scholarly journals Fibrinolytic or not : case series of stemi and deadly hemorrhagic stroke

2020 ◽  
Vol 14 (1) ◽  
Author(s):  
Sidhi Laksono Purwowiyoto ◽  
Steven Phillip
Keyword(s):  
Hemorrhagic Stroke ◽  
Case Series ◽  
Coronary Intervention ◽  
Stemi Patient ◽  
Fibrinolytic Therapy ◽  
High Tech ◽  
Percutaneous Coronary ◽  
Myocardial Infraction ◽  
Trained Staff ◽  
St Elevation

Cardiovascular diseases (CVD) like myocardial infraction (MI) is still becoming the leading cause of morbidity and mortality and major problem in our healthcare system. Nowadays, revolution in high-tech medical treatment alongside with well-trained staff could decrease adverse event in ST elevation myocardial infarction (STEMI) patient. However, in developing country like Indonesia, those still become a challenge. Fibrinolytic therapy is still common practice even though primary percutaneous coronary intervention (PPCI) preferred. Intracranial bleeding is one of the most unfavorable effect after fibrinolytic therapy. Clinical should aware with clinical deterioration. Here we present case series of deadly intracranial haemorrhage in STEMI patient after fibrinolytic therapy.

scholarly journals A rare complication of STEMI: Anaphylactic shock post-fibrinolytic

2021 ◽  
Vol 2 (3) ◽  
Author(s):  
Teddy Arnold Sihite ◽  
◽  
Muhammad H afizh Dewantara ◽  
Mega Febrianora ◽  
◽  
...  
Keyword(s):  
Percutaneous Coronary Intervention ◽  
Anaphylactic Shock ◽  
Myocardial Infarct ◽  
Rare Complication ◽  
Coronary Intervention ◽  
Stemi Patient ◽  
Fibrinolytic Therapy ◽  
First Line ◽  
Percutaneous Coronary ◽  
St Elevation

ST-Elevation Myocardial Infarct (STEMI) is the most common emergency condition that causes sudden death. The revascularization speed of the occluded coronary artery is the key to success in STEMI management in both aspects of reducing morbidity and mortality. Primary Percutaneous Coronary Intervention (PCI) is the first line of reperfusion management in the treatment of STEMI patients, but in some conditions, such actions cannot be performed then pharmaco-invasive strategies should be done. There are several complications of STEMI after fibrinolytic therapy. In this case report, we presented a rare complication of anaphylactic shock in STEMI patient underwent fibrinolytic therapy. Keywords: Anaphylactic shock; Fibrinolytic; PCI; STEMI.

scholarly journals The de Winter’s pattern revisited: a case series

2020 ◽  
Author(s):  
Thadathilankal-Jess John ◽  
Alfonso Pecoraro ◽  
Hellmuth Weich ◽  
Lloyd Joubert ◽  
Bradley Griffiths ◽  
...  
Keyword(s):  
Chest Pain ◽  
Early Recognition ◽  
Case Series ◽  
Coronary Intervention ◽  
Artery Occlusion ◽  
Percutaneous Coronary ◽  
History Of ◽  
St Elevation ◽  
Electrocardiogram Ecg ◽  
The Continuum

Abstract Background The de Winter’s electrocardiogram (ECG) pattern signifying proximal left anterior descending (LAD) artery occlusion was first described in 2008. The ECG changes were thought to be static and mechanisms for this were suggested. In addition, the optimal management of these patients was reported to be via a primary percutaneous coronary intervention (PCI) strategy. Case summary Case 1: A 48-year-old gentleman presented with a 2-h history of ischaemic chest pain with initial de Winter’s pattern on ECG. This progressed to anterior ST-elevation myocardial infarction (STEMI) complicated by ventricular fibrillation. Emergency angiography revealed a mid-vessel LAD occlusion which was successfully reperfused. Case 2: A 34-year-old female presented with a 2-h history of ischaemic chest pain with initial ECG showing a de Winter’s pattern. Due to concerns of performing PCI timeously, a pharmacoinvasive strategy of reperfusion was adopted with resolution of the de Winter’s pattern. Urgent angiography revealed a proximal LAD lesion which was successfully stented. Discussion The two cases highlight that the de Winter’s pattern may in fact not be static, but rather lie along the continuum of ischaemia and may evolve into STEMI. In addition, we provide further evidence that if primary PCI cannot be offered in a timeous manner, thrombolytic therapy may be considered in such patients. The de Winter’s pattern remains a high-risk ECG pattern that requires early recognition and intervention.

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