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

Michelle T Lee, Naddi Marah
About 350,000 cases of out-of-hospital cardiac arrest (OHCA) occur yearly in the United States. Unfortunately, even with treatment from emergency medical service (EMS) staff and hospitalization, only 12% survive past discharge for multiple reasons. Classically, Brugada syndrome (BrS) initially presents as a new syncopal episode in young males without obstructive coronary artery disease (CAD). However, in this case report, a patient who emergently presented with a ST-elevation myocardial infarction (STEMI) challenges the stereotypical presentation...
2018: Case Reports in Cardiology
Gianluigi Rellini, Rita Piazza, Elvira Loiudice, Matteo Cassin, Guglielmo Bernardi, Daniela Pavan, Eugenio Cervesato, Gian L Nicolosi
AIM: The aim of this study is to report the heterogeneity of clinical presentation in Tako-Tsubo syndrome (TTS), including a significant prevalence of normal ECG and echocardiographic patterns in a series of consecutive patients from a single center. METHODS AND RESULTS: From our database we selected a total of 168 cases of TTS. A total of 140 of these (Group A); 14 men (10%), mean age 60.3 years, range 39-87; 126 women (90%), mean age 66.1 years, range 43-93; matched the following reported criteria: typical stenocardic pain immediately following an emotional acute stress, or acute medical or surgical event within the preceding 12 h; acute rise and fall of troponin release; absence of significant coronary disease at coronary angiography...
October 12, 2018: Journal of Cardiovascular Medicine
M Reinthaler, F Jung, K Empen
BACKGROUND: Remote ischemic preconditioning (RIPC) has been demonstrated to induce potent cardioprotection in individuals experiencing coronary ischemia. A protocol combining limb ischemia and electronic muscle stimulation of the ischemic skeletal muscle (RIPC+), performed in advance of coronary artery occlusion, was superior in terms of infarct size reduction when compared to RIPC alone. METHODS: This study was performed to evaluate the benefit of RIPC + in humans compared to a standard RIPC protocol and a control group...
October 9, 2018: Clinical Hemorheology and Microcirculation
Sergio Barros-Gomes, Abdallah El Sabbagh, Mackram F Eleid, Sunil V Mankrad
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, 2, 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...
December 1, 2018: Echo Research and Practice
Abdallah Rebeiz, Roula Sasso, Rana Bachir, Zeina Mneimneh, Rima Jabbour, Mazen El Sayed
BACKGROUND: Arrival of patients with ST-elevation myocardial infarction (STEMI) by Emergency Medical Services (EMS) results in shorter reperfusion times and lower mortality in developed countries. OBJECTIVES: This study examines EMS use by STEMI patients in Lebanon and associated clinical outcomes. METHODS: A retrospective observational study with chart review was carried out for STEMI patients arriving to the Emergency Department of a tertiary care center in Lebanon between January 1, 2013 and August 31, 2016...
October 6, 2018: Journal of Emergency Medicine
Arindam Bose, Vidyut Jain, Girish Kawthekar, Chandrabala Chhabra, Nanda Hemvani, Dhananjay S Chitnis
Objective: The present study was aimed to establish a threshold value for cardiac troponin I (cTnI) for nonacute coronary syndrome (ACS) participants from the local population and also to determine the importance of serial time point estimation of cTnI in acute myocardial infarction (AMI), non-ST-elevated MI (NSTEMI), and unstable angina cases. Methods: The present study included 194 cases, admitted in ICCU with the complaint of anginal pain; 31 were diagnosed with AMI with typical electrocardiography (ECG) changes; whereas, 48 cases were diagnosed with NSTEMI...
September 2018: Indian Journal of Critical Care Medicine
Juan Martínez-Milla, Ángel José Maestre Bastardo, Marcelino Cortés
CLINICAL INTRODUCTION: A 76-year-old man with 50 years of smoking history was diagnosed in 2012 with diffuse interstitial lung disease, with radiological data of usual interstitial pneumonia. He came to the emergency room presenting with progression of dyspnoea for 1 week, concomitant with loss of 5 kg of weight, anorexia and poor general condition. He had tachypnoea at rest (30 breaths/min), peripheral cyanosis, speech interfered by cough and breathlessness, baseline oxygen saturation 90%, heart rate 40 beats/min and blood pressure 130/70 mm Hg...
October 3, 2018: Heart: Official Journal of the British Cardiac Society
Sokichi Kamata, Toshihiro Funatsu, Yoshito Itou, Toshikatsu Yagihara
Coronary malperfusion associated with aortic dissection usually requires aggressive surgical treatment or catheter revascularization. Here, we report a case of conservatively treated coronary malperfusion associated with acute type A dissection before aortic root replacement. An 81-year-old woman was rushed to our hospital in a state of circulatory shock after developing chest pain. She was severely hypotensive on admission, and the electrocardiogram (ECG) revealed anterior and lateral ST elevation. However, the initial fluid resuscitation increased her blood pressure to a normal level, and the ischemic ECG changes disappeared in about 20 min...
January 2018: Journal of Cardiology Cases
Ivo Strebel, Raphael Twerenbold, Desiree Wussler, Jasper Boeddinghaus, Thomas Nestelberger, Jeanne du Fay de Lavallaz, Roger Abächerli, Patrick Maechler, Diego Mannhart, Nikola Kozhuharov, Maria Rubini Giménez, Karin Wildi, Lorraine Sazgary, Zaid Sabti, Christian Puelacher, Patrick Badertscher, Dagmar I Keller, Òscar Miró, Carolina Fuenzalida, Sofia Calderón, F Javier Martin-Sanchez, Sergio Lopez Iglesias, Stefan Osswald, Christian Mueller, Tobias Reichlin
BACKGROUND: The value of the 12-lead ECG in the diagnosis of non-ST-elevation myocardial infarction (NSTEMI) is limited due to insufficient sensitivity and specificity of standard ECG criteria. The QRS-T angle reflects depolarization-repolarization heterogeneity and might assist in detecting patients with a NSTEMI (diagnosis) as well as predicting patients with an increased mortality risk (prognosis). METHODS: We prospectively enrolled 2705 consecutive patients with symptoms suggestive of NSTEMI...
September 19, 2018: International Journal of Cardiology
Shaimaa M Bashar, Shereen M Samir El-Sherbeiny, Mohamed Z Boraie
Background Acute myocardial infarction is a major cause of death all over the world. Irisin is a novel myokine released after exercise. This work aimed to study the correlation between the serum irisin level and the severity of the acute myocardial infarction in the exercise-trained rats. Methods Forty-eight male rats were classified into four groups (12 for each): group I, control sedentary (C); group II, exercise-trained (EX) (swimming for 8 weeks); group III, isoprenaline-induced infarct (MI); and group IV, exercise-trained infarct (EX-MI) (swimming for 8 weeks followed by isoprenaline-induced infarction)...
September 28, 2018: Journal of Basic and Clinical Physiology and Pharmacology
Jakob Almer, Viktor Elmberg, Josef Bränsvik, David Nordlund, Ardavan Khoshnood, Michael Ringborn, Marcus Carlsson, Ulf Ekelund, Henrik Engblom
BACKGROUND: Patients with acute coronary occlusion (ACO) may not only have ischemia-related ST-segment changes but also changes in the QRS complex. It has recently been shown in dogs that a greater ischemic QRS prolongation (IQP) during ACO is related to lower collateral flow. This suggests that greater IQP could indicate more severe ischemia and thereby more rapid infarct development. Therefore, the purpose was to evaluate the relationship between IQP and measures of myocardial injury in patients presenting with acute ST-elevation myocardial infarction (STEMI)...
September 28, 2018: Annals of Noninvasive Electrocardiology
K S Cheung, L P Leung, Y C Siu, T C Tsang, M Sh Tsui, C C Tam, R Hw Chan
INTRODUCTION: After ST-segment elevation myocardial infarction (STEMI), it is vital to shorten reperfusion time. This study examined data from a pilot project to shorten the door-to-balloon (D2B) time by using prehospital 12-lead electrocardiogram (ECG). METHODS: Fifteen ambulances equipped with X Series® Monitor/Defibrillator (Zoll Medical Corporation) were deployed to the catchment area of Queen Mary Hospital, Hong Kong, from November 2015 to December 2016. For patients with chest pain, prehospital 12-lead ECG was performed and tele-transmitted to attending physicians at the accident and emergency department for immediate interpretation...
October 2018: Hong Kong Medical Journal, Xianggang Yi Xue za Zhi
M B Plotnikov, G A Chernysheva, V I Smol'yakova, T M Plotnikova, S V Sysolyatin, Y A Kryukov
We studied anti-ischemic activity of n-tyrozol under conditions of repeated transient myocardial ischemia in rats caused by repeated (5×3 min) occlusion of the left coronary artery. n-Tyrozol administered intraperitoneally in a dose of 20 mg/kg daily over 4 days before the ischemia modeling (the last injection 15 min prior to the start of the experiment) produced a clear-cut anti-ischemic effect: it reduced ST elevation and promoted more complete recovery of ECG during reperfusion. During reperfusion periods, n-tyrozol significantly decreased the risk of ventricular fibrillation and shortened the duration of tachyarrhythmia episodes (ventricular tachycardia and fibrillation)...
September 2018: Bulletin of Experimental Biology and Medicine
Christopher P Roth, Morad Qarmali, Silvio H Litovsky, Brigitta C Brott
A 73-year-old woman with a past medical history of hypertension suffered a cardiac arrest. After successful resuscitation, she was hypotensive and tachycardic and the ECG showed ST elevation in the inferior and lateral precordial leads. Coronary angiography did not show evidence of obstructive coronary artery disease. A bedside echocardiogram demonstrated a large pericardial effusion with signs of cardiac tamponade. The echocardiogram and subsequent aortic root angiography did not reveal evidence of dissection...
August 25, 2018: Cardiovascular Pathology: the Official Journal of the Society for Cardiovascular Pathology
Joel M Guess, Cory G Madigan, Caleb B Hudspath, Jacob T Hurley, Shaun Martinho
Spontaneous coronary artery dissection (SCAD) is an uncommon cause of acute coronary syndromes, which has been gaining increased recognition with the routine use of coronary angiography and intravascular imaging techniques in patients presenting with ST-elevation myocardial infarction. Here we report the case of a healthy, 26-year-old active-duty male presented to Tripler Army Medical Center for evaluation of acute onset and worsening chest pain that occurred shortly after participating in an Army physical fitness test...
September 12, 2018: Military Medicine
Alain Tanguay, Johann Lebon, Eric Brassard, Denise Hébert, François Bégin
BACKGROUND: Prehospital 12‑lead electrocardiogram (ECG) is the most widely used screening tool for recognition of ST-segment elevation myocardial infarction (STEMI). However, prehospital diagnosis of STEMI based solely on ECGs can be challenging. OBJECTIVES: To evaluate the ability of emergency department (ED) physicians to accurately interpret prehospital 12‑lead ECGs from a remote location. METHODS: All suspected prehospital STEMI patients who were transported by EMS and underwent angiography between 2006 and 2014 were included...
September 6, 2018: American Journal of Emergency Medicine
Robert F Riley, Chadwick D Miller, Gregory B Russell, Elsayed Z Soliman, Brian C Hiestand, David M Herrington, Simon A Mahler
An initial electrocardiogram (ECG) and serial troponin measurements are both independently and incrementally predictive of acute coronary syndrome in patients presenting with undifferentiated chest pain in the Emergency Department (ED). However, it is unclear if serial (ECGs) add significant to the contemporary diagnostic evaluation of this patient group. The ASAP CATH study was a single center, prospective study that enrolled patients presenting to an ED with undifferentiated chest pain. In addition to standard clinical evaluation, serial ECGs were performed at 90-minute intervals to evaluate whether serial changes suggestive of ischemia developed (Q waves, ST elevation or depression, or T-wave inversion)...
August 1, 2018: American Journal of Cardiology
Kimmo Koivula, Kjell Nikus, Juho Viikilä, Jyrki Lilleberg, Heini Huhtala, Yochai Birnbaum, Markku Eskola
BACKGROUND: Both Q waves and T-wave inversion (TWI) in the presenting ECG are associated with a progressed stage of myocardial infarction, possibly with less potential for myocardial salvage with reperfusion therapy. Combining the diagnostic information from the Q- and T-wave analyses could improve the prognostic work-up in ST-elevation myocardial infarction (STEMI) patients. METHODS: We sought to determine the prognostic impact of Q waves and TWI in the admission ECG on patient outcome in STEMI...
September 6, 2018: Annals of Noninvasive Electrocardiology
John J Wang, Olle Pahlm, James W Warren, John L Sapp, B Milan Horáček
BACKGROUND: Criteria for electrocardiographic detection of acute myocardial ischemia recommended by the Consensus Document of ESC/ACCF/AHA/WHF consist of two parts: The ST elevation myocardial infarction (STEMI) criteria based on ST elevation (ST↑) in 10 pairs of contiguous leads and the other on ST depression (ST↓) in the same 10 contiguous pairs. Our aim was to assess sensitivity (SE) and specificity (SP) of these criteria-and to seek their possible improvements-in three databases of 12‑lead ECGs...
August 13, 2018: Journal of Electrocardiology
Ivo M van Dongen, Maarten Z H Kolk, Joëlle Elias, Veronique M F Meijborg, Ruben Coronel, Jacques M T de Bakker, Bimmer E P M Claessen, Ronak Delewi, Dagmar M Ouweneel, Esther M Scheunhage, René J van der Schaaf, Maarten-Jan Suttorp, Matthijs Bax, Koen M Marques, Pieter G Postema, Arthur A M Wilde, José P S Henriques
INTRODUCTION: Chronic total coronary occlusions (CTOs) have been associated with a higher prevalence of ventricular arrhythmias compared to patients without a CTO. We evaluated the effect of CTO revascularization on electrocardiographic (ECG) variables. METHODS: We studied a selection of ST-elevation myocardial infarction patients with a concomitant CTO enrolled in the EXPLORE trial. ECG variables and cardiac function were analysed at baseline and at 4 months follow-up...
September 2018: Journal of Electrocardiology
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