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ST-segment elevation myocardial infarction

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
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
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
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)
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
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
Kristi Reynolds, Alan S Go, Thomas K Leong, Denise M Boudreau, Andrea E Cassidy-Bushrow, Stephen P Fortmann, Robert J Goldberg, Jerry H Gurwitz, David J Magid, Karen L Margolis, Catherine J McNeal, Katherine M Newton, Rachel Novotny, Charles P Quesenberry, Wayne D Rosamond, David H Smith, Jeffrey J VanWormer, Suma Vupputuri, Stephen C Waring, Marc S Williams, Stephen Sidney
BACKGROUND: Monitoring trends in cardiovascular events can provide key insights into the effectiveness of prevention efforts. Leveraging data from electronic health records provides a unique opportunity to examine contemporary, community-based trends in acute myocardial infarction hospitalizations. METHODS: We examined trends in hospitalized acute myocardial infarction incidence among adults aged ≥25 years in 13 U.S. health plans in the Cardiovascular Research Network...
October 14, 2016: American Journal of Medicine
Filiz Kizilirmak, Gultekin Gunhan Demir, Beytullah Cakal, Hüseyin Saffet Bekoz, Fatih Erkam Olgun
Evans syndrome (ES) is a rare hematological disease characterized by autoimmune hemolytic anemia, immune thrombocytopenia, and/or neutropenia, all of which may be seen simultaneously or subsequently. Thrombotic events in ES are uncommon. Furthermore, non-ST segment-elevation myocardial infarction (NSTEMI) during ES is a very rare condition. Here, we describe a case of a 69-year-old female patient presenting with NSTEMI and ES. Revascularization via percutaneous coronary intervention (PCI) was scheduled and performed...
September 2016: Indian Heart Journal
B Sunil Abhishek, Sai C Vijay, V Avanthi, B Kumar
INTRODUCTION: Cardiovascular disorders are the major cause of mortality and morbidity globally as well as in India. In India, where resources are limited and majority of patients pay out of their own pocket, thrombolysis is still done for majority of STEMI cases. CASE SCENARIO: A 48-year-old male patient, nonhypertensive and nondiabetic, came to the ER with history of retrosternal chest pain suggestive of angina at rest. An Electrocardiogram (ECG) revealed ST-segment elevation in the anterior leads...
September 2016: Indian Heart Journal
Ana Blasco, Carmen Bellas, Leyre Goicolea, Ana Muñiz, Víctor Abraira, Ana Royuela, Susana Mingo, Juan Francisco Oteo, Arturo García-Touchard, Francisco Javier Goicolea
INTRODUCTION AND OBJECTIVES: Thrombus aspiration allows analysis of intracoronary material in patients with ST-segment elevation myocardial infarction. Our objective was to characterize this material by immunohistology and to study its possible association with patient progress. METHODS: This study analyzed a prospective cohort of 142 patients undergoing primary angioplasty with positive coronary aspiration. Histological examination of aspirated samples included immunohistochemistry stains for the detection of plaque fragments...
October 10, 2016: Revista Española de Cardiología
Sara Gaur, Charles A Taylor, Jesper M Jensen, Hans Erik Bøtker, Evald H Christiansen, Anne K Kaltoft, Niels R Holm, Jonathon Leipsic, Christopher K Zarins, Stephan Achenbach, Sophie Khem, Alan Wilk, Hiram G Bezerra, Jens F Lassen, Bjarne L Nørgaard
OBJECTIVES: This study sought to determine the diagnostic performance of noninvasive fractional flow reserve (FFR) derived from coronary computed tomography angiography (CTA) (FFRCT) for the diagnosis of lesion-specific ischemia in nonculprit vessels of patients with recent in ST-segment elevation myocardial infarction (STEMI). BACKGROUND: In patients with stable angina, FFRCT has high diagnostic performance in identification of ischemia-causing lesions. The potential value of FFRCT for assessment of multivessel disease in patients with recent STEMI has not been evaluated...
October 6, 2016: JACC. Cardiovascular Imaging
Raghavendra Charan P Makam, Nathaniel Erskine, David D McManus, Darleen Lessard, Joel M Gore, Jorge Yarzebski, Robert J Goldberg
Optimization of medical therapy during discharge planning is vital for improving patient outcomes after hospitalization for acute myocardial infarction (AMI). However, limited information is available about recent trends in the prescribing of evidence-based medical therapies in these patients, especially from a population-based perspective. We describe decade-long trends in the discharge prescribing of aspirin, angiotensin-converting enzyme inhibitors/angiotensin receptor blockers, β blockers, and statins in hospital survivors of AMI...
September 13, 2016: American Journal of Cardiology
Adam Ali Ghotbi, Andreas Kjaer, Lars Nepper-Christensen, Kiril Aleksov Ahtarovski, Jacob Thomsen Lønborg, Niels Vejlstrup, Kasper Kyhl, Thomas Emil Christensen, Thomas Engstrøm, Henning Kelbæk, Lene Holmvang, Lia E Bang, Rasmus Sejersten Ripa, Philip Hasbak
BACKGROUND: Determining infarct size and myocardial salvage in patients with ST-segment elevation myocardial infarction (STEMI) is important when assessing the efficacy of new reperfusion strategies. We investigated whether rest (82)Rb-PET myocardial perfusion imaging can estimate area at risk, final infarct size, and myocardial salvage index when compared to cardiac SPECT and magnetic resonance (CMR). METHODS: Twelve STEMI patients were injected with (99m)Tc-Sestamibi intravenously immediate prior to reperfusion...
October 14, 2016: Journal of Nuclear Cardiology: Official Publication of the American Society of Nuclear Cardiology
Jianlei Zheng, Jingyang Lin, Naiji Shen, Baiming Qu
BACKGROUND: It is well known that cardiologists empirically judge the culprit lesion of acute ST-segment elevation myocardial infarction (STEMI) according to the corresponding electrocardiographic leads. However, In addition to the obstruction of left anterior descending (LAD) coronary artery, rare cases with the occlusion of proximal right coronary artery (RCA) and/or isolated right ventricular (RV) branch showed the ST-segment elevation in precordial leads V1-V3 as well. CASE SUMMARY: We reported a patient complaining of acute chest pain and suffering ventricular fibrillation (VF) on admission...
October 2016: Medicine (Baltimore)
Jing Zhang, Chengyu Liu, Chenliang Pan, Ming Bai, Jin Zhang, Yu Peng, Dingchang Zheng, Zheng Zhang
Recurrent angina (RA) has an important influence on health status of patients after percutaneous coronary intervention (PCI). This study aimed to retrospectively investigate the effect of multiple clinical factors on both short-term and long-term development of RA.A total of 398 ST-segment elevation myocardial infarction (STEMI) patients were studied for up to 12 months. The primary clinical outcome, RA, was assessed at 1-month and 12-month. In multivariate analyses, the effect of clinical factors, including baseline demographics, medical history, infarction-related arteries, procedural characteristics of PCI, and the use of medicines, was investigated in patients with and without RA...
October 2016: Medicine (Baltimore)
Niyati Bhagwat, Shrikant Sahasrabuddhe
We report two cases of pseudo inferior wall myocardial infarction where ST segment elevation in inferior leads was caused by hyperkalemia and atrial tachycardia respectively. Only one case of pseudo inferior Ml caused by hyperkalemia has been reported so far and atrial tachycardia as a cause has hitherto been unreported.
June 2016: Journal of the Association of Physicians of India
Trinath Kumar Mishra, Biswajit Das
BACKGROUND: Coronary artery disease (CAD) is rising in epidemic proportions with India not being an exception. CAD in Indian scenario has its onset at a younger age with multitude of risk factors. OBJECTIVE: This study was carried out to obtain complete information about demographic profile, risk factors, clinical scenario, therapeutic modalities, natural course, outcome and changing profile of acute ST-segment elevated myocardial infarction (STEMI) patients. METHODS: This cross-sectional study was conducted in 45,122 acute STEMI patients admitted 1st March 1990 to 1st March 2014...
June 2016: Journal of the Association of Physicians of India
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