scholarly journals Antiphospholipid Syndrome - A Case Report of Pulmonary Thromboembolism, Followed with Acute Myocardial Infarction in Patient with Systemic Sclerosis

2015 ◽  
Vol 3 (4) ◽  
pp. 705-709 ◽  
Author(s):  
Marija Vavlukis ◽  
Irina Kotlar ◽  
Emilija Chaparoska ◽  
Bekim Pocesta ◽  
Hristo Pejkov ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Acute Myocardial Infarction ◽  
Pulmonary Embolism ◽  
Systemic Sclerosis ◽  
Antiphospholipid Syndrome ◽  
Total Occlusion ◽  
St Segment Elevation ◽  
St Segment ◽  
History Of ◽  
The Right

AIM: We are presenting an uncommon case of pulmonary embolism, followed with an acute myocardial infarction, in a patient with progressive systemic sclerosis.CASE PRESENTATION: A female 40 years of age was admitted with signs of pulmonary embolism, confirmed with CT scan, which also reviled a thrombus in the right ventricle. The patient had medical history of systemic sclerosis since the age of 16 years. She suffered an ischemic stroke 6 years ago, but she was not taking any anticoagulant or antithrombotic medications ever since. She received a treatment with thrombolytic therapy, and subsequent UFH, but, on the second day after receiving fibrinolysis, she felt chest pain accompanied with ECG changes consistent for ST-segment elevation myocardial infarction (STEMI). Urgent coronary angiography was undertaken, which reviled cloths causing total occlusion in 4 blood vessels, followed with thromboaspiration, but without successful reperfusion. Several hours later the patient developed rapid deterioration with letal ending. During the very short hospital course, blood sampling reviled presence of antiphospholipid antibodies.CONCLUSION: The acquired antiphospholipid syndrome is common condition in patients with systemic autoimmune diseases, but relatively rare in patients with systemic sclerosis. Never the less, we have to be aware of it when treating the patients with systemic sclerosis.

Abstract 552: Posterior Involvement Attenuates Predictive Value of ST-Segment Elevation in Lead V4R for Right Ventricular Involvement in Inferior Acute Myocardial Infarction

Circulation ◽  
2008 ◽  
Vol 118 (suppl_18) ◽  
Author(s):  
Masami Kosuge ◽  
Kazuo Kimura ◽  
Toshiaki Ebina ◽  
Kiyoshi Hibi ◽  
Kengo Tsukahara ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Acute Myocardial Infarction ◽  
Right Ventricular ◽  
Myocardial Reperfusion ◽  
Total Occlusion ◽  
St Segment Elevation ◽  
St Segment ◽  
Inferior Acute Myocardial Infarction ◽  
The Right ◽  
The Impact

ST-segment elevation (ST ↑) ≥1.0 mm in lead V4R is considered a reliable marker of right ventricular involvement (RVI) in inferior acute myocardial infarction (IMI). However, the impact of posterior involvement (PI) on the relation between RVI and ST ↑ in lead V4R is unknown. We studied 267 patients with a first IMI who had total occlusion and TIMI 3 flow of the right coronary artery within 6 h after the onset. A 12-lead ECG, lead V4R, and leads V7–9 were recorded on admission. RVI was defined as occlusion proximal to the first right ventricular branch. The perfusion territory was assessed by angiographic distribution score, and PI was defined as a score of ≥0.7. Myocardial blush grade was assessed immediately after reperfusion. Patients were stratified according to the presense or absense of PI and RVI. Times to admission and reperfusion were similar in the 4 groups. RVI was associated with higher peak creatine kinase and higher rates of impaired myocardial reperfusion (blush grade 0/1) and congestive heart failure during hospitalization in the presense or absense of PI, especially the former. RVI was associated with a higher rate of ST ↑ in lead V4R in the absence, but not in the presence, of PI. ST ↑ in lead V4R identified RVI with sensitivities of 34% and 96% (p<0.001) and specificities of 83% and 82% (NS) in the presence and absence of PI, respectively. In patients with reperfused IMI, RVI is associated with a larger infarct size and impaired myocardial reperfusion. However, the incidence of RVI diagnosed by ST ↑ in lead V4R was underestimated in the presence of posterior involvement. ST ↑ in lead V4R caused by RVI might be attenuated due to a reciprocal change in posterior ST ↑.

scholarly journals Non-rheumatic streptococcal myocarditis mimicking acute myocardial infarction in an adolescent male

2018 ◽  
Vol 28 (3) ◽  
pp. 454-457 ◽  
Author(s):  
Caitlin E. O’Brien ◽  
John D. Coulson ◽  
Priya Sekar ◽  
Jon R. Resar ◽  
Kristen Nelson McMillan
Keyword(s):  
Myocardial Infarction ◽  
Acute Myocardial Infarction ◽  
Young Adults ◽  
Chest Pain ◽  
Streptococcal Pharyngitis ◽  
Adolescent Male ◽  
Coronary Angiogram ◽  
St Segment Elevation ◽  
St Segment ◽  
History Of

AbstractAn adolescent male with a recent history of streptococcal pharyngitis presented with severe substernal chest pain, troponin leak, and ST-segment elevation, which are suggestive of acute inferolateral myocardial infarction. The coronary angiogram was normal. The patient was subsequently diagnosed with non-rheumatic streptococcal myocarditis. He was treated with amoxicillin and had excellent recovery. Non-rheumatic streptococcal myocarditis is an important mimic of acute myocardial infarction in young adults.

scholarly journals Treatment of patients with myocardial infarction depends on history of cancer

2017 ◽  
Vol 7 (7) ◽  
pp. 639-645 ◽  
Author(s):  
Sabine Rohrmann ◽  
Fabienne Witassek ◽  
Paul Erne ◽  
Hans Rickli ◽  
Dragana Radovanovic
Keyword(s):  
Myocardial Infarction ◽  
Acute Myocardial Infarction ◽  
Cancer Patients ◽  
St Segment Elevation ◽  
Segment Elevation Myocardial Infarction ◽  
Recommended Treatment ◽  
St Segment ◽  
History Of ◽  
Comorbidity Index ◽  
History Of Cancer

Background: Although cancer treatment considerably affects cardiovascular health, little is known about how cancer patients are treated for an acute myocardial infarction. We aimed to investigate whether acute myocardial infarction patients with a history of cancer received the same guideline recommended treatment as those acute myocardial infarction patients without and whether they differ with respect to inhospital outcome. Methods: All patients with ST-segment elevation myocardial infarction and non-ST-segment elevation myocardial infarction, enrolled between 2002 and mid-2015 in the acute myocardial infarction in Switzerland (AMIS Plus) registry with comorbidity data based on the Charlson comorbidity index were analysed. Patients were classified as having cancer if one of the cancer diseases of the Charlson comorbidity index was indicated. Immediate treatment strategies and inhospital outcomes were compared between groups using propensity score matching. Results: Of 35,249 patients, 1981 (5.6%) had a history of cancer. After propensity score matching for age, gender, Killip class >2, ST-segment elevation myocardial infarction and renal disease (1981 patients per group), significant differences were no longer found for a history of acute myocardial infarction, hypertension, diabetes, heart failure and cerebrovascular disease between cancer and non-cancer patients. However, cancer patients underwent percutaneous coronary intervention less frequently (odds ratio (OR) 0.76; 95% confidence interval (CI) 0.67–0.88) and received P2Y12 blockers (OR 0.82; 95% CI 0.71–0.94) and statins (OR 0.87; 95% CI 0.76–0.99) less frequently. Inhospital mortality was significantly higher in cancer patients (10.7% vs. 7.6%, OR 1.45; 95% CI 1.17–1.81). However, the main cause of death was cardiac in both groups ( P=0.06). Conclusion: Acute myocardial infarction patients with a history of cancer were less likely to receive guideline recommended treatment and had worse inhospital outcomes than non-cancer patients.

scholarly journals Acute Myocardial Infarction Caused by Filgrastim: A Case Report

2012 ◽  
Vol 2012 ◽  
pp. 1-2
Author(s):  
Cemil Bilir ◽  
Hüseyin Engin ◽  
Yasemin Bakkal Temi ◽  
Bilal Toka ◽  
Turgut Karabağ
Keyword(s):  
Myocardial Infarction ◽  
Acute Myocardial Infarction ◽  
Case Report ◽  
Cardiac Disease ◽  
Chest Discomfort ◽  
St Segment Elevation ◽  
Gm Csf ◽  
St Segment ◽  
History Of ◽  
Coronary Events

Common uses of the granulocyte-colony stimulating factors in the clinical practice raise the concern about side effects of these agents. We presented a case report about an acute myocardial infarction with non-ST segment elevation during filgrastim administration. A 73-year-old man had squamous cell carcinoma of larynx with lung metastasis treated with the chemotherapy. Second day after the filgrastim, patient had a chest discomfort. An ECG was performed and showed an ST segment depression and negative T waves on inferior derivations. A coronary angiography had showed a critical lesion in right coronary arteria. This is the first study thats revealed that G-CSF can cause acute myocardial infarction in cancer patients without history of cardiac disease. Patients with chest discomfort and pain who are on treatment with G-CSF or GM-CSF must alert the physicians for acute coronary events.

scholarly journals Az ügyeleti ellátás útvesztői egy korszerűtlen készítmény okozta iatrogenia kapcsán

2017 ◽  
Vol 158 (11) ◽  
pp. 426-431 ◽  
Author(s):  
Péter Arányi ◽  
János Tomcsányi
Keyword(s):  
Myocardial Infarction ◽  
Acute Myocardial Infarction ◽  
Side Effects ◽  
Antihypertensive Medication ◽  
Troponin I ◽  
Elevated Serum ◽  
St Segment Elevation ◽  
Severe Hyponatraemia ◽  
St Segment ◽  
History Of

Abstract: Hydrochlorothiazide became one of the most commonly prescribed first-line antihypertensive medication, though its use is often complicated with serious side-effects. A 66-year-old female patient with a history of hypertension had suffered a transient loss of consciousness, and referred to our cardiology unit with an ST-segment elevation and giant negative T-waves in V1-2 ECG leads, long QT-segment and elevated serum creatine-kinase (5392 U/L) and troponin I (4,357 ng/ml) levels. Acute myocardial infarction was not proven (later coronarography revealed preserved coronary circulation), but severe hyponatraemia and hypokalaemia was detected, explaining a possible symptomatic seizure, and which could be accounted for a 25 mg daily hydrochlorothiazide antihypertensive treatment and – as a precipitating insult – a one-week history of gastroenteritis. The case-report presents a unique differential diagnostic question where thiazide-induced hyponatraemia and hypokalaemia resulted in a clinical picture sharing some similarities with acute myocardial infarction. This case underlines the serious side-effects of an inappropriately used common antihypertensive medication. Orv. Hetil., 2017, 158(11), 426–431.

scholarly journals Frequency, Predictors, Distribution, and Morphological Characteristics of Layered Culprit and Nonculprit Plaques of Patients With Acute Myocardial Infarction

2020 ◽  
Vol 13 (10) ◽  
Author(s):  
Jiannan Dai ◽  
Chao Fang ◽  
Shaotao Zhang ◽  
Lulu Li ◽  
Yini Wang ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Acute Myocardial Infarction ◽  
Optical Coherence Tomography ◽  
Morphological Characteristics ◽  
Optical Coherence ◽  
Circumflex Artery ◽  
St Segment Elevation ◽  
Left Circumflex Artery ◽  
St Segment ◽  
The Right

Background: Subclinical atherothrombosis and plaque healing may lead to rapid plaque progression. The histopathologic healed plaque has a layered appearance when imaged using optical coherence tomography. We assessed the frequency, predictors, distribution, and morphological characteristics of optical coherence tomography layered culprit and nonculprit plaques in patients with acute myocardial infarction. Methods: A prospective series of 325 patients with acute myocardial infarction underwent optical coherence tomography imaging of all 3 native coronary arteries. Layered plaque phenotype had heterogeneous signal-rich layered tissue located close to the luminal surface that was clearly demarcated from the underlying plaque. Results: Layered plaques were detected in 74.5% of patients with acute myocardial infarction. Patients with layered culprit plaques had more layered nonculprit plaques; and they more often had preinfarction angina, ST-segment–elevation myocardial infarction, higher low-density lipoprotein cholesterol, and absence of antiplatelet therapy. Layered plaques tended to cluster in the proximal segment of the left anterior descending artery and left circumflex artery but were more uniformly distributed in the right coronary artery. As compared with nonlayered plaques, layered plaques had greater optical coherence tomography lumen area stenosis at both culprit and nonculprit sites. The frequency of layered plaque phenotype ( P =0.038) and maximum area of layered tissue ( P <0.001) increased from nonculprit thin-cap fibroatheromas to nonculprit ruptures to culprit ruptures. Conclusions: Layered plaques were identified in 3-quarters of patients with acute myocardial infarction, especially in the culprit plaques of patients with ST-segment–elevation myocardial infarction. Layered plaques had a limited, focal distribution in the left anterior descending artery, and left circumflex artery but were more evenly distributed in the right coronary artery and were characterized by greater lumen narrowing at both culprit and nonculprit sites. Graphic Abstract: A graphic abstract is available for this article.

scholarly journals Recovery of right ventricular function and strain in patients with ST-segment elevation myocardial infarction and concurrent chronic total occlusion

2021 ◽  
Author(s):  
Anna van Veelen ◽  
Joëlle Elias ◽  
Ivo M. van Dongen ◽  
Loes P. C. Hoebers ◽  
Bimmer E. P. M. Claessen ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Chronic Total Occlusion ◽  
Longitudinal Strain ◽  
Total Occlusion ◽  
St Segment Elevation ◽  
Segment Elevation Myocardial Infarction ◽  
St Segment ◽  
The Right ◽  
Rv Function

AbstractThe right ventricle (RV) is frequently involved in ST-segment elevation myocardial infarction (STEMI) when the culprit or concurrent chronic total occlusion (CTO) is located in the right coronary artery (RCA). We investigated RV function recovery in STEMI-patients with concurrent CTO. In EXPLORE, STEMI-patients with concurrent CTO were randomized to CTO percutaneous coronary intervention (PCI) or no CTO-PCI. We analyzed 174 EXPLORE patients with serial cardiovascular magnetic resonance imaging RV data (baseline and 4-month follow-up), divided into three groups: CTO-RCA (CTO in RCA, culprit in non-RCA; n = 89), IRA-RCA (infarct related artery [IRA] in RCA, CTO in non-RCA; n = 56), and no-RCA (culprit and CTO not in RCA; n = 29). Tricuspid annular plane systolic excursion (TAPSE), RV ejection fraction (RVEF), RV global longitudinal strain (GLS) and free wall longitudinal strain (FWLS) were measured. We found that RV strain and TAPSE improved in IRA-RCA and CTO-RCA (irrespective of CTO-PCI) at follow-up, but not in no-RCA. Only RV FWLS was different among groups at baseline, which was lower in IRA-RCA than no-RCA (− 26.0 ± 8.3% versus − 31.0 ± 6.4%, p = 0.006). Baseline RVEF, RV end-diastolic volume and TAPSE were associated with RVEF at 4 months. RV function parameters were not predictive of 4 year mortality, although RV GLS showed additional predictive value for New York Heart Association Classification > 1 at 4 months. In conclusion, RV parameters significantly improved in patients with acute or chronic RCA occlusion, but not in no-RCA patients. RV FWLS was the only RV parameter able to discriminate between acute ischemic and non-ischemic myocardium. Moreover, RV GLS was independently predictive for functional status.

Sign in / Sign up

Export Citation Format

Share Document