scholarly journals Differential Diagnosis of Fulminant Myocarditis and Acute Coronary Syndromes in the Case of Failure of Coronary Angiography: A Case Report

2021 ◽  
Vol 8 ◽  
Author(s):  
Xiangfei Huang ◽  
Yi Gao ◽  
Fuzhou Hua ◽  
Jun Ying
Keyword(s):  
Acute Coronary Syndrome ◽  
Coronary Artery ◽  
Coronary Angiography ◽  
Severe Disease ◽  
Fulminant Myocarditis ◽  
Ecg Changes ◽  
Laboratory Findings ◽  
Coronary Syndrome ◽  
Life Threatening ◽  
Coronary Syndromes

Fulminant myocarditis (FM) is a severe disease with a rapidly progressive and life-threatening course caused mainly by viral infection. The symptoms, laboratory findings, and presence of ECG changes resemble acute coronary syndrome. Therefore, coronary angiography is usually helpful in making the appropriate diagnosis. However, failure to obtain complete coronary artery images due to coronary artery anatomic variations poses a challenge for the diagnosis of FM. Here, we report a case of FM preliminarily diagnosed as acute coronary syndrome (ACS) due to the presence of coronary artery anomaly.

scholarly journals Evaluation of Platelet Parameters in Patients With Coronary Artery Disease

2020 ◽  
Author(s):  
Mahdieh Mehrpouri1 ◽  
Afshin Ahmad Pour ◽  
Esmail Shahabi Satlsar
Keyword(s):  
Risk Factors ◽  
Coronary Artery Disease ◽  
Acute Coronary Syndrome ◽  
Coronary Artery ◽  
Coronary Angiography ◽  
Healthy Volunteers ◽  
Ecg Changes ◽  
Coronary Syndrome ◽  
Significant Difference ◽  
Artery Disease

Coronary artery disease (CAD) is one of the leading causes of death worldwide; therefore, identifying new risk factors to predict the severity of the disease is thought to be associated with mortality reduction. In an effort to investigate whether platelet parameters are related to the extent of CAD and can be considered as risk factors, we designed experiments to evaluate platelet parameters in these patients. In a cross‐sectional study, sixty-nine patients with CAD (including fifty-two patients with acute coronary syndrome and seventeen patients with stable angina) and sixty-four healthy volunteers were evaluated for platelet count, mean platelet volume (MPV), and platelet distribution width (PDW). Echocardiography, electrocardiogram (ECG), and coronary angiography were conducted as well. Results showed significantly higher values for MPV and PDW in patients with acute coronary syndrome as compared to patients with stable angina and healthy volunteers (P<0.001 and P=0.009, respectively). There was no significant difference in platelet count between patients and healthy volunteers (P=0.379). Our results also revealed a significant difference in the ejection fraction (EF) percentage between the three groups (P=0.008). Investigating the correlation between platelet parameters and EF percentage, ECG changes, and the results of coronary angiography did not show any significant association. The present study showed that the elevated levels of MPV and PDW in patients with CAD are not related to the extent of coronary artery disease, which was estimated by echocardiography, ECG changes, and coronary angiography. Thus, these parameters cannot be considered as risk factors for coronary artery disease.

scholarly journals Myocarditis Mimicking an Acute Coronary Syndrome: A Case Related toSalmonella enteritis

2009 ◽  
Vol 2009 ◽  
pp. 1-2 ◽  
Author(s):  
B. Rossetti ◽  
G. Nguisseu ◽  
A. Buracci ◽  
L. Migliorini ◽  
G. Zanelli
Keyword(s):  
Risk Factors ◽  
Acute Coronary Syndrome ◽  
Coronary Artery ◽  
Coronary Angiography ◽  
Salmonella Enteritidis ◽  
Clinical Laboratory ◽  
Final Diagnosis ◽  
Gastrointestinal Infections ◽  
Coronary Syndrome ◽  
Salmonella Enteritis

Infective myocarditis is most commonly due to a viral infection; occasionally it has been related to bacteria. Gastrointestinal infections associated with myocarditis have only rarely been described in young people, and the pathogenesis is unclear. We report a case of myocarditis mimicking an acute coronary syndrome (ACS) in a patient hospitalized for fever and diarrhoea.Salmonella enteritidiswas isolated from stool, and no other pathogens were found. The coronary angiography was normal, and there were not other coronary artery risk factors, other than hypertension. The patient was treated with ciprofloxacin, acetylsalicylate acid, and ramipril with rapid clinical improvement and normalization of cardiac abnormalities. Final diagnosis ofSalmonella enteritisand related myocarditis was made based on clinical, laboratory, ECG and echocardiographical findings.

scholarly journals Assessment of the effectiveness of treatment in patients after acute coronary syndrome

2020 ◽  
Vol 25 (2) ◽  
pp. 9-18
Author(s):  
D. A. Shvets ◽  
S. V. Povetkin ◽  
A. Yu. Karasev ◽  
V. I. Vishnevsky
Keyword(s):  
Acute Coronary Syndrome ◽  
Drug Therapy ◽  
Coronary Artery ◽  
Coronary Angiography ◽  
Secondary Prevention ◽  
Generic Drugs ◽  
Myocardial Revascularization ◽  
Cardiovascular Complications ◽  
Drug Prevention ◽  
Coronary Syndrome

Aim. To assess the effectiveness of secondary drug prevention and surgical myocardial revascularization in patients with coronary artery disease (CAD) during long-term follow-up after acute coronary syndrome (ACS).Material and methods. The study involved 400 patients with ACS discharged from the hospital in 2012-2016. The diagnosis was verified according to the European Society of Cardiology (ESC) guidelines. There were no exclusion criteria. We analyzed the data of medical records (complaints, medical history, physical examination, laboratory and instrumental data). Repeated data collection was carried out by distance survey and during a face-to-face examination during 2018. According to the clinical course of CAD, all patients were divided into 2 groups. Group 1 consisted of 151 patients with complicated course of CAD, group 2 — 249 patients with stable CAD. We analyzed drug therapy recommended at hospital discharge and taken at the time of the repeated examination. The drug names and daily dosage used for the secondary prevention of CAD were recorded. Assessment of survival without cardiovascular complications was carried out according to the Kaplan-Mayer analysis.Results. Seven-year mortality was 22,5%. The total number of cardiovascular events was 37,7%. The main reason for the frequent complications was the insufficient secondary prevention of CAD after ACS. We found that the drugs and their dosage did not have a significant effect on survival. Statin use is associated with a paradoxical increase in the number of complications. The increased frequency of use and dosage of statins are a consequence of unfavorable course of CAD and do not have the proper preventive effect. For some groups of drugs, we observed irregular intake over the observation period. The low effectiveness of therapy is not only due to insufficient doses, but also in the frequent use of generic drugs. The significant effect of coronary angiography on the probability of cardiovascular complications compared with stenting is due to high proportion of coronary angiography use without revascularization.Conclusion. The combination of following factors of drug therapy can explain the low effectiveness of secondary CAD prevention: low dose (26,1±2,8 mg for atorvastatin), irregular intake and common use of generic drugs (97,6% for statins), present in different ratios. The contribution of surgical treatment to reducing cardiovascular complications is lower, the more significant residual coronary artery stenosis.

scholarly journals Allergic acute coronary syndrome: Amoxicillin/clavulanic acid intake

2021 ◽  
Vol 11 (2) ◽  
pp. 064-068
Author(s):  
Filipa Ribeiro Lucas ◽  
João Gigante ◽  
Steve Harakeh ◽  
Pedro Vieira
Keyword(s):  
Acute Coronary Syndrome ◽  
Acute Coronary Syndromes ◽  
Myocardial Injury ◽  
Kounis Syndrome ◽  
Laboratory Findings ◽  
Coronary Syndrome ◽  
Antibiotic Allergy ◽  
Allergen Concentration ◽  
Amoxicillin Clavulanic Acid ◽  
Coronary Syndromes

Anaphylaxis rarely manifests as a vasospastic acute coronary syndrome (ACS). Kounis Syndrome (KS) is described as the coincidental occurrence of chest pain and clinical and laboratory findings of ACS. The prognosis depends on the magnitude of the initial allergic response, the patient’s sensitivity, comorbidities, the site of antibody antigen reaction, the allergen concentration, and the route of allergen entrance. We report a rare case of KS secondary to antibiotic allergy. This case may suggest that Kounis syndrome should be taught in the differential diagnosis of acute coronary syndromes. Clinicians should be aware of this adverse effect and consider it during diagnostic workup of myocardial injury.

scholarly journals Nonalcoholic Fatty Liver Disease and Coronary Artery Disease: Big Brothers in Patients with Acute Coronary Syndrome

2020 ◽  
Vol 2020 ◽  
pp. 1-5
Author(s):  
Mauricio Montemezzo ◽  
Ahmed AlTurki ◽  
Fabio Stahlschmidt ◽  
Marcia Olandoski ◽  
Jean Rodrigo Tafarel ◽  
...  
Keyword(s):  
Acute Coronary Syndrome ◽  
Liver Disease ◽  
Coronary Artery ◽  
Coronary Angiography ◽  
Fatty Liver ◽  
Fatty Liver Disease ◽  
Nonalcoholic Fatty Liver ◽  
Coronary Syndrome ◽  
Diagnostic Coronary Angiography ◽  
Grade Iii

Background. The prevalence of nonalcoholic fatty liver disease (NAFLD) has been increasing. This study aimed to evaluate the prevalence of NAFLD, as diagnosed by ultrasound, in patients with acute coronary syndrome (ACS) and to assess whether NAFLD is associated with the severity of coronary obstruction as diagnosed by coronary angiography. Methods. We performed a prospective single-center study in patients hospitalized due to acute coronary syndrome who underwent diagnostic coronary angiography. Consecutive patients who presented to the emergency room were diagnosed with acute coronary syndrome and were included. All patients underwent ultrasonography of the upper abdomen to determine the presence or absence of NAFLD; NAFLD severity was graded from 0 to 3 based on a previously validated scale. All patients underwent diagnostic coronary angiography in the same hospital, with the same team of interventional cardiologists, who were blinded to the patients’ clinical and ultrasonographic data. CAD was then angiographically graded from none to severe based on well-established angiographic criteria. Results. This study included 139 patients, of whom 83 (59.7%) were male, with a mean age of 59.7 years. Of the included patients, 107 (77%) patients had CAD, 63 (45%) with serious injury. Regarding the presence of NAFLD, 76 (55.2%) had NAFLD including 18 (23.6%) with grade III disease. In severe CAD, 47 (60.5%) are associated with NAFLD, and 15 (83.3%) of the patients had severe CAD and NAFLD grade III. Conclusions. NAFLD is common in patients with ACS. The intensity of NAFLD detected by ultrasonography is strongly associated with the severity of coronary artery obstruction on angiography.

Anti-Platelet and Anti-Thrombotic Therapy Post-AMI

2011 ◽  
Author(s):  
Dana Dawson ◽  
Keith Fox
Keyword(s):  
Myocardial Infarction ◽  
Acute Coronary Syndrome ◽  
Coronary Artery ◽  
Acute Coronary Syndromes ◽  
Myocardial Reperfusion ◽  
St Elevation Myocardial Infarction ◽  
Coagulation Cascade ◽  
Coronary Syndrome ◽  
Coronary Syndromes ◽  
St Elevation

• Acute coronary syndromes (ACS) encompass a spectrum of presentations which include unstable angina, non-ST-elevation myocardial infarction (NSTEMI or NSTE-ACS), and ST-elevation myocardial infarction (STEMI or STE-ACS)• Anti-platelet and anti-thrombotic agents are administered as ancillary therapy to myocardial reperfusion in patients presenting with an acute coronary syndrome, to maintain the patency of the infarct-related coronary artery• More specific and potent inhibitors of platelet activation and of the coagulation cascade are emerging with the aim being to further improve clinical outcomes in patients presenting with an acute coronary syndrome, without increasing the risks of major bleeding.

scholarly journals Multiple Life-threatening Coronary Artery Spasms after Percutaneous Coronary Intervention for Acute Coronary Syndrome

2019 ◽  
Vol 58 (2) ◽  
pp. 233-238 ◽  
Author(s):  
Toshiki Sawai ◽  
Yu Tajima ◽  
Atsuya Hirota ◽  
Shigetada Yamamoto ◽  
Hiroshi Nakajima ◽  
...  
Keyword(s):  
Percutaneous Coronary Intervention ◽  
Acute Coronary Syndrome ◽  
Coronary Artery ◽  
Coronary Intervention ◽  
Coronary Syndrome ◽  
Percutaneous Coronary ◽  
Life Threatening

scholarly journals Acute coronary syndrome with elevation of ST associated with ergotamine abuse

2019 ◽  
Vol 57 (1) ◽  
pp. 69-71 ◽  
Author(s):  
Gabriel E. Pérez Baztarrica ◽  
Leonardo P. Armijos Carrion ◽  
Juan H. Abarca Real ◽  
William A. Paredes Lima ◽  
Otto P. Giler Saltos ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Acute Coronary Syndrome ◽  
Coronary Artery ◽  
Coronary Angiography ◽  
Aortic Dissection ◽  
Case Reports ◽  
St Segment Elevation ◽  
Coronary Syndrome ◽  
Segment Elevation Myocardial Infarction ◽  
St Segment

Abstract There are few case reports of cases of carotid and aortic dissection related to the ergotamine abuse, but the cases that affect the coronary arteries is a very rare coronary. We present a patient of a 48-year-old female with an ST-segment elevation myocardial infarction attributable to chronic ergotamine use. The coronary angiography showed dissection of right coronary artery proximal.

scholarly journals Angiographic Studies of Coronary Artery Disease in Dhulikhel Hospital

2013 ◽  
Vol 9 (1) ◽  
pp. 43-46
Author(s):  
R Koju ◽  
S Humagain
Keyword(s):  
Acute Coronary Syndrome ◽  
Coronary Artery ◽  
Coronary Angiography ◽  
Stable Angina ◽  
Coronary Stenosis ◽  
Coronary Artery Occlusion ◽  
Artery Occlusion ◽  
Coronary Syndrome ◽  
Diagnostic Angiography ◽  
Artery Disease

Background Coronary Artery Diseases (CAD), one of the the leading causes of death, is increasing globally. The number of CAD is also increasing in Nepal. Dhulikhel Hospital is also providing cardiovascular services to populations from semiurban and rural population of mid region of country. It started coronary angiography services from April 2012. This paper aims to analyze pattern of coronary artery occlusion in patients undergoing coronary angiography during April to September months of 2012. Methods There were a total of 36 cases of diagnostic angiography and coronary interventions done in Dhulikhel Hospital from April to September 2012. Among them 32 cases of coronary angiography done for Acute Coronary Syndrome and Stable Angina, were analyzed using SPSS 17. Results Males were higher in number than females and majority of the patients were above 55 years. Out of 32 cases, 13 (40.6%) had Acute Coronary Syndrome (ACS) and 19(59.4%) had Stable Angina. Six out of 32 were found to have normal coronaries. One patient with ACS had normal coronary. Out of all the patients with coronary stenosis, four had left main disease, 14 had LAD stenosis, 7 had LCX stenosis and 12 patients had RCA stenosis. Thirteen had severe coronary stenosis. Nine out of 12 ACS patients had more than one coronary artery involved, which is significantly higher than the stable angina group (P<0.01). Severe stenosis was found to be more common in ACS group (p<0.001) when compared to the stable angina group. Conclusion Coronary angiography is a useful diagnostic and therapeutic tool for CAD. Coronary status is significantly different in ACS and stable angina. ACS has more chance of having multivessel stenosis whereas stable angina has single vessel, less severe or normal coronaries. Severity of stenosis is also high in ACS than in stable angina. DOI: http://dx.doi.org/10.3126/njh.v9i1.8348 Nepalese Heart Journal Vol.9(1) 2012 pp.43-46

scholarly journals ASSOCIATION OF THROMBOLYSIS IN MYOCARDIAL INFARCTION (TIMI) RISK SCORE WITH EXTENT OF CORONARY ARTERY DISEASE IN PATIENTS WITH UNSTABLE ANGINA AND NSTEMI

2021 ◽  
Vol 70 (Suppl-4) ◽  
pp. S787-91
Author(s):  
Saleha Abbas ◽  
Abdul Hameed Siddiqui ◽  
Ammar Cheema ◽  
Ayesha Abbas ◽  
Syed Khawar Abbas Jaffri ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Coronary Artery Disease ◽  
Acute Coronary Syndrome ◽  
Coronary Artery ◽  
Coronary Angiography ◽  
Unstable Angina ◽  
Risk Score ◽  
Coronary Syndrome ◽  
Co Morbidity ◽  
Artery Disease

Objective: To evaluate the correlation between thrombolytic in Myocardial Infarction risk score with the severity of coronary lesions found by coronary angiography during hospitalization in patients with non-ST elevation Acute coronary syndrome. Study Design: Cross sectional study. Place and Duration of Study: Adult Cardiology department, Armed Forces Institute of Cardiology & National Institute of Heart Diseases, Rawalpindi from Jul to Dec 2018.Methodology: Patients who had chest pain suggestive of angina or anginal equivalent symptoms and diagnosis of Acute Coronary Syndrome (ACS) were included in the study. Patients with Acute Coronary Syndrome were risk stratified with Thrombolysis In Myocardial Infarction risk scores and were further evaluated with coronary angiograms to assess the extent of coronary artery disease. Results: Total 115 patients were recruited in the study with mean age 57.08 ± 10.2 years. There were 87 (75.7%) male patients while 28 (24.3%) female patients. The most common co-morbidity was hypertension 66 (57.4%) followed by diabetes mellitus 39 (33.9%) and smoking 25 (21.7%). 71 (61.7%) patients had one angina episode in the last 2 hours while 34 patients had two angina episodes in the last 2 hours. Cardiac biomarkers were raised in 36 (31.3%) patients. 60 (52.2%) used aspirin in the last 7 days. Chi-square test was applied between Thrombolysis In Myocardial Infarction Score and Coronaries lesions, which showed statistically significant results (p<0.001). Conclusion: Our study demonstrates that among patients presenting with Non-STE Acute coronary syndrome i.e. unstable angina /NSTEMI who are referred for coronary angiography, clinical risk stratification according......

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