19 MULTIPLE SITES OF CARDIAC RUPTURE IN THE SETTING OF ACUTE MYOCARDIAL INFARCTION WITH NON-OBSTRUCTIVE CORONARY ARTERY DISEASE

2005 ◽  
Vol 53 (1) ◽  
pp. S257.2-S257
Author(s):  
A. P. Mehrle ◽  
M. D. Winniford ◽  
M. R. McMullan ◽  
T. N. Skelton
Keyword(s):  
Myocardial Infarction ◽  
Coronary Artery Disease ◽  
Acute Myocardial Infarction ◽  
Coronary Artery ◽  
Obstructive Coronary Artery Disease ◽  
Cardiac Rupture ◽  
Artery Disease

scholarly journals Takotsubo Syndrome Associated with ST Elevation Myocardial Infarction

2019 ◽  
Vol 2019 ◽  
pp. 1-6 ◽  
Author(s):  
Saad Ezad ◽  
Michael McGee ◽  
Andrew J. Boyle
Keyword(s):  
Myocardial Infarction ◽  
Coronary Artery Disease ◽  
Acute Myocardial Infarction ◽  
Coronary Artery ◽  
Wall Motion ◽  
Obstructive Coronary Artery Disease ◽  
Takotsubo Syndrome ◽  
St Elevation ◽  
Wall Motion Abnormalities ◽  
Artery Disease

Background. Takotsubo syndrome is a reversible heart failure syndrome which often presents with symptoms and ECG changes that mimic an acute myocardial infarction. Obstructive coronary artery disease has traditionally been seen as exclusion criteria for the diagnosis of takotsubo; however, recent reports have called this into question and suggest that the two conditions may coexist. Case Summary. We describe a case of an 83-year-old male presenting with chest pain consistent with acute myocardial infarction. The ECG demonstrated anterior ST elevation with bedside echocardiography showing apical wall motion abnormalities. Cardiac catheterisation found an occluded OM2 branch of the left circumflex artery with ventriculography confirming apical ballooning consistent with takotsubo and not in the vascular territory supplied by the occluded epicardial vessel. Repeat echocardiogram 6 weeks later confirmed resolution of the apical wall motion abnormalities consistent with a diagnosis of takotsubo. Discussion. This case demonstrates the finding of takotsubo syndrome in a male patient with acute myocardial infarction. Traditionally, this would preclude a diagnosis of takotsubo; however, following previous reports of takotsubo in association with coronary artery dissection and acute myocardial infarction in female patients, new diagnostic criteria have been proposed which allow the diagnosis of takotsubo in the presence of obstructive coronary artery disease. This case adds to the growing body of literature that suggests takotsubo can coexist with acute myocardial infarction; however, it remains to be elucidated if it is a consequence or cause of myocardial infarction.

Abstract 433: Coronary Artery Ectasia in Patients with Obstructive Coronary Artery Disease

2015 ◽  
Vol 35 (suppl_1) ◽  
Author(s):  
Shasha Xu ◽  
Jianjun Jiang ◽  
Huanhuan Zhu ◽  
Bing Wang ◽  
Congfeng Fang ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Coronary Artery Disease ◽  
Acute Myocardial Infarction ◽  
Uric Acid ◽  
Coronary Artery ◽  
Angina Pectoris ◽  
Obstructive Coronary Artery Disease ◽  
Coronary Artery Ectasia ◽  
Old Myocardial Infarction ◽  
Artery Disease

Background and Objective: The pathophysiology of isolated coronary artery ectasia (CAE) remains poorly understood although associations between CAE and a broad spectrum of different diseases, especially atherosclerotic coronary artery disease have been reported. This study aimed to investigate the clinical characteristics of CAE and its relationship to obstructive artery disease in the Chinese Population. Methods and Results: This study recruited 3793 consecutive patients who had undergone coronary angiography for suspected coronary artery disease (CAD) between January 2009 and December 2014. The median age of the patients was 63 years (range, 27 to 94 years) and the majority (69.71%) was male. There were 3068 patients with obstructive coronary artery disease, including angina pectoris (n=1611), acute myocardial infarction (n=1265), and old myocardial infarction (n=192). A total of 120 cases (Male, n=93, female, n=27) with a median age of 63 years (range, 28-86) were identified as CAE in patients undergoing coronary angiography. Co-existent CAD was present in 94% of CAE patients, including 56 angina pectoris; 53 acute myocardial infarction; and 4 old myocardial infarction cases. The prevalence of CAE in patients with obstructive coronary artery disease was 3.67%. The frequency of arterial involvement was: right coronary artery (RCA), 63%; left anterior descending artery (LAD), 43%; left circumflex artery (LCX), 38%; and left main artery (LM), 14%. CAE affected only 1 major vessel in 83% of cases, 2 vessels in 12%, and all 3 vessels in 5%. Using multivariate analysis, serum levels of uric acid were independently associated with present of CAE (P<0.001), while other cardiovascular risk factors such age, arterial hypertension, dyslipidemia, smoking, and diabetes mellitus did not show statistically significant associations (P>0.05). Conclusion: The prevalence of CAE in patients with obstructive coronary artery disease was 3.67%. The RCA was the most commonly affected and most patients had single vessel involvement. Increased serum uric acid level may be a potential risk factor for presence of CAE.

scholarly journals Evaluation of visual and quantitative parameters of MPS SPECT in MINOCA patients in one year after acute coronary syndrome: comparison with CMR

2021 ◽  
Vol 22 (Supplement_3) ◽  
Author(s):  
A Mochula ◽  
O Mochula ◽  
A Maltseva ◽  
D Vorobyeva ◽  
V Ryabov ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Coronary Artery Disease ◽  
Acute Myocardial Infarction ◽  
Coronary Artery ◽  
Myocardial Perfusion ◽  
Obstructive Coronary Artery Disease ◽  
Quantitative Parameters ◽  
Artery Disease ◽  
One Year ◽  
Type Of Injury

Abstract Funding Acknowledgements Type of funding sources: None. Background. In recent years a group of patients with acute myocardial infarction without obstructive coronary artery disease (MINOCA) is of interest. In this group of patients, there is a lack of information related to myocardial perfusion, blood flow and reserve, which could be important in term of risk and prognosis assessment. Purpose. To assess the visual and quantitative MPS SPECT parameters in MINOCA patients compared to cardiac magnetic resonance (CMR) data. Methods.  In the period from 2017 to 2018 were examined 18 (8 male, mean 62.9 ± 10.7years) consecutive patients with acute myocardial infarction without obstructive coronary artery disease (MINOCA). Within 7-10 days after admission to the hospital and one year later all patients underwent SPECT myocardial perfusion scintigraphy (MPS) with the assessment of standard indices (SSS, SRS, SDS) and quantitative parameters: rest MBF (rMBF), stress MBF (sMBF) and CFR (on CZT gamma-camera). Also, all patients underwent CMR. Based on CMR data all patient were divided into two groups: 1) patients with non-ischemic type of injury and 2) patients with ischemic type of injury. Results. We found out significant correlation between regional quantitative SPECT indices and transmural extent of myocardial infarction evaluated by CMR: r=–0.4 for sMBF; r=–0.35 for CFR (p &lt; 0.05). In the first hospitalization this groups of patient didn`t have of any differences, according visual and quantitative data by SPECT. However, in one year, visual analysis showed that SSS and SDS were significantly (p &lt; 0.001) lower in patient with ischemic type of injury by CMR data: 2 (2; 3) vs 5.5 (4; 9) and 2 (1; 3) vs 4.5 (2; 5), respectively. According to the quantitative MPS data analysis, global and CFR values were significantly lower in patients with non-ischemic type of injury 1.30 (1.14; 1.75) vs 1.71 (1.34; 1.81). Conclusion. The analysis of quantitative MPS SPECT parameters showed that such approach allows identifying MBF and CFR disturbances. These results showed that MINOCA patients are heterogeneous group and require more strong investigation, observation and treatment.

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