scholarly journals Case Report: Effective Treatment for Acute Chlorpyrifos Poisoning Complicated by a Non-ST-Segment Elevation Myocardial Infarction

2021 ◽  
Vol 8 ◽  
Author(s):  
Changqing Ye ◽  
Qiang Zhang ◽  
Yongsheng Chao ◽  
Chun Yin
Keyword(s):  
Myocardial Infarction ◽  
Case Report ◽  
Rare Complication ◽  
Clinical Manifestations ◽  
Organophosphorus Pesticide ◽  
Coronary Intervention ◽  
Organophosphate Insecticide ◽  
St Segment Elevation ◽  
First Case ◽  
St Segment

Background: Acute myocardial infarction (AMI) is a rare complication of acute organophosphorus pesticide poisoning. Although chlorpyrifos has been widely used as an organophosphate insecticide, a few cases of AMI complicated by chlorpyrifos poisoning have been reported thus far. Hence, a suitable treatment strategy remains to be explored.Case Presentation: Based on the clinical manifestations, medical history, results of an auxiliary examination, and serum biomarkers, a 65-year-old male farmer with complaints of nausea, vomiting, chest tightness, and pain was clearly diagnosed as having a severe chlorpyrifos self-poisoning with acute non-ST-segment elevation MI. Because the patient and his family confirmedly refused a coronary intervention, conservative treatment was used instead. It should be noted that there were some conflicts of the management for chlorpyrifos poisoning and AMI. Although rapid atropinization would contribute to the relief of muscarinic symptoms, it would also lead to an increased heart rate and myocardial oxygen consumption in AMI. Furthermore, the reduction of platelet aggregation, which is necessary for coronary recanalization of an AMI patient, is known to aggravate the gastrointestinal injury caused by poisoning. In this case, these conflicts were properly addressed, which led to an excellent effect and prognosis of the patient.Conclusions: To our knowledge, this is the first case report of acute chlorpyrifos poisoning with AMI. It is emphasized that patients with chest pain or coronary heart disease should be treated with atropine more cautiously because of the possible AMI. Moreover, proper resolution of conflicts in the management for chlorpyrifos poisoning and AMI played contributing roles in patient improvement.

scholarly journals Simultaneous Multi-Vessel Very Late Stent Thrombosis in Acute ST-Segment Elevation Myocardial Infarction

2021 ◽  
Vol 2021 ◽  
pp. 1-3
Author(s):  
Yuefeng Chen ◽  
Michael Amponsah ◽  
Cyril Nathaniel
Keyword(s):  
Myocardial Infarction ◽  
Stent Thrombosis ◽  
Rare Complication ◽  
Coronary Intervention ◽  
Very Late Stent Thrombosis ◽  
Acute Setting ◽  
St Segment Elevation ◽  
Segment Elevation Myocardial Infarction ◽  
St Segment ◽  
Percutaneous Coronary

Simultaneous multi-vessel very later stent thrombosis (VLST) is a very rare complication of percutaneous coronary intervention (PCI). We present a case of simultaneous multi-vessel VLST as the cause of acute ST-segment elevation myocardial infarction (STEMI). PCI of the culprit vessel was performed at acute presentation. Resolution of in-stent thrombosis in non-culprit vessels was noted on coronary angiography 2 days later. Our case suggests that PCI for culprit lesion in acute setting may be a reasonable option for simultaneous multi-vessel VLST.

Acute ST-Segment Elevation Myocardial Infarction Associated With Diclofenac-Induced Anaphylaxis: Case Report

2009 ◽  
Vol 18 (4) ◽  
pp. 388-386 ◽  
Author(s):  
J. W. B. de Groot ◽  
A. T. M. Gosselink ◽  
J. P. Ottervanger
Keyword(s):  
Myocardial Infarction ◽  
Acute Myocardial Infarction ◽  
Case Report ◽  
Coronary Stenosis ◽  
Temporal Relationship ◽  
Rare Complication ◽  
Kounis Syndrome ◽  
St Segment Elevation ◽  
Segment Elevation Myocardial Infarction ◽  
St Segment

A patient in whom acute myocardial infarction developed during diclofenac-induced anaphylaxis is described. ST-segment elevation myocardial infarction is a rare complication of anaphylactic reactions, but can occur even in patients with angiographically normal coronary arteries. Physicians should be aware of such a complication in order to diagnose it early and treat it properly. In the patient described here, according to the temporal relationship with diclofenac intake and the exclusion of coronary stenosis, it is probable that diclofenac caused the symptoms. To our knowledge, this is the first reported case of Kounis syndrome due to diclofenac. The patient’s recovery was uneventful.

Posterior wall myocardial infarction: A case report

2017 ◽  
Vol 70 (1-2) ◽  
pp. 44-47
Author(s):  
Milenko Cankovic ◽  
Snezana Bjelic ◽  
Vladimir Ivanovic ◽  
Anastazija Stojsic-Milosavljevic ◽  
Dalibor Somer ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Case Report ◽  
Chest Pain ◽  
Myocardial Revascularization ◽  
Posterior Wall ◽  
Circumflex Artery ◽  
St Segment Elevation ◽  
Therapeutic Benefits ◽  
St Segment ◽  
Therapeutic Algorithms

Introduction. Acute myocardial infarction is a clinical manifestation of coronary disease which occurs when a blood vessel is narrowed or occluded in such a way that it leads to irreversible myocardial ischemia. ST segment depression in leads V1?V3 on the electrocardiogram points to the anterior wall ischemia, although it is actually ST elevation with posterior wall myocardial infarction. In the absence of clear ST segment elevation, it may be overlooked, leading to different therapeutic algorithms which could significantly affect the outcome. Case report. A 77 year-old female patient was admitted to the Coronary Care Unit due to prolonged chest pain followed by nausea and horizontal ST segment depression on the electrocardiogram in V1?V3 up to 3 mm. ST segment elevation myocardial infarction of the posterior wall was diagnosed, associated with the development of initial cardiogenic shock and ischemic mitral regurgitation. An emergency coronarography was performed as well as primary percutaneous coronary intervention with stent placement in the circumflex artery, the infarct-related artery. Due to a multi-vessel disease, surgical myocardial revascularization was indicated. Conclusion. Posterior wall transmural myocardial infarction is the most common misdiagnosis in the 12 lead electrocardiogram reading. Routine use of additional posterior (lateral) leads in all patients with chest pain has no diagnostic or therapeutic benefits, but it is indicated when posterior or lateral wall infarction is suspected. The use of posterior leads increases the number of diagnosed ST segment elevation myocardial infarctions contributing to better risk assessment, prognosis and survival due to reperfusion therapy.

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