Recurrent asymptomatic Takotsubo syndrome after 20 years: are we looking at the tip of the iceberg only?

2020 ◽  
Author(s):  
Giulia Iannaccone ◽  
Rocco Antonio Montone ◽  
Marco Giuseppe Del Buono ◽  
Maria Chiara Meucci ◽  
Riccardo Rinaldi ◽  
...  
Keyword(s):  
Acute Coronary Syndrome ◽  
Chest Pain ◽  
Coronary Artery ◽  
Myocardial Stunning ◽  
Physical Stress ◽  
Takotsubo Syndrome ◽  
Presenting Symptoms ◽  
Coronary Syndrome ◽  
Epicardial Coronary Artery

Takotsubo syndrome (TS) is an acute and reversible form of myocardial stunning preceded by emotional or physical stress, not explained by an obstruction of an epicardial coronary artery as in acute coronary syndrome. Over the last decades, TS is receiving growing attention, leading to an increase in awareness and diagnostic rate. Chest pain and dyspnea are the most common presenting symptoms; however, nonspecific presentations make the diagnosis challenging for clinicians. Here, we present the case of a 76-year-old female who experienced two completely asymptomatic episodes of TS 20 years apart.

Novel Emergency Department Risk Score Discriminates Acute Coronary Syndrome Among Chest Pain Patients With Known Coronary Artery Disease

2016 ◽  
Vol 15 (4) ◽  
pp. 138-144 ◽  
Author(s):  
Matthew T. Crim ◽  
Scott A. Berkowitz ◽  
Mustapha Saheed ◽  
Jason Miller ◽  
Amy Deutschendorf ◽  
...  
Keyword(s):  
Coronary Artery Disease ◽  
Emergency Department ◽  
Acute Coronary Syndrome ◽  
Chest Pain ◽  
Coronary Artery ◽  
Risk Score ◽  
Coronary Syndrome ◽  
Artery Disease ◽  
Pain Patients

Coronary artery calcium scoring for ruling-out acute coronary syndrome in chest pain CT

2017 ◽  
Vol 35 (10) ◽  
pp. 1565-1567 ◽  
Author(s):  
Ricarda Hinzpeter ◽  
Kai Higashigaito ◽  
Fabian Morsbach ◽  
David Benz ◽  
Robert Manka ◽  
...  
Keyword(s):  
Acute Coronary Syndrome ◽  
Chest Pain ◽  
Coronary Artery ◽  
Coronary Artery Calcium ◽  
Calcium Scoring ◽  
Coronary Syndrome ◽  
Coronary Artery Calcium Scoring

P817Family history of coronary artery disease predicts acute coronary syndrome in 28,188 chest pain patients

2018 ◽  
Vol 39 (suppl_1) ◽  
Author(s):  
A Wahrenberg ◽  
P Magnusson ◽  
A Discacciati ◽  
L Ljung ◽  
T Jernberg ◽  
...  
Keyword(s):  
Coronary Artery Disease ◽  
Acute Coronary Syndrome ◽  
Chest Pain ◽  
Coronary Artery ◽  
Coronary Syndrome ◽  
History Of ◽  
Artery Disease ◽  
Pain Patients

scholarly journals Acute coronary syndrome in a young woman with a giant coronary aneurysm and mitral valve prolapse: a case report and literature review

2021 ◽  
Vol 49 (3) ◽  
pp. 030006052199952
Author(s):  
Xiaoyan Jiang ◽  
Jiamin Li ◽  
Xuehua Zhang ◽  
Han Chen
Keyword(s):  
Acute Coronary Syndrome ◽  
Chest Pain ◽  
Coronary Artery ◽  
Mitral Valve ◽  
Young Woman ◽  
Mitral Valve Prolapse ◽  
Artery Aneurysm ◽  
Coronary Aneurysm ◽  
Coronary Syndrome ◽  
Giant Coronary Aneurysm

Acute coronary syndrome in the young population is infrequently seen and has a different etiology from that in the elderly population. Giant coronary artery aneurysms are rare and usually asymptomatic, but they can cause acute clinical symptoms such as chest pain or chest tightness. We herein describe a young woman with a history of mitral valve prolapse who developed sudden-onset chest pain. She had mild elevations of her creatine kinase and cardiac troponin levels; however, no ST segment alteration was found on an electrocardiogram, and no abnormal regional wall movement was noted on echocardiography. Cardiac magnetic resonance imaging with late gadolinium enhancement revealed a “mass” at the right coronary artery and linear subendocardial enhancement at the posterior wall. Coronary angiography later confirmed a giant coronary aneurysm with a substantial thrombus. The combined presence of the coronary artery aneurysm and mitral valve prolapse in this patient was likely a sequela of Kawasaki disease.

scholarly journals Prognosis and follow-up of young patients admitted to a critical coronary care unit with acute coronary syndrome

2021 ◽  
Vol 10 (Supplement_1) ◽  
Author(s):  
DF Arroyo Monino ◽  
C Barea Gonzalez ◽  
MP Ruiz Garcia ◽  
T Seoane Garcia ◽  
JC Garcia Rubira
Keyword(s):  
Acute Coronary Syndrome ◽  
Chest Pain ◽  
Coronary Artery ◽  
Hospital Mortality ◽  
Coronary Care Unit ◽  
Young Patients ◽  
St Segment Elevation ◽  
Coronary Syndrome ◽  
Coronary Care

Abstract Funding Acknowledgements Type of funding sources: None. Introduction The presence of young patients admitted to a Critical Coronary Care Unit (CCCU) with the diagnosis of Acute Coronary Syndrome (ACS) is very common nowadays. The prognosis of these patients seems to be better than the elderly ones, although there are few records that endorse this statement. Objective Our aim is to carry out a follow-up of this population and study their prognosis during the index hospitalization and the follo-up. Methods Retrospective, descriptive, unicentric and observational registry of young patients (<45 years old) admitted to one CCCU with the diagnosis of ACS between January 2.010 and November 2.020. The follow-up of these patients was performed using the electronic platform of Andalusian Health Security System. Results A total number of 252 patients were included in the registry, with a mean age of 40 years old, being male 206 (81,7%). The main reason of the admission was ACS with persistent ST segment elevation (STEMI) (177 patients – 70,2%). The most prevalent risk factor in this population was active smoking (198 patients – 78,6%). The main underlying mechanism of the ACS was the rupture of an atherosclerotic plaque (194 patients – 77%) and in most cases, there was only 1 coronary artery affected (153 patients – 60,7%). Intra-hospital mortality was low (2 patients died of cardiovascular cause – 0,8%, and 1 died of non-cardiovascular cause – 0,4%). Left ventricle ejection fraction (LVEF) at the discharge was preserved in 166 patients (65,9% - mean 58%), and reduced (<40%) in 37 patients (14,7%). The median of the follow-up was 77 months (minimum 1 month and maximum 132 months). A total number of 5 patients died during this follow-up (2%, 3 during the first year), 3 of them of cardiovascular cause; these 3 patients had reduced LVEF at the discharge. During this follow-up, 64 (25,4%) patients were re-admitted to the hospital due to cardiovascular causes, most of them (30 – 11,9%) with the diagnosis of chest pain and 20 of them (7,9%) with the diagnosis of a new ACS. Conclusions Young patients admitted to our CCCU with the diagnosis of ACS presented most frequently with STEMI, affecting predominantly one coronary artery. Most of them had preserved LVEF at the discharge. The prognosis of this group of patients is good, with a low intra-hospital mortality and during the follow-up, with clear relation with the presence of reduced LVEF at the discharge. Re-admission was relatively frequent, mostly due to chest pain.

scholarly journals Missed myocardial infarction in a vicenarian with malignant anomalous right coronary artery causing acute coronary syndrome: a case report

2021 ◽  
Vol 15 (1) ◽  
Author(s):  
Nafeesah Ali ◽  
Kandace Baggan ◽  
Shari S. Khan ◽  
Paramanand Maharaj ◽  
Ronan G. Ali
Keyword(s):  
Risk Factors ◽  
Coronary Artery Disease ◽  
Acute Coronary Syndrome ◽  
Chest Pain ◽  
Coronary Artery ◽  
Acute Coronary Syndromes ◽  
Low Risk ◽  
Coronary Syndrome ◽  
Coronary Syndromes ◽  
Artery Disease

Abstract Background Traditional coronary artery disease risk factors are well established and help risk stratify most patients presenting with chest pain syndromes. Young patients (under age 30 years) without other risk factors are thought to be at very low risk of coronary artery disease and acute coronary syndromes. Case presentation We highlight the case of a 27-year-old Afro-Caribbean male who presented to hospital with chest pain and was discharged from the emergency room because he was thought to be low risk for ischemic heart disease. Laboratory investigations subsequently confirmed acute coronary syndrome. He was found to have an anomalous right coronary artery with a malignant origin running between the aorta and pulmonary artery eventually requiring surgical correction. Anomalous origins of the coronary arteries are rare causes of acute coronary syndromes, chest pain, and sudden cardiac death. Conclusion Our patient could have easily had an adverse outcome as his diagnosis was missed by the initial treating physician. It is important to consider anomalous coronary artery origin in the evaluation of young symptomatic patients who may be otherwise low risk and not have traditional risk factors for ischemic heart disease.

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