An interesting case of hyperhomocysteinemia presenting as acute myocardial infarction and cerebral venous thrombosis

Coronary artery spasm can cause recurrent variant angina with ST-segment elevation. The patient was asymptomatic with normal vitals and ECG was normal. We present a case associated with transient ST-segment elevation and significant increase in troponin levels with non-critical lesion with normal CAG

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The Incidence of Deep Venous Thrombosis in Patients with an Acute Myocardial Infarction Treated with Acenocoumarol or Indobufen

Thrombosis and Haemostasis ◽

10.1055/s-0038-1657261 ◽

1982 ◽

Vol 48 (02) ◽

pp. 222-225 ◽

Cited By ~ 2

Author(s):

S H A Peters ◽

J J C Jonker ◽

A C de Boer ◽

G J H den Ottolander

Keyword(s):

Myocardial Infarction ◽

Acute Myocardial Infarction ◽

Venous Thrombosis ◽

Deep Venous Thrombosis ◽

Prognostic Index ◽

Impedance Plethysmography ◽

Antiplatelet Drug ◽

Bleeding Complications ◽

Double Blind ◽

Significant Difference

SummaryIn a randomized double blind clinical trial, we compared indobufen, an antiplatelet drug, with acenocoumarol for the prevention of deep venous thrombosis (D. V. T.) in patients with acute myocardial infarction. Therapy was started on admission and continued for 10 days. All patients were screened daily with impedance plethysmography (I.P.G.) and 125I-fibrinogen leg scanning. Diagnosis of D.V.T. was made when either one or both tests became positive. 74 patients were randomized to treatment with indobufen (200 mg b.i.d.) and 76 patients to acenocoumarol (controlled by thrombotest). The incidence of venous thrombosis in patients with indobufen was 11% and in those treated with acenocoumarol 9%. Major bleeding was observed in 2 patients treated with acenocoumarol. In the indobufen group, no bleeding complications or other serious side-effects were observed. The majority of patients developed thrombosis after the first week of admission. For patients with and without thrombosis, there was no significant difference between the two treatment groups concerning the age, the coronary prognostic index, the maximum C.P.K. value, mobility, incidence of congestive heart failure and the site or extent of the infarct. In this study no clinical or laboratory (fibrinogen, platelet count and anti-thrombin III) parameter, either alone or in combination, was of predictive value for the development of D.V.T. It can be concluded that indobufen appears to be as good as acenocoumarol for the prevention of D.V.T. in patients with acute myocardial infarction. Because it is safe and easy to administer, indobufen seems to be preferable. Prophylaxis is required for at least 10 days.

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Deep Venous Thrombosis and Pulmonary Embolism in Acute Myocardial Infarction

Pulmonary Embolism - Progress in Respiratory Research ◽

10.1159/000386911 ◽

2015 ◽

pp. 113-119

Author(s):

P. Niederle ◽

I. Prerovsk� ◽

J. šimonov� ◽

V. št�dlerov� ◽

M. Riedel ◽

...

Keyword(s):

Myocardial Infarction ◽

Acute Myocardial Infarction ◽

Pulmonary Embolism ◽

Venous Thrombosis ◽

Deep Venous Thrombosis

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Biophysical Characteristics of Erythrocytes during Acute Myocardial Infarction and Venous Thrombosis

Thrombosis and Haemostasis ◽

10.1055/s-0038-1649119 ◽

1972 ◽

Vol 28 (03) ◽

pp. 524-534 ◽

Cited By ~ 1

Author(s):

P Resnitzky ◽

A Yaari ◽

D Danon

Keyword(s):

Myocardial Infarction ◽

Acute Myocardial Infarction ◽

Venous Thrombosis ◽

Red Blood Cells ◽

Cell Population ◽

Blood Cells ◽

Osmotic Fragility ◽

Electric Mobility ◽

Cell Mobility ◽

Acute Mi

SummaryThe osmotic fragility (OF), density distribution (DDC) and electrophoretic mobility (EPM) of red blood cells were examined in groups of patients suffering from acute myocardial infarction (MI), arteriosclerotic heart disease and precordial pains (ASHD), and deep-vein thrombosis. In patients with acute MI there is a reduction in electric mobility which returns to normal range within 3 weeks. The slow RBCs were in no case slower than the slowest cells of a normal curve representing the oldest portion of the red cell population. In a definite percentage of these patients there are also changes in the OF and the DDC indicating a narrower cell population. These changes are apparently consequent to the disappearance of the slowest cells from the circulation. Mobility tests were done in buffered saline and after three washings. The cell mobility of normal patients was slowed after ½ to 1 hour incubation with the plasma of patients suffering from fresh MI. These results agree with the existence of plasma factors affecting the electric charge of RBCs. The mobility of red blood cells of patients with acute MI underwent incubation with normal plasma returned to normal. The cells of patients with ASHD and precordial pains show also a reduction in average mobility although in a lesser degree. The possibility that this group of patients suffer from micro-infarct not detected by the usual clinical tests, has been considered. Patients with deep-venous thrombosis show similar changes in cell mobility as patients with acute MI. A possible relation between reduced RBC electric mobility and thromboembolism among MI patients was suggested.

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Recurrent diclofenac-induced acute myocardial infarction: An interesting case with wandering ST-segment elevation

Hong Kong Journal of Emergency Medicine ◽

10.1177/1024907919845526 ◽

2019 ◽

Vol 27 (5) ◽

pp. 304-307

Author(s):

Emre Özdemir ◽

Zeynep Karakaya ◽

Mustafa Karaca ◽

Fatih Topal ◽

Umut Payza

Keyword(s):

Myocardial Infarction ◽

Acute Myocardial Infarction ◽

Antiplatelet Agent ◽

Coronary Spasm ◽

Interesting Case ◽

Allergic Reactions ◽

Anterior Myocardial Infarction ◽

St Segment Elevation ◽

Coronary Syndrome ◽

St Segment

Introduction: Allergic acute myocardial infarction with ST-segment elevation is rare, and vasoconstrictor mediators released from mast cells are responsible for its pathogenesis. Several medications have been reported to lead to acute myocardial infarction with ST-segment elevation, as a part of systemic allergic reactions and this entity is known as Kounis syndrome (KS). Case presentation: We presented a patient with recurrent KS who had no allergic reactions, except coronary spasm after parenteral diclofenac administration. First, she experienced anterior myocardial infarction with ST-segment elevation after administration of diclofenac 2 years ago. The second presentation was acute inferior-posterior myocardial infarction with ST-segment elevation with atrioventricular complete block leading to cardiogenic shock. She had no significant coronary stenosis responsible for each myocardial infarction with ST-segment elevation. However, she had a catheter-induced coronary spasm of non-dominant right coronary artery. She was considered to have a recurrent allergic myocardial infarction with ST-segment elevation due to parenteral diclofenac usage and treated with a calcium antagonist, statin, and dual antiplatelet agent. Discussion: KS can manifest as same as acute coronary syndrome. All drugs or any allergen can cause this event.KS had three variants but In all three conditions, treatment is antithrombotic or vasodilatator regime. Conclusion: As atherosclerosis events on coronary, allergic coronary events also may recurs. However, unlike the literature, our case is differentiated by recurrence of similar events in different coronary vessels.

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Value of Low Dose Heparin in Prevention of Deep Venous Thrombosis After Acute Myocardial Infarction

10.1055/s-0039-1687250 ◽

1979 ◽

Author(s):

J.F. Cade

Keyword(s):

Myocardial Infarction ◽

Acute Myocardial Infarction ◽

Venous Thrombosis ◽

Deep Venous Thrombosis ◽

Cardiac Failure ◽

Low Dose ◽

Medical Patients ◽

Dose Heparin ◽

Coronary Care ◽

Low Dose Heparin

Low-dose heparin has become widely used in the prophylaxis of venous thromboembolism in surgical patients but its use in medical patients is less well established. In particular, the reported incidence of deep venous thrombosis (DVT) after acute myocardial infarction (AMI) has varied considerably, as has its response to low-dose heparin prophylaxis. In 94 patients admitted with a provisional diagnosis of AMI, treatment was allocated randomly and blindly as either heparin 5,000 U subcutaneously twice daily or placebo. DVT was diagnosed by daily 125-I fibrinogen leg scanning. DVT occurred in 10% of control patients and in 3% of treated patients. All DVT’s occurred in patients with subsequently proven AMI (68% of admissions) in whom the incidence was 19% in those untreated and 5% in those treated. DVT was more common in patients with cardiac failure (14%) than in those without (3%). There was no difference in incidence of DVT between patients with or without clinically significantly arrhythmias or hypotension. Multivariate analysis combining these factors failed to improve the prediction of DVT. It is concluded that patients admitted for acute Coronary Care are a relatively low risk group for DVT. Minidose heparin appears to be warranted only in those with proven AMI and cardiac failure.

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Thrombophilia - Some Interesting Case Reports of Cerebral Venous Thrombosis

South Asian Research Journal of Oral and Dental Sciences ◽

10.36346/sarjods.2019.v01i01.003 ◽

2019 ◽

Vol 01 (01) ◽

pp. 15-18

Author(s):

Selvaraj Pitchai ◽

Kalaimani . ◽

Akshay chowdary ◽

Swathi . ◽

Vignesh . ◽

...

Keyword(s):

Venous Thrombosis ◽

Cerebral Venous Thrombosis ◽

Case Reports ◽

Interesting Case

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Cellular composition of human early and advanced coronary atherosclerotic lesions

10.1101/2021.10.07.21264647 ◽

2021 ◽

Author(s):

Diana Sharysh ◽

Anton V. Markov ◽

Evgeniya S. Grigoryeva ◽

Olga E. Savelieva ◽

Aleksei A. Sleptcov ◽

...

Keyword(s):

Myocardial Infarction ◽

Acute Myocardial Infarction ◽

Flow Cytometry ◽

Atherosclerotic Lesion ◽

Interesting Case ◽

Atherosclerotic Plaques ◽

Cellular Composition ◽

Atherosclerotic Lesions ◽

A Cell ◽

First Time

AbstractObjectiveHere, we identify and quantify leukocytes, macrophages, endothelial cells (ECs), and vascular smooth muscle cells (VSMCs) with contractile and macrophage-like phenotypes by flow cytometry to compare human early and advanced coronary atherosclerotic plaques.Approach and ResultsSixteen coronary atherosclerotic lesions of 6 patients (3 women, 3 men, age 82 ± 9 years), including one case of restenosis after coronary stenting, were collected at autopsy. The cause of death of all patients was acute myocardial infarction. The lesions were categorized into early (EALs, n = 5) and advanced (AALs, n = 11) atherosclerotic stages. We analyzed a cell suspension stained with antibodies against CD45, CD68, CD31, and αSMA (ACTA2). We noted a decrease in the number of CD45+ cells and an increase in the CD45+CD68+ subpopulation of leukocytes from EALs to AALs. Numbers of CD45−αSMA+CD68+ cells positively correlated with the CD45+CD68+ macrophage number (r = 0.81; ρ = 0.64; p < 0.05) and the histological type of an atherosclerotic lesion (r = 0.81; ρ = 0.87; p < 0.05). As an interesting case, we analyzed cellular composition of the stented coronary artery and revealed significantly greater numbers of macrophages, αSMA+CD68+ VSMCs, and ECs in comparison with nonstented plaques.ConclusionsHuman early and advanced coronary atherosclerotic lesions differ in their counts of leukocytes and leukocyte subpopulations. For the first time, αSMA+CD68+ VSMCs were identified in early atherosclerotic stages of coronary arteries. Additionally, the restenotic coronary lesion contains mostly cells and is enriched in ECs, macrophages, and αSMA+CD68+ VSMCs in particular.

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