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("ECG" OR "EKG") AND ("STEMI" OR "ST Elevation")

Ahmed Abuosa, Jamilah AlRahimi, Nasir Mansour, Ashar Bilal, Atif AlQabbani, Akram Neyaz
A case of a young Saudi patient with a previous diagnosis of bronchial asthma, nasal polyps, and chronic smoker, presented with atypical chest pain, elevated serum troponin and borderline ischemic electrocardiogram (ECG) changes, with no significant regional wall motion abnormalities at bedside echocardiography is reported. The patient was admitted to the coronary care unit for continuous monitoring as possible acute coronary syndrome, non-ST elevation myocardial infarction (STEMI). One hour after admission, the patient had ventricular fibrillation (VF) cardiac arrest that required three DC shocks and amiodarone bolus before returning of spontaneous circulation, which followed the fourth shock...
October 2018: Journal of the Saudi Heart Association
Sergio Barros-Gomes, Abdullah El Sabbagh, Mackram F Eleid, Sunil V Mankad
Non-atherosclerotic myocardial infarction (MI) is an important but often misdiagnosed cause of acute MI. Furthermore, non-atherosclerotic MI with concomitant acute stroke and pulmonary embolism due to in-transit thrombus across a patent foramen ovale (PFO) is a rare but potentially fatal combination (1-3). Early detection of this clinical entity can facilitate delivery of targeted therapies and avoid poor outcome (1, 2). Here, we describe a 68-year-old female with hypertension, tobacco abuse, and chronic obstructive pulmonary disease presenting with facial droop, right arm weakness and aphasia...
August 11, 2018: Echo Research and Practice
S A Berns, E A Shmidt, O A Nagirnyak, A V Klimenkova, M N Litvinova, T Y Sergeeva, O L Barbarash
PURPOSE: to study the role of clinical factors and treatment tactics in the development of adverse outcomes in patients with non-STelevation acute coronary syndrome (NSTEACS) for five years follow up. MATERIALS AND METHODS: The study included 415 patients with NSTEACS observed for 60±4 months from the date of discharge. Adverse events (AE) were unstable angina (UA), myocardial infarction (MI), ischemic stroke or patient's death. The favorable 5-year outcome was identified in 200, adverse outcome - in 178 patients...
July 2018: Kardiologiia
Islam ElSayed Shehata, Cheng-I Cheng, Pei-Hsun Sung, Ahmed S Ammar, Islam Abd El-Moneem El-Sherbiny, Islam Ghanem Ahmed Ghanem
BACKGROUND: Following acute ST elevation myocardial infarction (STEMI), restoration of large-vessel patency does not mean complete perfusion recovery. Little is known regarding the predictors of successful myocardial reperfusion for the STEMI patients undergoing pharmacologic and mechanical reperfusion strategies. AIM OF THE WORK: The aim of this clinical study was to find out the predictors of myocardial functional recovery following reperfusion of acute STEMI, represented by 3-month global longitudinal strain (GLS) value assessed by speckle tracking echocardiography...
August 2, 2018: Echocardiography
Yama Fakhri, Jacob Melgaard, Hedvig Bille Andersson, Mikkel Malby Schoos, Yochai Birnbaum, Claus Graff, Maria Sejersten, Jens Kastrup, Peter Clemmensen
BACKGROUND: Terminal QRS distortion on the electrocardiogram (ECG) is a sign of severe ischemia in patients with STEMI and can be quantified by the Sclarovsky-Birnbaum Severity of Ischemia. Due to score complexity, it has not been applied in clinical practice. Automatic scoring of digitally recorded ECGs could facilitate clinical application. We aimed to develop an automatic algorithm for the severity of ischemia. METHODS: Development set: 50 STEMI ECGs were manually (Manual-score) and automatically (Auto-score) scored by our designed algorithm...
October 1, 2018: International Journal of Cardiology
Aruna Ramesh, Kenneth A LaBresh, Rhea Begeman, Bentley Bobrow, Teri Campbell, Nayanjeet Chaudhury, Marcia Edison, Timothy B Erickson, John D Manning, Bellur S Prabhakar, Pavitra Kotini-Shah, Naresh Shetty, Pamela A Williams, Terry Vanden Hoek
Background: A system of care designed to measure and improve process measures such as symptom recognition, emergency response, and hospital care has the potential to reduce mortality and improve quality of life for patients with ST-elevation myocardial infarction (STEMI). Objective: To document the methodology and rationale for the implementation and impact measurement of the Heart Rescue India project on STEMI morbidity and mortality in Bangalore, India. Study Design: A hub and spoke STEMI system of care comprised of two interventional, hub hospitals and five spoke hospitals will build and deploy a dedicated emergency response and transport system covering a 10 Km...
June 2018: Contemporary Clinical Trials Communications
Göksel Çinier, Ahmet İlker Tekkeşin, Duygu Genç, Ufuk Yıldız, Emrecan Parsova, Levent Pay, Bryce Alexander, Emrah Bozbeyoğlu, Ceyhan Türkkan, Ahmet Taha Alper, Adrian Baranchuk
INTRODUCTION: Interatrial block (IAB) is strongly associated with recurrence of atrial fibrillation (AF) in different clinical scenarios. Atrial fibrosis is considered the responsible mechanism underlying the pathogenesis of IAB. The aim of this study was to investigate whether IAB predicted AF at 12 months follow up in a population of patients with ST segment elevation myocardial infarction (STEMI). METHODS: Prospective, single center, observational study of patients presenting with ST-segment elevation myocardial infarction (STEMI) and referred to primary percutaneous coronary intervention (P-PCI)...
July 18, 2018: Clinical Cardiology
Mehdi Sheibani, Nasim Zamani, Hossein Hassanian-Moghaddam
We aimed to evaluate electrocardiographic (ECG) abnormalities in mortalities due to pure methadone toxicity in ICU patients since methadone-related mortality may be due to cardiac complications even in acute toxicities. In a retrospective single-center study, files of all patients who had died with confirmed diagnosis of pure methadone toxicity between 2011 and 2016 were evaluated. Autopsy was performed in all cases. A cardiologist measured all ECG quantitative and qualitative indices. Fifty-one deaths were recorded...
July 17, 2018: Cardiovascular Toxicology
Kirstine Calloe, Gary L Aistrup, José M Di Diego, Robert J Goodrow, Jacqueline A Treat, Jonathan M Cordeiro
Brugada syndrome (BrS) is an inherited disease associated with ST elevation in the right precordial leads, polymorphic ventricular tachycardia (PVT), and sudden cardiac death in adults. Mutations in the cardiac sodium channel account for a large fraction of BrS cases. BrS manifests in the right ventricle (RV), which led us to examine the biophysical and molecular properties of sodium channel in myocytes isolated from the left (LV) and right ventricle. Patch clamp was used to record sodium current (INa ) in single canine RV and LV epicardial (epi) and endocardial (endo) myocytes...
July 2018: Physiological Reports
János Tomcsányi
A case of ST-segment elevation myocardial infarction (STEMI) is presented with pathologic transient Q-waves in the precordial leads disappearing after percutaneous coronary intervention (PCI). Orv Hetil. 2018; 159(29): 1208-1209.
July 2018: Orvosi Hetilap
David Wong, Yochai Birnbaum
ECG Quiz: Diffuse ST elevations with broad differential in 57 year old man.
July 2018: Journal of Electrocardiology
Mat Goebel, Luke Busico, Greg Snow, Joseph Bledsoe
BACKGROUND: Limited work has established an objective measure of ECG quality that correlates with physician opinion of the study. We seek to establish a threshold of acceptable ECG data quality for the purpose of ruling out STEMI derived from emergency physician opinion. METHODS: A panel of three emergency physicians rated 240 12-Lead ECGs as being acceptable or unacceptable data quality. Each lead of the ECG had the following measurements recorded: baseline wander, QRS signal amplitude, and artifact amplitude...
July 2018: Journal of Electrocardiology
Kimmo Koivula, Markku Eskola, Juho Viikilä, Jyrki Lilleberg, Heini Huhtala, Yochai Birnbaum, Kjell Nikus
BACKGROUND: Grade 3 ischemia (G3I) in the 12‑lead electrocardiogram (ECG) predicts poor outcome in patients with ST-elevation myocardial infarction (STEMI). The outcome of G3I in "real-life" patient cohorts is unclear. METHODS: The aim of the study was to establish the prognostic significance of grade 2 ischemia (G2I), G3I and the STEMI patients excluded from ischemia grading (No grade of ischemia, NG) in a real-life patient population. We assessed in-hospital, 30-day and 1-year mortality as well as other endpoints...
July 2018: Journal of Electrocardiology
Joseph Allencherril, Yama Fakhri, Henrik Engblom, Einar Heiberg, Marcus Carlsson, Jean-Luc Dubois-Rande, Sigrun Halvorsen, Trygve S Hall, Alf-Inge Larsen, Svend Eggert Jensen, Hakan Arheden, Dan Atar, Peter Clemmensen, Maria Sejersten Ripa, Yochai Birnbaum
BACKGROUND: Anteroseptal ST elevation myocardial infarction (STEMI) is traditionally defined on the electrocardiogram (ECG) by ST elevation (STE) in leads V1-V3, with or without involvement of lead V4. It is commonly taught that such infarcts affect the basal anteroseptal myocardial segment. While there are suggestions in the literature that Q waves limited to V1-V4 represent predominantly apical infarction, none have evaluated anteroseptal ST elevation territories. We compared the distribution of the myocardium at risk (MaR) in STEMI patients presenting with STE limited to V1-V4 and those with more extensive STE (V1-V6)...
July 2018: Journal of Electrocardiology
Wei Xia, Xiao-Yan Feng
BACKGROUND ST-segment elevation myocardial infarction (STEMI) is an acute and life-threatening disease. Adverse cardiac events (ACEs) are defined as cardiovascular death or worsening congestive heart failure in STEMI patients. The present study investigated the predictive role of fragmented QRS complex (fQRS) in risks of ACEs in STEMI. MATERIAL AND METHODS This study was a retrospective analysis involving patients who underwent percutaneous coronary intervention (PCI) or thrombolysis. STEMI patients were divided into the fQRS group (259 cases) and the non-fQRS group (161 cases)...
July 5, 2018: Medical Science Monitor: International Medical Journal of Experimental and Clinical Research
Eka Ginanjar, Yulianto Yulianto, Simon Salim, Wawan Setyawan
Myocardial infarction simultaneously involving two or more culprit lesions is extremely rare and usually has a poor clinical outcomes including mortality. Management of this complicated condition is challenging and limited time. Nevertheless, autopsy studies revealed that thrombotic occlusion of more than one major epicardium coronary artery is not uncommon. A 68-year-old woman presented with sudden onset of limited breath and chest discomfort since two hours prior to admission. She also felt exert dyspnoea since one month ago...
April 2018: Acta Medica Indonesiana
Erwin Christian de Bliek
Prompt diagnosis of acute ST segment elevation myocardial infarction (STEMI) by the initial ECG is important in order to perform an urgent coronary angiography as soon as possible and achieve successful revascularization, therewith improving mortality and morbidity. Several diseases and conditions can mimic an acute myocardial infarction (AMI) but may not benefit from a (percutaneous) revascularization strategy. This narrative clinical review will discuss the ECG features of some of the causes of non-ischemic ST segment elevation to facilitate early recognition, prevent wrongful diagnosis and improve treatment outcomes...
March 2018: Turkish Journal of Emergency Medicine
Aihua Wang, Jing Xu, Li Liu, Zijun Chen
BACKGROUND: The de Winter electrocardiogram (EKG) pattern is a novel sign that indicates left anterior descending coronary artery (LAD) occlusion in patients with chest pain. This study aimed to assess the prevalence and clinical characteristics of patients with this pattern. HYPOTHESIS: The de Winte EKG pattern is an special anterior ST-segment elevation myocardial infarction(STEMI) equivalents without obvious ST-segment elevation. METHODS: This retrospective study included all patients with anterior myocardial infarction admitted between January 2011 and December 2017...
June 23, 2018: Clinical Cardiology
Derek M Culnan, Rajiv Sood
Burn injuries generate multisystem physiological derangements. The authors present a case series of three patients developing acute coronary syndrome (ACS) stemming from coronary vasospasm (CVS) over a course of 5 months. This etiology of ACS is significant as it has previously not been described in burn patients and requires a different management algorithm than vaso-occlusive disease. All patients were admitted to a single accredited burn unit. Burn mechanisms were flash burn, chemical fire, and house fire...
December 4, 2017: Journal of Burn Care & Research: Official Publication of the American Burn Association
Rajveer Joea, Sarah J Strube, Todd K Zynda
Spontaneous coronary artery dissection (SCAD) is a variant of acute coronary syndrome (ACS) that is poorly understood. SCAD has been linked to fibromuscular dysplasia (FMD), connective tissue disease (CTD), pregnancy and hormonal imbalance, systemic inflammatory conditions (e.g. IBD, vasculitis), and coronary artery vasospasm rather than traditional cardiac risk factors. Symptomology generally accompanying SCAD is indistinguishable from ACS making the timely recognition and diagnosis vital for prompt treatment...
June 2018: Cardiology Research
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