intervention ◽  
Clinical Outcomes ◽  
Smoking Status ◽  
Coronary Intervention ◽  
St Segment Elevation ◽  
Beneficial Effects ◽  
St Segment ◽  
Increased Risk ◽  
Percutaneous Coronary

Abstract Smoking is one of the leading risk factors for cardiovascular diseases, including ischemic heart disease and hypertension. However, in acute myocardial infarction (AMI) patients, smoking has been associated with better clinical outcomes, a phenomenon termed the “smoker’s paradox.” Given the known detrimental effects of smoking on the cardiovascular system, it has been proposed that the beneficial effects of smoking on outcomes is due to age differences between smokers and non-smokers and is therefore a smoker’s pseudoparadox. The aim of this study was to evaluate the association between smoking status and clinical outcomes in ST-segment elevation (STEMI) and non-STEMI (NSTEMI) patients treated by percutaneous coronary intervention (PCI), using a national multi-ethnic Asian registry. In unadjusted analyses, current smokers had better clinical outcomes following STEMI and NSTEMI. However, after adjusting for age, the protective effect of smoking was lost, confirming a smoker’s pseudoparadox. Interestingly, although current smokers had increased risk for recurrent MI within 1 year after PCI in both STEMI and NSTEMI patients, there was no increase in mortality. In summary, we confirm the existence of a smoker’s pseudoparadox in a multi-ethnic Asian cohort of STEMI and NSTEMI patients and report increased risk of recurrent MI, but not mortality, in smokers.

scholarly journals Antiphospholipid Syndrome - A Case Report of Pulmonary Thromboembolism, Followed with Acute Myocardial Infarction in Patient with Systemic Sclerosis

2015 ◽  
Vol 3 (4) ◽  
pp. 705-709 ◽  
Author(s):  
Marija Vavlukis ◽  
Irina Kotlar ◽  
Emilija Chaparoska ◽  
Bekim Pocesta ◽  
Hristo Pejkov ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Acute Myocardial Infarction ◽  
Pulmonary Embolism ◽  
Systemic Sclerosis ◽  
Antiphospholipid Syndrome ◽  
Total Occlusion ◽  
St Segment Elevation ◽  
St Segment ◽  
History Of ◽  
The Right

AIM: We are presenting an uncommon case of pulmonary embolism, followed with an acute myocardial infarction, in a patient with progressive systemic sclerosis.CASE PRESENTATION: A female 40 years of age was admitted with signs of pulmonary embolism, confirmed with CT scan, which also reviled a thrombus in the right ventricle. The patient had medical history of systemic sclerosis since the age of 16 years. She suffered an ischemic stroke 6 years ago, but she was not taking any anticoagulant or antithrombotic medications ever since. She received a treatment with thrombolytic therapy, and subsequent UFH, but, on the second day after receiving fibrinolysis, she felt chest pain accompanied with ECG changes consistent for ST-segment elevation myocardial infarction (STEMI). Urgent coronary angiography was undertaken, which reviled cloths causing total occlusion in 4 blood vessels, followed with thromboaspiration, but without successful reperfusion. Several hours later the patient developed rapid deterioration with letal ending. During the very short hospital course, blood sampling reviled presence of antiphospholipid antibodies.CONCLUSION: The acquired antiphospholipid syndrome is common condition in patients with systemic autoimmune diseases, but relatively rare in patients with systemic sclerosis. Never the less, we have to be aware of it when treating the patients with systemic sclerosis.

An hs-TNT Second Peak Associated with High CRP at Day 2 Appears as Potential Biomarkers of Micro-Vascular Occlusion on Magnetic Resonance Imaging after Reperfused ST-Segment Elevation Myocardial Infarction

Cardiology ◽  
2018 ◽  
Vol 140 (4) ◽  
pp. 227-236 ◽  
Author(s):  
Fabien Huet ◽  
Mariama Akodad ◽  
Nils Kuster ◽  
Hélène Kovacsik ◽  
Florence Leclercq ◽  
...  
Keyword(s):  
Magnetic Resonance Imaging ◽  
Myocardial Infarction ◽  
Magnetic Resonance ◽  
Vascular Occlusion ◽  
Coronary Intervention ◽  
Resonance Imaging ◽  
St Segment Elevation ◽  
St Segment ◽  
Increased Risk ◽  
Second Peak

Introduction: Micro-vascular occlusion (MVO) in a myocardial infarction (MI) is associated with an increased risk of heart failure and mortality. Hs-T-troponin has a double peak kinetic after MI. The aim was to determine if this kinetic was correlated to MVO evaluated by cardiac magnetic resonance imaging (MRI) after MI. Methods: This is a monocentric retrospective study. Inclusion criteria were hospitalization for MI, Thrombolysis In Myocardial Infarction flow 0 at coronary angiography, reperfusion within 12 h from the onset of chest pain, cardiac MRI within the first month, and a 5-days’ biological follow-up with at least hs-T-Troponin and C-reactive protein (CRP). Statistics were performed using the R software. Results: Ninety-eight patients were included. Fifty-three patients (54.1%) had MVO at MRI. The existence of MVO was associated with a trend of more kissing procedure during primary percutaneous coronary intervention (p = 0.06), a significantly more frequent second peak of troponin (p = 0.048), a significantly higher CRP level (p < 0.0001) and a longer time to balloon (p = 0.01). The association of CRP level above 40 mg/L at day 2 and the observation of a second peak of troponin were associated to 95% of MVO in ST-segment elevation MI patients. By contrast, in the absence of these 2 criteria, MVO was absent in 78% of the cases. This score was associated with a higher rate of hospitalisation at 2 years. Conclusion: A biological score integrating hs-TNT second peak and CRP might help to predict MVO and predict outcomes after reperfused MI in our population.

scholarly journals ST-Segment Elevation in the Right Precordial Leads in Patients with Acute Anterior Myocardial Infarction

2016 ◽  
Vol 33 (1) ◽  
pp. 58-63 ◽  
Author(s):  
Leili Pourafkari ◽  
Saeid Joudi ◽  
Samad Ghaffari ◽  
Arezou Tajlil ◽  
Babak Kazemi ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Anterior Myocardial Infarction ◽  
St Segment Elevation ◽  
St Segment ◽  
The Right

Thrombectomy in Acute Myocardial Infarction

2009 ◽  
Vol 4 (1) ◽  
pp. 86 ◽  
Author(s):  
On Topaz ◽  
Allyne Topaz ◽  
Pritam R Polkampally ◽  
◽  
◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Mechanical Thrombectomy ◽  
Tissue Perfusion ◽  
Coronary Intervention ◽  
Direct Result ◽  
St Segment Elevation ◽  
Direct Stenting ◽  
Increased Risk ◽  
Thrombus Removal ◽  
Antegrade Flow

Percutaneous coronary intervention (PCI) is the preferred management strategy for ST-segment-elevation myocardial infarction (STEMI) patients. However, a significant number of revascularisations result insuboptimal restoration of epicardial antegrade flow and inadequate myocardial tissue perfusion. This is mainly attributed to the underlying thrombus burden within the infarct-related vessel. Interventions for thrombotic lesions are clearly associated with an increased risk of acute and long-term complications. Thrombus remains a predictor of ischaemic complications, immediate and late stent thrombosis, increased in-hospital complications, death at six months and recurrent MI. Two types of thrombus removal device are available for utilisation in the setting of acute MI (AMI): aspiration-based catheters and mechanical thrombectomy. Administration of either systemic or selective adjunct pharmacotherapy can be useful in conjunction with application of all thrombus removal devices. Recent studies have demonstrated that thrombus aspiration is applicable and safe in a large majority of patients with STEMI, resulting in better reperfusion and clinical outcomes than standard PCI. However, it is unclear whether these findings are a direct result of a reduction in thrombus burden, facilitation of direct stenting or a combination of the two. The heavier the underlying thrombus burden, the higher the yield of mechanical thrombectomy over aspiration catheter. The role of thrombectomy as a useful adjunct therapy aimed specifically at direct contact and clearance of AMI-related thrombus continues to evolve.

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