scholarly journals Cardiac headache in acute coronary syndrome

2017 ◽  
Vol 4 (3) ◽  
pp. 21
Author(s):  
Phillip Tran ◽  
Robert Ziffra ◽  
Hoai V. Nguyen ◽  
Selena M. Losee

Acute coronary syndrome may present in a wide distribution of symptoms. The classic presentation includes substernal chest pain, neck pain, dyspnea or syncope. In patients with coronary risk factors who present with headaches, acute coronary syndrome is rare, but has been previously reported. We describe a case of 63-year-old female who presented with a severe headache and developed a Non ST Elevation Myocardial Infarction.

2009 ◽  
Vol 3 ◽  
pp. CMC.S3284 ◽  
Author(s):  
Douglas Wright ◽  
Claire Kenny-Scherber ◽  
Alison Montgomery ◽  
Omid Salehian

Acute coronary syndrome (ACS) in pregnancy has traditionally been considered to be a rare event, but the combination of normal physiological changes of pregnancy and more prevalent cardiovascular risk factors are increasing its incidence in this population. The present report describes a 39 year-old woman that is seven weeks pregnant presenting with a non ST elevation myocardial infarction. The incidence, risk factors, pathophysiology and management of ACS in pregnancy are discussed.


2020 ◽  
Vol 28 (6) ◽  
pp. 312-315
Author(s):  
Noor Dastgir ◽  
Arslan Masood ◽  
Ahmed Muqeet ◽  
Gul Zaman Khan Niazi

Background Coronary artery ectasia is a relatively common entity characterized by inappropriate dilatation of the coronary vasculature. In some cases of acute coronary syndrome without obstructive coronary lesions, coronary ectasia is the sole cause. The exact mechanism of its development is unknown but evidence suggests a combination of genetic predisposition, common risk factors for coronary artery disease, and abnormal vessel wall metabolism. As there are few data regarding the pattern of coronary risk factors in patients with coronary ectasia, the objective of the study was to determine the frequency and distribution of coronary risk factors in patients with acute coronary syndrome solely due to coronary ectasia. Methods The study included 155 patients over a period of 6 months, with coronary angiographic evidence of coronary ectasia as the sole cause of acute coronary syndrome. There were 79 (51%) men and 76 (49%) women with a mean age 51.92 ± 7.83 years; 73 (47.10%) were aged 20–50 years and 82 (52.90%) were 51–80 years of age. The frequencies of coronary risk factors were stratified according to sex and the two age groups. Results Seventy-one patients (45.80%) had diabetes mellitus, 83 (53.54%) had hypertension, 55 (35.48%) were smokers, 46 (29.68%) had dyslipidemia, and 47 (30.3%) were obese. Conclusion Hypertension is the leading coronary risk factors in patients with acute coronary syndrome solely due to coronary ectasia, followed by diabetes mellitus and smoking.


2021 ◽  
Author(s):  
Soraya Siabani ◽  
Leila Gholizadeh ◽  
Hossein Siabani ◽  
Nahid Saleh

Abstract Background: Myocardial infarction in younger adults is an understudied research area. Objectives: This paper reports on characteristics, risk factors, and disease outcomes of young adults with St-elevation myocardial infarction (STEMI).Methods: This is a sub-analysis of data from the Kermanshah Acute Coronary Syndrome Registry, including all patients aged ≤45 with STEMI (n=247) registered in the registry from June 2017 to June 2019. Results: Patients aged ≤45 constituted 10.66% of all patients with STEM; the majority was male (91.8%), and the most common CVD risk factors included: smoking (56.7%), low high-density lipoprotein (55.5%), elevated triglyceride (44.4%), hypertension (38.2%), hypercholesterolemia (38.1%), elevated low-density lipoprotein (26.3%), and obesity (24.3%). Many patients (62.8%) received primary percutaneous coronary intervention (PCI), and in-hospital mortality was low at 0.8%. Conclusions: Younger adults should be screened for CVD risk factors, and are educated and supported to participate in programs that aim to reduce risk through risk factor modification.


1970 ◽  
Vol 2 (2) ◽  
pp. 175-178 ◽  
Author(s):  
AFMS Haque ◽  
AR Siddiqui ◽  
SMM Rahman ◽  
SA Iqbal ◽  
NN Fatema ◽  
...  

Background: Coronary artery disease (CAD) is a worldwide health epidemic. Acute coronary syndrome is a potentially life-threatening condition and patient may die or become disabled in the prime of life. There is documented evidence that South Asian people develop CAD at a higher rate and also at an early age. If the affected individual is 40 yrs old or below, the tragic consequences are catastrophic. Methods: It was a retrospective observational study to find out the pattern of acute coronary syndrome in the young (40 years old or less) in a military hospital (CMH Dhaka) from July 2007 to July 2008 and to analyze the risk factors and the angiographic characteristics of coronary vessels. Consecutive 64 young patients including both male and female admitted into this hospital were the study subjects. Out of these patients 53 were males and 11 were females. Among these patients coronary risk factors and angiographic pattern were studied. 64 older patients with Acute coronary syndrome (age more than 40 years) were also studied. Results: Out of 64 young patients 15.6% patients presented to this hospital as UA, 9.37% presented as Non-Q MI, 28.12% Acute Anterior MI, 14.06% Acute Anteroseptal MI, 26.56% Acute Inferior MI, 6.25% Acute Infero-posterior MI. Smoking was the most common risk factor among these young patients. 64.06% patients were smoker. Dyslipidaemia was present among 50% patients, 37.55% were hypertensive, 15.62% were diabetic, and 15.62% were obese. SVCAD was the most common lesion and it was 53.12%. 26.56% patients had DVCAD and TVCAD was present among 20.31% patients. In the older group (more than 40 years) most common risk factor was dyslipidaemia (71.88%) and smoking was present among 48.43% patients. Conclusion: Young patients have a different risk factor profile in comparison with older patients. Smoking is a strong and quite common coronary risk factor in the young ACS patients who are 40 years or less. Risk factor identification and control is very crucial in the primary and secondary prevention in young patients with CAD. Keywords: Acute coronary syndrome; Risk factors; Coronary Angiography DOI: 10.3329/cardio.v2i2.6635Cardiovasc. j. 2010; 2(2) : 175-178


2019 ◽  
Vol 19 (1) ◽  
Author(s):  
Udaya Ralapanawa ◽  
Pallegoda Vithanage Ranjith Kumarasiri ◽  
Kushalee Poornima Jayawickreme ◽  
Prabashini Kumarihamy ◽  
Yapa Wijeratne ◽  
...  

Abstract Background Acute Coronary Syndrome (ACS) is one of the leading causes of death worldwide and studies have shown higher mortality rates and premature death in South Asian countries. The occurrence and effect of risk factors differ by type ofACS.Epidemiological studies in the Sri Lankan population are limited. Methods This is a cross sectional descriptive study conducted at the Teaching Hospital Peradeniya, Sri Lanka among patients presenting with ACS. Data was collected by an interviewer administered structured questionnaire and epidemiological patterns and risk factors were analyzed. Results The sample of 300 patients had a mean age of 61.3+/− 12.6 and male sex showed higher association with all three type of ACS compared to female with a P value of 0.001. This study showed higher mean age of 62.2 ± 11.4 years amongst unstable angina (UA) patients and 61.9 ± 14.5 years amongst non ST elevation myocardial infarction (NSTEMI) patients compared to 59.2 ± 11.2 years for ST elevation myocardial infarction (STEMI) patients with no significant statistical difference (P = 0.246). Approximately 55.8% STEMI patients, 39.8% UA and 35.5% NSTEMI patients were smokers indicating a significant association between smoking and STEMI (P = 0.017). Nearly 54.5% STEMI, 35.4% UA and 32.7% NSTEMI patients consumed alcohol and there was a very strong association between alcohol consumption and STEMI (P = 0.006). Almost 51.8% NSTEMI patients, 47.8% UA patients and 29.9% STEMI patients had hypertension(HT) (P = 0.008) indicating significant association of HT with UA and NSTEMI. About 33.6% UA patients and 30.0% NSTEMI patients had DM whilst only 22.1% of STEMI patients had DM of no significance (p = 0.225). Around 15.0% patients with UA, 25.5% with NSTEMI and 11.7% with STEMI had dyslipidemia (P = 0.032). There was a very strong association between a past history of ACS or stable angina with NSTEMI and UA (P = 0.001). Conclusion Smoking and alcohol abuse are significantly associated with STEMI.Patients with NSTEMI or Unstable Angina had higher rates of hypertension and were more likely to have a history of ACS or stable angina than STEMI patients. Patients with NSTEMI were more likely than patients with STEMI or UA to have dyslipidemia.


2021 ◽  
Vol 28 (Supplement_1) ◽  
Author(s):  
T Ando ◽  
T Watanabe ◽  
S Matsuo ◽  
T Samejima ◽  
J Yamagishi ◽  
...  

Abstract Funding Acknowledgements Type of funding sources: Foundation. Main funding source(s): Grant-in-aid from.jpgu Prefecture Background The newly developed Cardiac Rehabilitation.jpgu Network (CR-GNet) has been implemented to create a regional alliance network and to provide periodic follow-up examinations to enhance the disease management in patients with cardiovascular disease. The effectiveness of a network like this support system has not yet been evaluated in Japan. Purpose We aimed to examine the feasibility of the CR-GNet in disease management, assisting patients in attaining physical fitness and its impact on long-term outcomes after acute coronary syndrome (ACS). Methods We enrolled 47 patients with ACS in the CR-GNet between February 2016 and September 2019; of these, 37, 29, and 21 patients underwent follow-up assessments for exercise capacity (peak oxygen uptake) at 3 months, 6 months, and 1 year after discharge, respectively. Major adverse cardiac events (MACE) were defined as the composite of death from cardiac causes, cardiac arrest, myocardial infarction, and rehospitalization due to unstable or progressive angina. MACE were compared with controls who were not registered in the CR-GNet. Results The coronary risk factors, except blood pressure, improved at 3 and 6 months, and 1 year after discharge. These risk factors in each patient significantly reduced from 2.9 at admission to 1.6, 1.4, and 1.9 at 3 months, 6 months, and 1 year after discharge (p < 0.05), respectively. Peak oxygen uptake was significantly higher at 3 months, 6 months, and 1 year after discharge to 17.5 ± 4.9 ml/kg/min, 17.9 ± 5.1 ml/kg/min, and 17.5 ± 5.5 ml/kg/min, respectively, than that at discharge (14.7 ± 3.6 ml/kg/min) (p < 0.05). During follow-up, there was no significant difference; MACE did not occur in any patients in the CR-GNet but occurred in controls. Conclusions The CR-GNet is a feasible option for long-term management of ACS patients. The prognostic impact of the CR-GNet needs further investigation with a larger sample size and longer follow-up. Table1 At admission 3 months 6 months 1 year Average number 2.9 1.6* 1.4** 1.9*** † Average number of coronary risk factors for all patients (n = 21) p = 0.004, vs. at admission; **p = 0.001, vs. at admission; ***p = 0.011, vs. at admission; †p = 0.035, vs. at 6 months


Circulation ◽  
2014 ◽  
Vol 130 (suppl_2) ◽  
Author(s):  
Sunao Kojima ◽  
Hisao Ogawa ◽  

Introduction: Brief episodes of ischemia increases cardiac tolerance to a subsequent major ischemic insult. Prehospital medication may affect the mode of presentation in acute myocardial infarction (AMI) and pharmacologically precondition the heart toward ischemic episodes. Hypothesis: We assessed the hypothesis that antecedent therapy confers cardioprotection in patients suffering an AMI. Methods: The Japanese Acute Coronary Syndrome Study (JACSS) is a retrospective and multicenter observational study that is being conducted at 35 medical institutions in Japan. The JACSS database includes information on consecutive 1,204 patients who were hospitalized within 48 hours after the onset of AMI. Results: A total of 1,010 ST-elevation myocardial infarction (STEMI) and 194 non STEMI (NSTEMI) patients were included and the differences of the mode of presentation, prehospital medication and coronary risk factors were investigated in the present study. Coronary risk factors such as sex, hypertension, diabetes mellitus, hypercholesterolemia, smoking, obesity and previous coronary artery disease were comparable between STEMI and NSTEMI groups. Prehospital medication with aspirin, nitrates, β-blockers and calcium-channel blockers but not with angiotensin-converting enzyme inhibitors, angiotensin II receptor blockers and statins were associated with the onset as NSTEMI. A stepwise regression analysis including coronary risk factors and prehospital medication revealed that chronic therapy with nitrates and β-blockers reduced the onset as STEMI compared with that as NSTEMI (table) Conclusions: Antecedent therapy with nitrates and β-blockers was associated with reduced severity of myocardial injury in response to an acute coronary event. Our findings may help to explain the missing link between a shift away from STEMI in favor of NSTEMI and a combined capability of nitrates and β-blockers to act as pharmacological inducers of ischemic preconditioning.


Author(s):  
Stephen D’Auria ◽  
Ravi Ramani

Chest pain is a common presenting complaint faced by the rapid response team (RRT), and can herald a serious process such as acute coronary syndrome or aortic dissection, or be secondary to a minor muscle strain. A methodical approach to chest pain is necessary to avoid premature diagnostic closure. One of the most feared diagnoses is a myocardial infarction. Fortunately, there are well-established guidelines describing the necessary steps for treatment of both ST elevation myocardial infarction (STEMI) and non-ST elevation myocardial infarction (NSTEMI). This chapter will address the differential for chest pain as well as established guidelines for treatment of acute coronary syndrome.


2017 ◽  
Vol 5 (2) ◽  
pp. 106-109
Author(s):  
Md Zahid Alam ◽  
Aparna Rahman ◽  
Shabnam Jahan Hoque ◽  
SM Rezaul Irfan ◽  
Md Babul Miah ◽  
...  

Background: Dyslipidemia is one of the main risk factors with prognostic significance in relation to coronary heart disease. Aggressive treatment has been recommended in acute coronary syndrome (ACS). We examined pattern of dyslipidemia in ST Elevation myocardial infarction (STEMI) and Non- ST elevation myocardial infarction (NSTEMI). We also compare the lipid status in between two types of myocardial infarction (MI).Methods: This cross sectional observational study was carried out enrolling 100 subjects with ST elevation and Non ST elevation Myocardial Infarction, in the Department of Cardiology, BIRDEM General Hospital, Shahbag, Dhaka, over a period of six months from January 2012 to June 2012. Fasting lipid profile was done in next morning of admission in both type of MI.Results: Mean age and gender difference was significant between STEMI and NSTEMI. Mean Cholesterol (chol), Triglyceride (TG), high density lipoprotein (HDL) and low density lipoprotein (LDL) were not statistically significant between male and female groups. All mean cholesterol, TG, HDL, LDL were significantly high in older age group. The Mean cholesterol (220.7±28.1Vs208.4±20.9), triglyceride (182.8±34.4 Vs 147.4±28.9), HDL (35.14±5.7 Vs 41.65±3.8) and LDL (160.7±26.2 Vs148.3±16.8)were also statistically significant between STEMI and NSTEMI groups (p<0.05).Conclusion: Dyslipidemia is the dominating coronary risk factors. It could be concluded that significant differences are observed between two types of MI. Lipid status is relatively more uncontrolled in ST elevated MI and must be managed with all possible therapeutic modules to minimize further complications.Bangladesh Crit Care J September 2017; 5(2): 106-109


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