scholarly journals CLINICAL CASE OF SUCCESSFUL MANAGEMENT OF ACUTE MYOCARDIAL INFARCTION DURING PREGNANCY

2019 ◽  
Vol 72 (2) ◽  
pp. 298-301
Author(s):  
Oleh A. Loskutov ◽  
Andrii O. Zhezher ◽  
Yevhen M. Sulimenko
Keyword(s):  
Myocardial Infarction ◽  
Coronary Artery ◽  
Clinical Case ◽  
Bare Metal Stent ◽  
Key Factors ◽  
Successful Management ◽  
Diagnostic Measures ◽  
Specialized Center ◽  
Stent System ◽  
History Of

Introduction: There have recently been increasingly frequent reports of myocardial infarction (MI) in pregnancy and in the postpartum period. Pertinent and timely treatment affect maternal and fetal morbidity and mortality. Clinical case: We are reporting about a 42 years old woman at the 19th week of gestation, with complains of chest pain with irradiation into the left arm, and shortness of breath. It was known from the history of present illness, that at the time of the event ventricular fibrillation was recorded and resuscitation measures with cardioversion were performed. Subsequently, after an additional examination in the hospital, a diagnosis of MI has been determined. Coronary angiography with cardiac ventriculography (CVG) has been performed and stenosis of left anterior descending coronary artery (LAD) and right coronary artery (RCA) detected. A revascularization with the insertion of the bare-metal stent system has performed and double antiplatelet therapy prescribed. At 37 weeks of gestation, the patient gave birth to a healthy child by caesarean section. Conclusions: This clinical case illustrates the importance of minimizing the time to hospitalization of a pregnant woman with a MI to a specialized center for timely and complete diagnostic measures, which, in turn, allow to properly choose the tactics of patient management. Timely revascularization and properly selected anticoagulation are the key factors of the successful management in this category of patients.

scholarly journals Prevalence and Clinical Correlates of Coronary Artery Disease among New Dialysis Patients in the United States: A Cross-Sectional Study

2001 ◽  
Vol 12 (7) ◽  
pp. 1516-1523 ◽  
Author(s):  
AUSTIN G. STACK ◽  
WENDY E. BLOEMBERGEN
Keyword(s):  
United States ◽  
Risk Factors ◽  
Myocardial Infarction ◽  
Coronary Artery Disease ◽  
Coronary Artery ◽  
The United States ◽  
Comorbid Conditions ◽  
Clinical Correlates ◽  
History Of ◽  
Artery Disease

Abstract. Despite the high prevalence of coronary artery disease (CAD) among patients with end-stage renal disease (ESRD), few studies have identified clinical correlates using national data. The purpose of this study was to determine the prevalence and clinical associations of CAD in a national random sample of new ESRD in the United States in 1996/1997 (n = 4025). Data on demographic characteristics and comorbidities were obtained from the Dialysis Morbidity and Mortality Study, Wave 2. The principal outcome was CAD, defined as the presence of a previous history of CAD, myocardial infarction, or angina, coronary artery bypass surgery, coronary angioplasty, or abnormal coronary angiographic findings. Multivariate logistic regression analysis was used to assess the relationship of conventional factors and proposed uremic factors to the presence of CAD. CAD was present in 38% of patients. Of the total cohort, 17% had a history of myocardial infarction and 23% had angina. Several conventional risk factors, including advancing age, male gender, diabetes mellitus, and smoking, were significantly associated with CAD. Of the proposed uremic factors, lower serum albumin levels but higher residual renal function and higher hematocrit values were significantly associated with the presence of CAD. Vascular comorbid conditions, structural cardiac abnormalities, white race, and geographic location were also strongly correlated with the presence of CAD. This national study suggests that several conventional CAD risk factors may also be risk factors for CAD among the ESRD population. This study identifies nonconventional factors such as serum albumin levels, vascular comorbid conditions, and structural cardiac abnormalities as important disease correlates. Future logitudinal studies are required to explore the relative importance of the relationships observed here.

Factor XIII Val34Leu variant protects against coronary artery disease

2007 ◽  
Vol 97 (03) ◽  
pp. 458-463 ◽  
Author(s):  
Zsuzsanna Bereczky ◽  
Éva Katona ◽  
Róza Ádány ◽  
László Muszbek ◽  
Zoltán Vokó
Keyword(s):  
Myocardial Infarction ◽  
Coronary Artery Disease ◽  
Coronary Artery ◽  
Protective Effect ◽  
Factor Xiii ◽  
Empirical Bayes ◽  
Meta Analysis ◽  
Environmental Interactions ◽  
History Of ◽  
Artery Disease

SummarySeveral studies suggested that Val34Leu variant of factor XIII (FXIII) might have a protective effect against coronary artery disease (CAD), but studies not supporting these findings have also been published. The authors performed a meta-analysis of 16 studies on 5,346 cases and 7,053 controls that investigated the association between Val34Leu polymorphism and CAD defined as history of myocardial infarction or significant stenosis on a coronary artery assessed by coronary angiography. Because of the heterogeneity of the study-specific results, the pooled effect estimates were calculated by a random-effects empirical Bayes model. The combined odds ratios for CAD were 0.82 (95% confidence interval [95% Cl] 0.73, 0.94) for the heterozygotes of the FXIIIVal34Leu variant, 0.89 (95% CI 0.69, 1.13) for the homozygotes, and 0.81 (95% CI 0.70, 0.92) for the heterozygotes and homozygotes combined. The results were essentially the same when only myocardial infarction was considered as outcome. The beneficial effect of the polymorphism might be smaller than the effect estimates obtained in this metaanalysis, because the analysis raised the possibility of publication bias. Data published in the literature suggest that gene-gene and gene-environmental interactions might significantly influence the protective effect of FXIII-AVal34Leu polymorphism.

Occlusive coronary artery disease and parental history of myocardial infarction

1979 ◽  
Vol 8 (3) ◽  
pp. 419-428 ◽  
Author(s):  
Alfred J. Anderson ◽  
Richard F. Loeffler ◽  
Joseph J. Barboriak ◽  
Alfred A. Rimm
Keyword(s):  
Myocardial Infarction ◽  
Coronary Artery Disease ◽  
Coronary Artery ◽  
Parental History ◽  
History Of ◽  
Artery Disease

scholarly journals Left Internal Thoracic Artery Graft to Left Anterior Descending Coronary Artery after Blunt-Chest-Trauma Myocardial Infarction: 14-Year Outcome

2017 ◽  
Vol 44 (3) ◽  
pp. 214-218
Author(s):  
Paulo Roberto B. Evora ◽  
Minna Moreira D. Romano ◽  
Gabriela B. Tannus de Souza ◽  
Danilo T. Wada ◽  
André Schmidt ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Acute Myocardial Infarction ◽  
Coronary Artery ◽  
Blunt Chest Trauma ◽  
Chest Trauma ◽  
Internal Thoracic Artery ◽  
Myocardial Revascularization ◽  
Left Internal Thoracic Artery ◽  
Artery Graft ◽  
History Of

In 2005, we reported an acute myocardial infarction secondary to a left anterior descending coronary artery injury sustained in a motorcycle accident. The treatment was late myocardial revascularization with in situ left internal thoracic artery-to-left anterior descending coronary artery anastomosis. There is little information available about the natural history of acute myocardial infarction after blunt chest trauma, especially when treated in this manner. This present communication reports the 14-year outcome in our patient.

scholarly journals Giant Coronary Artery Aneurysms Involving More Than One Coronary Artery

2021 ◽  
Author(s):  
Matthew S Khouzam ◽  
Nayer Khouzam
Keyword(s):  
Myocardial Infarction ◽  
Coronary Artery ◽  
Aortic Aneurysm ◽  
Right Coronary Artery ◽  
Coronary Artery Aneurysm ◽  
Artery Aneurysm ◽  
Coronary Artery Aneurysms ◽  
St Segment ◽  
History Of ◽  
The Right

Abstract Background: Coronary artery aneurysms are rare findings in patients undergoing coronary angiography. The presence of multiple coronary artery aneurysms located in more than one coronary artery is even more uncommon. The pathophysiology of such aneurysms is unknown, but the majority are often due to atherosclerosis, congenital heart disease, or vasculitis. Case Presentation: We present a rare case of a 78-year-old female patient who presented with unstable angina and non-ST segment elevation myocardial infarction. On coronary angiography she was found to have three separate 1 cm saccular aneurysms involving the proximal left anterior descending coronary artery. The right coronary artery could not be visualized. Computed chest tomography revealed a 6.6 x 6.3 cm saccular aneurysm of the right coronary artery, and a 4.4 cm fusiform aneurysm of the ascending aorta. The patient gave no history of percutaneous coronary intervention or cardiac surgical procedures. She had a previous history of endovascular stenting of an abdominal aortic aneurysm. The sizable right coronary artery aneurysm showed extrinsic compression of both the right atrium and ventricle with right ventricular hypokinesis. Serological studies for vasculitis were all negative. Pathology of the aneurysm wall revealed calcific atherosclerosis without evidence of vasculitis. The patient underwent subtotal resection of the right coronary aneurysm with ligation of the proximal and distal ends of the right coronary artery and double bypass surgery to the left anterior descending and right posterior descending coronary arteries. Conclusion: The presence of multiple, large coronary artery aneurysms is very rare. Treatment can be challenging and should be individualized. Surgical treatment is recommended for giant coronary artery aneurysms to prevent potential complications. Keywords: coronary artery aneurysm, aortic aneurysm, atherosclerosis, non-ST segment 32 elevation myocardial infarction, case report

scholarly journals Coronary Flow in Patients with Three-Vessel Disease: Simulated Hemodynamic Variables in relation to Angiographically Assessed Collaterality and History of Myocardial Infarction

2011 ◽  
Vol 2011 ◽  
pp. 1-10 ◽  
Author(s):  
Issam Abouliatim ◽  
Majid Harmouche ◽  
Agnès Drochon ◽  
Mahmoud Maasrani ◽  
Hervé Corbineau ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Coronary Artery ◽  
Left Ventricular ◽  
Left Ventricular Ejection ◽  
Collateral Flow ◽  
Anterior Myocardial Infarction ◽  
Ventricular Ejection Fraction ◽  
Flow Rates ◽  
Chronic Occlusion ◽  
History Of

We study patients with stenoses of the left main coronary artery (LMCA), left anterior descending artery (LAD), and left circumflex branch (LCx) and with chronic occlusion of the right coronary artery (RCA), undergoing off-pump coronary surgery. An analog electrical model is used to provide quantitative estimations of the distribution of flows and pressures across the coronary network (in the stenosed native arteries, the collateral branches, the capillary areas, and so forth). The present paper demonstrates that the clinical information collected for the 10 patients included in the study (Rentrop score, history of myocardial infarction, left ventricular ejection fraction (LVEF)) are well correlated with the predicted hydrodynamic data. Patients with a good collaterality (Rentrop score = 3) or patients without anterior myocardial infarction have (i) less severe stenoses on the LMCA, (ii) lower microvascular resistances, (iii) higher grafts flow rates when the revascularization is performed, (iv) higher collateral flow rates towards the territory of the occluded artery, (v) better perfusion of this area, and (vi) better total perfusion of the heart.

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