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https://www.readbyqxmd.com/read/28250684/acute-st-segment-elevation-myocardial-infarction-the-prognostic-importance-of-lead-augmented-vector-right-and-leads-v7-v9
#1
Veeresh Patil Hebbal, Huliyurdurga Srinivasasetty Natraj Setty, Cholenahalli Manjunath Sathvik, Vikram Patil, Sarthak Sahoo, Cholenahalli Nanjappa Manjunath
BACKGROUND: Acute myocardial infarction (MI) is associated with high mortality and among survivors have high morbidity. Electrocardiogram (ECG), a cost-effective and easily available, has traditionally been used not only just for diagnosis of MI but also for culprit vessel recognition and for prognostication. However, the role of lead augmented vector right (aVR) and leads V7-V9 in acute MI are often neglected in clinical practice. We studied the role of lead aVR and leads V7-V9 in ST-elevation MI (STEMI) patients...
January 2017: Journal of Natural Science, Biology, and Medicine
https://www.readbyqxmd.com/read/28124201/hyperkalemia-masked-by-pseudo-stemi-infarct-pattern-and-cardiac-arrest
#2
Shareez Peerbhai, Luke Masha, Adrian DaSilva-DeAbreu, Abhijeet Dhoble
BACKGROUND: Hyperkalemia is a common electrolyte abnormality and has well-recognized early electrocardiographic manifestations including PR prolongation and symmetric T wave peaking. With severe increase in serum potassium, dysrhythmias and atrioventricular and bundle branch blocks can be seen on electrocardiogram. Although cardiac arrest is a worrisome consequence of untreated hyperkalemia, rarely does hyperkalemia electrocardiographically manifest as acute ischemia. CASE PRESENTATION: We present a case of acute renal failure complicated by malignant hyperkalemia and eventual ventricular fibrillation cardiac arrest...
December 2017: International Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28040835/novel-ecg-changes-in-acute-coronary-syndromes-would-improvement-in-the-recognition-of-stemi-equivalents-affect-time-until-reperfusion
#3
Joshua Wall, Leigh D White, Astin Lee
Current guidelines recommend that patients with non-ST elevation myocardial infarction (NSTEMI) are treated with medical management alone, or in combination with coronary angiography within 24 h. Recent research suggests that NSTEMIs show angiographic evidence of complete occlusion at rates comparable to STEMIs, suggesting a subgroup of NSTEMI patients who require urgent angiography. Novel ECG changes, termed 'STEMI-equivalents', have been described as a way of identifying this subgroup. The aim of this study was to determine whether patients with STEMI-equivalent ECG changes experience similar degrees of myocardial damage, and would thus benefit from urgent PCI...
December 31, 2016: Internal and Emergency Medicine
https://www.readbyqxmd.com/read/27936877/-a-rare-ecg-manifestation-of-left-sided-pneumothorax-inferior-stemi-with-precordial-brugada-pattern
#4
Attila Frigy, Ildikó Kocsis, Lajos Fehérvári, Lehel Máthé
Recognition and identification of the cause of non-coronary ST elevation is important in daily practice, mainly for avoiding unnecessary diagnostic and therapeutic procedures. In this case, a rare cause, spontaneous, left sided tension pneumothorax was in the background of the suddenly appearing, complex ECG changes - ST elevation mimicking inferior wall myocardial infarction associated with type 1 Brugada pattern ("coved" ST-segment elevation ≥ 2 mm) in the precordial leads. The clinical picture and course, the differential diagnostic problems related to the case and the possible causes of the ECG changes will be presented...
December 2016: Orvosi Hetilap
https://www.readbyqxmd.com/read/27847262/the-angelmed-guardian-system-is-there-a-role-for-implantable-devices-for-early-detection-of-coronary-artery-occlusion
#5
REVIEW
Toby Rogers, Arie Steinvil, Rebecca Torguson, Ron Waksman
The AngelMed Guardian System is an implantable device similar to a single chamber pacemaker that continuously monitors the intracardiac electrogram for evidence of ST segment shift indicating acute coronary artery occlusion. The system aims to reduce time to presentation by alerting patients to present to a medical facility whether symptoms are present or not. In March 2016, the US Food and Drug Administration (FDA) assembled a meeting of the Circulatory System Devices Panel to review the results of the AngelMed for Early Recognition and Treatment of STEMI (ALERTS) pivotal trial and the accompanying premarket approval (PMA) application for regulatory approval of the AngelMed Guardian System in the US...
December 2016: Cardiovascular Revascularization Medicine: Including Molecular Interventions
https://www.readbyqxmd.com/read/27762311/temporal-shifts-in-clinical-presentation-and-underlying-mechanisms-of-atherosclerotic-disease
#6
REVIEW
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)...
January 2017: Nature Reviews. Cardiology
https://www.readbyqxmd.com/read/27714584/contemporary-management-of-st-segment-elevation-myocardial-infarction
#7
REVIEW
Ajay Yadlapati, Mark Gajjar, Daniel R Schimmel, Mark J Ricciardi, James D Flaherty
ST-elevation myocardial infarction (STEMI), which constitutes nearly 25-40 % of current acute myocardial infarction (AMI) cases, is a medical emergency that requires prompt recognition and treatment. Since the 2013 STEMI practice guidelines, a wealth of additional data that may further advance optimal STEMI practices has emerged. These data highlight the importance of improving patient treatment and transport algorithms for STEMI from non-primary percutaneous coronary intervention (PCI) centers. In addition, a focus on the reduction of total pain-to-balloon (P2B) times rather than simply door-to-balloon (D2B) times may further improve outcomes after primary PCI for STEMI...
December 2016: Internal and Emergency Medicine
https://www.readbyqxmd.com/read/27543469/spontaneous-coronary-artery-dissection-case-series-and-review-of-literature
#8
REVIEW
Satyavan Sharma, Nikhil Raut, Anil Potdar
AIM: Spontaneous coronary artery dissection (SCAD) is a less recognized cause of ST elevation myocardial infarction (STEMI) in clinical practice. The aim of this communication is to describe a case series in South Asian population and highlight on the long-term clinical outcomes on conservative management. METHODS: A retrospective analysis of data of five patients (6 instances) of SCAD managed in a tertiary care center during January 1994 to June 2015 was done. Clinical, angiographic, therapeutic, and follow-up data till end of June 2015 are analyzed...
July 2016: Indian Heart Journal
https://www.readbyqxmd.com/read/27147636/mode-of-admission-and-its-effect-on-adherence-to-reperfusion-therapy-guidelines-in-belgian-stemi-patients
#9
Céline Rousseaux, Pierre Mols, Peter R Sinnaeve, Carl Convens, Philippe Dubois, Pascal Vranckx, Sofie Gevaert, Patrick Coussement, Ahmed Se Ramadan, Christophe Beauloye, Marc Renard, Patrick Evrard, Jean-François Argacha, Herbert De Raedt, Kristien Wouters, Marc J Claeys
OBJECTIVES: Emergency medical services play a key role in the recognition and treatment of ST-segment elevation myocardial infarction (STEMI). This study evaluates the effect of emergency medical services use on adherence to reperfusion therapy guidelines in Belgian STEMI patients and on in-hospital mortality. METHODS: The mode of admission with against without emergency medical services was associated with baseline risk profile, reperfusion modalities and in-hospital mortality in 5692 consecutive STEMI patients from 2012 to 2014...
September 2016: European Heart Journal. Acute Cardiovascular Care
https://www.readbyqxmd.com/read/26961064/thrombus-aspiration-in-acute-myocardial-infarction
#10
REVIEW
Karim D Mahmoud, Felix Zijlstra
The success of primary percutaneous coronary intervention (PCI) in patients with ST-segment elevation myocardial infarction (STEMI) is often hampered by incomplete microvascular myocardial reperfusion owing to distal embolization of thrombus resulting in microvascular obstruction. To address this problem, thrombus aspiration devices have been developed that can be used to evacuate coronary thrombus either manually or mechanically. Thrombus aspiration has the potential to reduce the local thrombus load, minimize the need for balloon predilatation, facilitate direct stenting, prevent distal embolization, and ultimately improve myocardial reperfusion...
July 2016: Nature Reviews. Cardiology
https://www.readbyqxmd.com/read/26910240/the-incidence-and-significance-of-acute-kidney-injury-following-emergent-contrast-administration-in-patients-with-stemi-and-stroke
#11
Michael Robert Marchick, Brandon Russell Allen, Emily Cassin Weeks, Jonathan Jacob Shuster, Marie-Carmelle Elie
The authors have investigated the incidence of acute kidney injury (AKI) and short-term mortality following an activated STEMI and stroke alert at a tertiary referral and academic center. A single center, retrospective chart review of STEMI and stroke activation patients from January 2010 to March 2012. Data was collected and reviewed from an institutional database following IRB-approval. Inclusion criteria were STEMI patients taken for cardiac catheterization, excluding patients receiving hemodialysis due to end-stage renal disease (ESRD)...
September 2016: Internal and Emergency Medicine
https://www.readbyqxmd.com/read/26864325/the-recognition-of-stemi-by-paramedics-and-the-effect-of-computer-interpretation-respect-a-randomised-crossover-feasibility-study
#12
RANDOMIZED CONTROLLED TRIAL
Richard Pilbery, M Dawn Teare, Steve Goodacre, Francis Morris
BACKGROUND: The appropriate management of patients with ST-segment elevation myocardial infarction (STEMI) depends on accurate interpretation of the 12-lead ECG by paramedics. Computer interpretation messages on ECGs are often provided, but the effect they exert on paramedics' decision-making is not known. The objective of this study was to assess the feasibility of using an online assessment tool, and collect pilot data, for a definitive trial to determine the effect of computer interpretation messages on paramedics' diagnosis of STEMI...
July 2016: Emergency Medicine Journal: EMJ
https://www.readbyqxmd.com/read/26843199/in-vivo-assessment-of-myocardial-viability-after-acute-myocardial-infarction-a-head-to-head-comparison-of-the-perfusable-tissue-index-by-pet-and-delayed-contrast-enhanced-cmr
#13
Stefan A J Timmer, Paul F A Teunissen, Ibrahim Danad, Lourens F H J Robbers, Pieter G H M Raijmakers, Robin Nijveldt, Albert C van Rossum, Adriaan A Lammertsma, Niels van Royen, Paul Knaapen
BACKGROUND: Early recognition of viable myocardium after acute myocardial infarction (AMI) is of clinical relevance, since affected segments have the potential of functional recovery. Delayed contrast-enhanced magnetic resonance imaging (DCE-CMR) has been validated extensively for the detection of viable myocardium. An alternative parameter for detecting viability is the perfusable tissue index (PTI), derived using [(15)O]H2O positron emission tomography (PET), which is inversely related to the extent of myocardial scar (non-perfusable tissue)...
April 2017: Journal of Nuclear Cardiology: Official Publication of the American Society of Nuclear Cardiology
https://www.readbyqxmd.com/read/26603617/thrombus-aspiration-in-st-segment-elevation-myocardial-infarction
#14
REVIEW
R A Meneguz-Moreno, R A Costa, A A, J Ribamar Costa, A Abizaid
Primary percutaneous coronary intervention (PCI) has become the treatment of choice in patients with ST-segment elevation myocardial infarction (STEMI) throughout the last years. A significant number of studies have demonstrated a morbidity and mortality benefit over thrombolysis, which has been attributed to better coronary perfusion in patients undergoing primary PCI. Even though it usually achieves normal flow in the affected epicardial vessel, myocardial reperfusion is not fully restored in a significant percentage of patients...
December 2015: Minerva Cardioangiologica
https://www.readbyqxmd.com/read/26560436/precordial-junctional-st-segment-depression-with-tall-symmetric-t-waves-signifying-proximal-lad-occlusion-case-reports-of-stemi-equivalence
#15
Ruben W de Winter, Rob Adams, Niels J W Verouden, Robbert J de Winter
Timely reperfusion therapy by means of primary percutaneous coronary intervention (PCI) is the preferred treatment for patients with ST-segment elevation myocardial infarction. A significant number of patients with large acute myocardial infarction, caused by occlusion of an epicardial coronary artery, do not show ST-elevation on the electrocardiogram. Other ECG abnormalities may be present, the so called STEMI-equivalents. One such STEMI equivalent, junctional ST-segment depression followed by tall symmetrical T-waves in the precordial leads, often in combination with slight ST-elevation in lead AVR, has been associated with proximal occlusion of the left anterior descending coronary artery...
January 2016: Journal of Electrocardiology
https://www.readbyqxmd.com/read/26286904/finding-traction-for-mechanical-circulatory-support-during-coronary-interventions
#16
EDITORIAL
Garrick C Stewart
No abstract text is available yet for this article.
September 29, 2015: Circulation
https://www.readbyqxmd.com/read/26275407/high-risk-percutaneous-coronary-intervention-in-a-patient-with-a-single-coronary-artery-presenting-as-stemi-and-cardiogenic-shock
#17
Murad Abdelsalam, Mrinalini Krishnan, Sandeep Banga, William B Bachinsky
Cardiogenic shock due to ST elevation myocardial infarction in a patient with a single coronary artery involving the sole vessel is a rare presentation. This can be clinically and angiographically challenging. Proper recognition of the topography of diseased vessels and a systematic guarded approach can lead to procedural success. We report a case of an 81-year-old woman who presented with chest pain followed by a near syncope associated with an acute myocardial infarction. Coronary angiography revealed a single proximally occluded right coronary artery and an anomalous left main coronary artery (originating from the proximal right coronary artery) and occluded distal left circumflex artery...
August 14, 2015: BMJ Case Reports
https://www.readbyqxmd.com/read/26154447/setting-up-an-efficient-therapeutic-hypothermia-team-in-conscious-st-elevation-myocardial-infarction-patients-a-uk-heart-attack-center-experience
#18
Shahed Islam, James Hampton-Till, Shah MohdNazri, Noel Watson, Ellie Gudde, Tom Gudde, Paul A Kelly, Kare H Tang, John R Davies, Thomas R Keeble
Patients presenting with ST elevation myocardial infarction (STEMI) are routinely treated with percutaneous coronary intervention to restore blood flow in the occluded artery to reduce infarct size (IS). However, there is evidence to suggest that the restoration of blood flow can cause further damage to the myocardium through reperfusion injury (RI). Recent research in this area has focused on minimizing damage to the myocardium caused by RI. Therapeutic hypothermia (TH) has been shown to be beneficial in animal models of coronary artery occlusion in reducing IS caused by RI if instituted early in an ischemic myocardium...
December 2015: Therapeutic Hypothermia and Temperature Management
https://www.readbyqxmd.com/read/25890944/the-recognition-of-stemi-by-paramedics-and-the-effect-of-computer-interpretation-respect-a-cluster-randomised-crossover-pilot-study
#19
Richard Pilbery, Dawn Teare, Steve Goodacre, Francis Morris
BACKGROUND: Timely diagnosis and appropriate management of patients with ST-segment elevation myocardial infarction (STEMI) depends on accurate interpretation of the 12-lead ECG by paramedics. Computer interpretation messages on ECGs are often provided, but the effect they exert on paramedics' decision making is not known. The objective of this pilot study was to assess the feasibility of a trial using an online assessment tool, to determine the effect of computer interpretation messages on paramedics' diagnosis of STEMI...
May 2015: Emergency Medicine Journal: EMJ
https://www.readbyqxmd.com/read/25818495/baseline-q-waves-and-time-from-symptom-onset-to-st-segment-elevation-myocardial-infarction-insights-from-plato-on-the-influence-of-sex
#20
RANDOMIZED CONTROLLED TRIAL
Naji Kholaif, Yinggan Zheng, Pushpa Jagasia, Anders Himmelmann, Stefan K James, Philippe Gabriel Steg, Robert F Storey, Cynthia M Westerhout, Paul W Armstrong
BACKGROUND: The prognostic value of time from symptom onset to reperfusion may be enhanced by the identification of Q waves on the presenting electrocardiogram (ECG) in patients with ST-segment elevation myocardial infarction (STEMI). We evaluated whether the relative prognostic utility of these 2 metrics was altered by sex. METHODS: Q waves in the distribution of the ST-segment elevation on the baseline ECG were evaluated by a blinded core laboratory in 2838 STEMI patients (2163 men and 675 women) from the PLATelet inhibition and patient Outcomes (PLATO) trial who underwent percutaneous coronary intervention (PCI) within 12 hours of symptom onset...
August 2015: American Journal of Medicine
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