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ST elevation myocardial infarction

Mustafa Topuz, Fahrettin Oz, Oguz Akkus, Omer Sen, Ayse Nur Topuz, Atilla Bulut, Suleyman Ozbicer, Sefa Okar, Mevlut Koc, Mustafa Gur
OBJECTIVE: We aimed to investigate the compliance of plasma apelin-12 levels to show angiographic properties and hospital MACE in patients with ST-elevation myocardial infarction (STEMI) undergoing primary percutaneous coronary intervention (PCI). MATERIAL AND METHODS: The association of apelin-12 levels with the N/L ratio on admission was assessed in 170 consecutive patients with primary STEMI undergoing primary PCI. All patient SYNTAX scores and thrombolysis in myocardial infarction (TIMI) flow grades were also assessed...
October 20, 2016: Perfusion
Richard J Hamilton, Vadim Keyfes, Sahil S Banka
BACKGROUND: Synthetic cannabinoids (SC) are recreational designer drugs intended to mimic delta-9-tetrahydrocannabinol while surreptitiously circumventing classification by the Drug Enforcement Administration. CASE REPORT: A 50-year-old black male arrived in the Emergency Department transported by Emergency Medical Services (EMS) for altered mental status after complaining of chest pain associated with smoking SCs. EMS found the patient with an empty foil pack labeled "Scooby Snax Limited Edition Blueberry Potpourri...
October 19, 2016: Journal of Emergency Medicine
Birga Maier, Katrin Wagner, Steffen Behrens, Leonhard Bruch, Reinhard Busse, Dagmar Schmidt, Helmut Schühlen, Roland Thieme, Heinz Theres
BACKGROUND: Assessment of quality of care in patients with myocardial infarction (MI) should be based on data that effectively enable determination of quality. With the need to simplify measurement techniques, the question arises whether routine data can be used for this purpose. We therefore compared data from a German sickness fund (AOK) with data from the Berlin Myocardial Infarction Registry (BMIR). METHODS: We included patients hospitalised for treatment of MI in Berlin from 2009-2011...
October 21, 2016: BMC Health Services Research
Gerard Pasterkamp, Hester M den Ruijter, Peter Libby
The concept of the 'vulnerable plaque' originated from pathological observations in patients who died from acute coronary syndrome. This recognition spawned a generation of research that led to greater understanding of how complicated atherosclerotic plaques form and precipitate thrombotic events. In current practice, an increasing number of patients who survive their first event present with non-ST-segment elevation myocardial infarction (NSTEMI) rather than myocardial infarction (MI) with ST-segment elevation (STEMI)...
October 20, 2016: Nature Reviews. Cardiology
Michelle Ma Kip, Lotte Mg Steuten, Hendrik Koffijberg, Maarten J IJzerman, Ron Kusters
Early health technology assessment can provide insight in the potential cost-effectiveness of new tests to guide further development decisions. This can increase their potential benefit but often requires evidence which is lacking in early test development stages. Then, expert elicitation may be used to generate evidence on the impact of tests on patient management. This is illustrated in a case study on a new triple biomarker test (copeptin, heart-type fatty acid binding protein, and high-sensitivity troponin [HsTn]) at hospital admission...
October 19, 2016: Journal of Evaluation in Clinical Practice
Antonio Zingarelli, Sara Seitun, Roberto Delfino, Alberto Valbusa, Manrico Balbi, Claudio Brunelli
No abstract text is available yet for this article.
December 2016: Minerva Cardioangiologica
Afsin Emre Kayipmaz, Orcun Ciftci, Cemil Kavalci, Emir Karacaglar, Haldun Muderrisoglu
BACKGROUND: This study aimed to explore the ST segment elevation myocardial infarction (STEMI) management practices of emergency medicine specialists working in various healthcare institutions of seven different geographical regions of Turkey, and to examine the characteristics of STEMI presentation and patient admissions in these regions. METHODS: We included 225 emergency medicine specialists working in all geographical regions of Turkey. We e-mailed them a 20-item questionnaire comprising questions related to their STEMI management practices and characteristics of STEMI presentation and patient admissions...
2016: PloS One
Ahmad Separham, Samad Ghaffari, Hossein Najafi, Reza Ghaffari, Mojtaba Ziaee, Hossein Babaei
Allopurinol may have protective effects over ischemic reperfusion injury and reduce infarct size. In this randomized study, we aimed to evaluate the impact of allopurinol in patients with acute ST elevation myocardial infarction (STEMI) undergoing thrombolytic therapy. Overall, 140 patients with STEMI were randomly assigned to receive 400 mg of allopurinol or placebo before treating with streptokinase. Then, study group received 100 mg of allopurinol daily for 28 days and placebo group received placebo for the same period...
October 2016: Journal of Cardiovascular Pharmacology
Giacomo Veronese, Federico Germini, Stella Ingrassia, Ombretta Cutuli, Valeria Donati, Luca Bonacchini, Maura Marcucci, Andrea Fabbri
BACKGROUND: Electrocardiogram (ECG) interpretation is widely performed by emergency physicians. We aimed to determine the accuracy of interpretation of potential ST-segment elevation myocardial infarction (STEMI) ECGs by emergency physicians. METHODS: Thirty-six ECGs resulted in putative STEMI diagnoses were selected. Participants were asked to focus on whether or not the ECG in question met the diagnostic criteria for an acutely blocked coronary artery causing a STEMI...
October 19, 2016: Acute Cardiac Care
Saeed Alipour Parsa, Isa Khaheshi, Mehdi Memaryan, Mohammadreza Naderian
To present an unusual case in order to clarify one of the most important differential diagnoses of ST-elevation myocardial infarction in a postmenopausal woman. A 72-year-old woman with asthma attack and retrosternal chest pain was presented to our emergency unit. She had used albuterol spray ten-times before admission due to accentuated dyspnea. Initial ECG revealed ST-segment elevation in leads V1-V6, I and aVL. Emergent coronary angiography indicated normal coronary arteries, and left ventriculography showed significant akinesia of apical segments...
October 19, 2016: Future Cardiology
S Grautoff
The ECG is a very important diagnostic tool if an acute coronary syndrome is suspected. It should be performed immediately when medical staff contacts the patient. If an ST elevation myocardial infarction (STEMI) is diagnosed, immediate reperfusion of the occluded vessel should be the primary goal. Therefore, even subtle signs of an anterior wall infarction diagnosed by the ECG which lead to suspicion of complete occlusion of a coronary artery should be known and diagnosed by all physicians who may have contact with these types of patients...
October 18, 2016: Medizinische Klinik, Intensivmedizin und Notfallmedizin
Ahmed Farag, Aneesha Chauhan, Sunita Avinash, Chee K Liew, Jonas Eichhöfer, Anoop Chauhan
This case illustrates the complexities of performing a primary percutaneous intervention in a patient with chronic Type A aortic aneurysm and dissection with contraindications for surgical management. We also discuss the significant risk that the patient had to overcome to survive an undiagnosed aortic dissection and an acute ST elevation myocardial infarction.
April 2016: Aorta (Stamford, Conn.)
Raffaele Piccolo, Gennaro Galasso, Ingo Eitel, Alberto Dominguez-Rodriguez, Allan Zeeberg Iversen, Youlan L Gu, Pedro Abreu-Gonzalez, Bart J G L de Smet, Giovanni Esposito, Stephan Windecker, Holger Thiele, Federico Piscione
Cigarette smokers with ST-segment elevation myocardial infarction (STEMI) may present different response to potent antithrombotic therapy compared to nonsmokers. We assessed the impact of smoking status and intracoronary abciximab in patients with STEMI undergoing primary percutaneous coronary intervention (PCI). We pooled data from 5 randomized trials comparing intracoronary versus intravenous abciximab bolus in patients undergoing primary PCI. The primary end point was the composite of death or reinfarction at a mean follow-up of 292 ± 138 days...
September 13, 2016: American Journal of Cardiology
Waldemar Elikowski, Małgorzata Małek-Elikowska, Bartosz Kudliński, Paweł Skrzywanek, Sławomir Smól, Stanisław Rzymski
In typical takotsubo cardiomyopathy (TC) apical transient left ventricular dysfunction with concomitant ECG changes mimicking acute anterior myocardial infarction can be observed. Reverse TC (RTC) characterized by contractile disturbances in all basal and often simultaneous mid-ventricular segments is definitely less frequent. ECG pattern of RTC is less known. The authors present ECG findings in 5 cases of RTC in course of intracranial hemorrhage (ICH); 3 patients were diagnosed with subarachnoid hemorrhage (SAH) and the other two with intracerebral hemorrhage or subdural posttraumatic hematoma...
September 29, 2016: Polski Merkuriusz Lekarski: Organ Polskiego Towarzystwa Lekarskiego
Ching-Hui Huang, Chen-Ling Kuo, Ching-Shan Huang, Wan-Min Tseng, Ie Bin Lian, Chia-Chu Chang, Chin-San Liu
Exogenous administration of coenzyme Q10 (CoQ10) has been shown in experimental models to have a protective effect against ischemia-reperfusion injury. However, it is unclear whether follow-up plasma CoQ10 concentration is prognostic of left ventricular (LV) performance after primary balloon angioplasty in patients with acute ST segment elevation myocardial infarction (STEMI).We prospectively recruited 55 patients with STEMI who were treated with primary coronary balloon angioplasty. Plasma CoQ10 concentrations were measured before primary angioplasty (baseline) and 3 days, 7 days, and 1 month after STEMI using high-performance liquid chromatography...
August 2016: Medicine (Baltimore)
Jackson J Liang, Eric R Fenstad, Christopher D Janish, Lawrence J Sinak
Left ventricular non-compaction cardiomyopathy is a rare congenital cardiomyopathy, which usually presents early in life but may also manifest into adulthood. We present the case of an elderly woman with left ventricular non-compaction cardiomyopathy, which was discovered incidentally following an ST-elevation myocardial infarction.
October 18, 2016: Acute Cardiac Care
Colin Johnston
Aldosterone's deleterious pathophysiological effects on the cardiovascular system if blocked by mineralcorticord antagonists (MRAs) logically should lead to improvement in heart function and outcomes in heart failure (HF). The first trial to test this hypothesis was tthe RALES trial in 1999 which treated patients with class III-IV HF with spironolactone. It showed significant reduction in mortality and cardiovascular hospitalzation rates. This was confirmed & extended in EMHASIS-HF RCT with classs II-III being treated with ACEIs & BB who received placebo or elperinone (a MRA) with again a statistically significant fall in mortality & hospitalization...
September 2016: Journal of Hypertension
Chong-Jin Kim
With several lines of evidence, angiotensin-converting enzyme (ACE) inhibitors are recommended in patients with left ventricular systolic dysfunction or heart failure after myocardial infarction, and angiotensin receptor blockers (ARBs) are indicated in patients who are intolerant of ACE inhibitors. Up to 20% of patients cannot tolerate ACE inhibitors due to adverse reactions such as cough or angioedema, ARBs could be an alternative to ACE inhibitors. However, there is lack of data whether ARBs are comparable to ACE inhibitors in patients with myocardial infarction...
September 2016: Journal of Hypertension
Ernest Spitzer, Susanne Hadorn, Thomas Zanchin, Kyohei Yamaji, Aris Moschovitis, Thomas Pilgrim, Stefan Stortecky, Peter Jüni, Dik Heg, Stephan Windecker, Lorenz Räber
AIMS: Randomised controlled trials (RCTs) represent the most robust source of evidence-based medicine. However, the generalisability of RCTs is limited by the inclusion of selected populations. We sought to assess the external validity of a contemporary trial including patients with ST-elevation myocardial infarction (STEMI) undergoing primary percutaneous coronary intervention (PPCI). METHODS AND RESULTS: Patients presenting to Bern University Hospital during the inclusion period of the COMFORTABLE AMI trial were divided into three groups: RCT participants (41%), eligible not included (17...
October 20, 2016: EuroIntervention
Injune Park, Youn Jung Kim, Shin Ahn, Chang Hwan Sohn, Dong Woo Seo, Won Young Kim
Electrocardiogram changes in subarachnoid hemorrhage (SAH) have been described as ST-T changes that mimic acute coronary syndrome and even acute ST-segment elevation myocardial infarction. Elevation of cardiac enzymes and abnormality of regional myocardial wall motion have been reported frequently for SAH. We report a case of an out-of-hospital cardiac arrest survivor with high suspicion of ST-segment elevation myocardial infarction based on the electrocardiogram and bedside echocardiography, who had normal coronary arteries on emergent coronary angiography...
December 2015: Clin Exp Emerg Med
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