scholarly journals Ventricular Fibrillation Cardiac Arrest in Young Female from Diffuse Left Anterior Descending Coronary Vasospasm

2019 ◽  
Vol 3 (4) ◽  
pp. 395-397
Author(s):  
Christopher Wilson ◽  
Eric Melnychuk ◽  
John Bernett
Keyword(s):  
Myocardial Infarction ◽  
Emergency Department ◽  
Cardiac Arrest ◽  
Chest Pain ◽  
Coronary Artery ◽  
Ventricular Fibrillation ◽  
Young Female ◽  
Coronary Vasospasm ◽  
Fatal Complication ◽  
St Elevation

This is a case of the most severe and potentially fatal complication of coronary artery vasospasm. We report a case of a 40-year-old female presenting to the emergency department (ED) via emergency medical services with chest pain. The patient experienced a ventricular fibrillation cardiac arrest while in the ED. Post-defibrillation electrocardiogram showed changes suggestive of an ST-elevation myocardial infarction (STEMI). Cardiac catheterization showed severe left anterior descending spasm with no evidence of disease. Coronary vasospasm is a consideration in the differential causes of ventricular fibrillation and STEMI seen in the ED.

scholarly journals Clomiphene Associated Inferior STEMI in a Young Female due to Right Coronary Artery Dissection

2017 ◽  
Vol 2017 ◽  
pp. 1-3 ◽  
Author(s):  
Feras Husain Abuzeyad ◽  
Eltigani Seedahmed Ibnaouf ◽  
Mudhaffar Al Farras
Keyword(s):  
Myocardial Infarction ◽  
Coronary Artery ◽  
Hormonal Therapy ◽  
Ovulation Induction ◽  
Final Diagnosis ◽  
Young Female ◽  
Artery Dissection ◽  
Coronary Artery Dissection ◽  
Coronary Syndrome ◽  
St Elevation

Nonatherosclerotic spontaneous coronary artery dissection (NA-SCAD) is an uncommon cause of myocardial infarction. It most commonly affects females in the perimenopausal age. NA-SCAD has been associated with many predisposing factors including pregnancy and hormonal therapy for both contraception and ovulation induction. The presented case is a previously healthy 41-year-old woman diagnosed with inferior ST-elevation myocardial infarction due to right descending coronary artery dissection associated with recent use of clomiphene monotherapy for ovulation induction (a previously fertile woman), which was not previously reported. Learning Objectives. Emergency physicians (EPs) should be aware about NA-SCAD as a cause of acute coronary syndrome (ACS) especially in perimenopausal women even with no risk factors. NA-SCAD occurs more commonly in the postpartum period and in females following hormonal therapy. Here, clomiphene monotherapy was reported as a possible contributing factor to NA-SCAD. Guidelines for NA-SCAD management are not up to date, and EPs should avoid some interference before the final diagnosis of the cause of myocardial infarction.

scholarly journals Meningococcemia Presenting as a Myocardial Infarction

2015 ◽  
Vol 2015 ◽  
pp. 1-4
Author(s):  
Daniel Lachant ◽  
David Trawick
Keyword(s):  
Myocardial Infarction ◽  
Emergency Department ◽  
Chest Pain ◽  
Cardiogenic Shock ◽  
Neisseria Meningitidis ◽  
Early Recognition ◽  
Myocardial Dysfunction ◽  
Shortness Of Breath ◽  
Gram Negative ◽  
St Elevation

Neisseria meningitidisis an encapsulated gram negative diplococcus that colonizes the nasopharynx and is transmitted by aerosol or secretions with the majority of cases occurring in infants and adolescents. Meningococcemia carries a high mortality which is in part due to myocarditis. Early recognition and prompt use of antibiotics improve morbidity and mortality. We report a 55-year-old male presenting to the emergency department with chest pain, shortness of breath, and electrocardiogram changes suggestive of ST elevation MI who developed cardiogenic shock and multisystem organ failure fromN. meningitidis. We present this case to highlight the unique presentation of meningococcemia, the association with myocardial dysfunction, and the importance of early recognition and prompt use of antibiotics.

scholarly journals Spontaneous Coronary Artery Dissection – A Case Report

2018 ◽  
Vol 12 (2) ◽  
pp. 105-107
Author(s):  
Samsun Nahar ◽  
Fatema Begum ◽  
Momenuzzaman ◽  
KN Khan
Keyword(s):  
Myocardial Infarction ◽  
Case Report ◽  
Chest Pain ◽  
Coronary Artery ◽  
Artery Dissection ◽  
Spontaneous Coronary Artery Dissection ◽  
Coronary Artery Dissection ◽  
St Elevation ◽  
The Right ◽  
Spontaneous Dissection

Spontaneous coronary artery dissection is a rather rare cause of myocardial infarction, chest pain, and sudden death.There are currently no known direct causes of this condition.Most of the reported dissections have occurred in the left anterior descending coronary artery.Herein, we report the case of a 58-year-old woman who presented at our institution with an acute ST-elevation myocardial infarction secondary to a spontaneous dissection of the right coronary artery. Primary PCIresolved the occlusion of the artery, and the patient was discharged from the hospital on medical therapy.University Heart Journal Vol. 12, No. 2, July 2016; 105-107

scholarly journals Mass-Querade: Spontaneous Intramural Oesophageal Haematoma Following Thrombolysis in the Setting of Myocardial Infarction

2020 ◽  
Author(s):  
Rajoo Ramachandran ◽  
Sanchanaa Sree Balakrishnan ◽  
Sheela Chinnappan ◽  
MP Venkata Sai
Keyword(s):  
Myocardial Infarction ◽  
Computed Tomography ◽  
Cardiac Arrest ◽  
Chest Pain ◽  
Mediastinal Mass ◽  
Complete Recovery ◽  
Neck Swelling ◽  
Clinical Complications ◽  
Extrinsic Compression ◽  
St Elevation

Spontaneous Intramural Oesophageal Haematoma (IEH) is a rare oesophageal emergency. This report describes the case of a 70-year-old diabetic male, who presented with chest pain and was started on thrombolysis as Electrocardiography (ECG) showed ST elevation Myocardial Infarction (MI). As the patient developed gum bleeding and neck swelling, thrombolysis was stopped. Computed Tomography (CT) showed a non-enhancing mediastinal mass, causing significant extrinsic compression of the distal trachea and a diagnosis of IEH, possibly secondary to thrombolysis was made. Although IEH generally resolves spontaneously with conservative management, the patient remained poorly ventilated despite intubation and expired due to cardiac arrest following failure of resuscitative efforts, eight days after the initial thrombolysis. Several cases of uncomplicated IEH where complete recovery was achieved with conservative treatment are reported in literature; however, there are fewer reports on the poorer outcomes in patients with multiple co-morbidities and co-existent clinical complications.

Systemic vascular air embolus following CT-guided transthoracic needle biopsy: a potentially fatal complication

2021 ◽  
Vol 14 (5) ◽  
pp. e240406
Author(s):  
Pia Iben Pietersen ◽  
Gitte Maria Jørgensen ◽  
Anders Christiansen
Keyword(s):  
Cardiac Arrest ◽  
Chest Pain ◽  
Coronary Artery ◽  
Needle Biopsy ◽  
Fatal Complication ◽  
Transthoracic Needle Biopsy ◽  
Ct Guided ◽  
Transthoracic Biopsy ◽  
Low Incidence ◽  
Air Embolus

Following an uncomplicated CT-guided transthoracic biopsy, a patient becomes unconscious and subsequently dies despite immediate cardiac resuscitation. The patient felt well during the procedure but started complaining about dizziness and chest pain when he sat up. When he again was put in a supine position, cardiac arrest was noted. A CT scan performed when the symptoms initiated was afterwards rigorously reviewed by the team and revealed air located in the left ventricle, aorta and right coronary artery.We present a rare but potentially lethal complication following CT-guided transthoracic needle biopsy—systemic vascular air embolus. Knowledge and evidence about the complication are sparse because of low incidence and varying presentation. However, immediate initiation of treatment can save a life, and awareness of the complication is therefore crucial.

Abstract 17234: Cisplatin Induced Coronary Artery Atherosclerosis Leading To St-elevation Myocardial Infarction: A Case Report

Circulation ◽  
2021 ◽  
Vol 144 (Suppl_2) ◽  
Author(s):  
Sheikh Bilal B Khalid ◽  
Javaria Mahmood
Keyword(s):  
Myocardial Infarction ◽  
Coronary Artery Disease ◽  
Chest Pain ◽  
Coronary Artery ◽  
Left Ventricular ◽  
Premature Coronary Artery Disease ◽  
Chemotherapeutic Regimen ◽  
History Of ◽  
St Elevation ◽  
Artery Disease

Introduction: Cisplatin-based chemotherapeutic regimen (CBCR) is known for increasing risk of venous thromboembolic (TE) disease. We report a unique case of STEMI associated with CBCR which we believe was caused by coronary artery thrombosis. Case description: A 31-yo man with a past history of germ cell tumor presented with chest pain radiating to back and left arm. It started this morning and intensity did not worsen with exertion. He denied any dyspnea, diaphoresis or palpitations. He was non-smoker and non-obese. He denied any family history of premature coronary artery disease. He had undergone unilateral orchiectomy a year ago, and was currently receiving chemotherapy with bleomycin, etoposide and cisplatin; the last dose of his 3 rd cycle was given the day before. EKG showed ST elevation in leads I, aVL, V4 and V5. Troponin I was high to 6.9 ng/ml (ULN 0.045 ng/ml). He received intravenous infusion of thrombolytic. An angiogram done the next day showed moderate mid-LAD disease with residual clot. A CT scan and an echocardiogram later showed left ventricular thrombus (LVT). He was kept on therapeutic enoxaparin along with aspirin. Follow up echocardiogram showed resolution of the thrombus. His chemotherapy was stopped, and he has been kept on active surveillance since then. Discussion: Most cases of CBCR-associated myocardial infarction that have been reported have been seen in the older population with other risk factors for coronary artery disease. Cases where angiographic data was available, coronary artery vasospasm appeared to be the culprit rather than a true plaque rupture. While the presence of LVT raises possibility of thromboembolism to coronaries causing MI, the angiographic findings support accelerated plaque formation to be the cause of infarction. In earlier reports, elevated pre-treatment level of von Willebrand factor has been postulated to have some role in the disease pathogenesis. Other possible mechanisms for pathogenesis include endothelial cell damage, platelet activation, and imbalance between thromboxane-prostacyclin levels. This case emphasizes the need to keep cardiac etiologies of chest pain in the differential when evaluating patients on CBCR as timely intervention is life saving and prevent morbidity.

scholarly journals On the Precipice of Disaster – Fulminant Acute Myocarditis Mimicking ST-Elevation Myocardial Infarction in a Young Patient

2021 ◽  
Vol 31 (2) ◽  
pp. 361-365
Author(s):  
Ruxandra DRAGOI GALRIHNO ◽  
Anca BALINISTEANU ◽  
Vladimir BRATU ◽  
Andrea CIOBANU ◽  
Laura MITREA ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Chest Pain ◽  
Acute Myocarditis ◽  
Young Patients ◽  
Coronary Vasospasm ◽  
St Elevation Myocardial Infarction ◽  
Fulminant Myocarditis ◽  
Ecg Changes ◽  
St Elevation ◽  
Rare Situation

Although acute myocarditis and coronary vasospasm are common differential diagnoses in the case of young patients with persistent ST elevation, the association of coronary vasospasm and acute fulminant myocarditis is a rare situation. We present the case of a 21 year-old male who presented with chest pain, ECG changes and biomarker levels initially interpreted as ST elevation myocardial infarction (STEMI), in which severe coronary vasospasm was identifi ed. Shortly after, he developed cardiogenic shock and fulminant acute myocarditis was suspected.

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