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acute coronary syndrome with normal coronary artery

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https://www.readbyqxmd.com/read/29330042/differences-in-the-ct-findings-between-vulnerable-plaque-and-culprit-lesions-in-acute-coronary-syndrome
#1
Eun Ju Chun, Jin Hee Han, Seung Min Yoo, Hwa Yeon Lee, In Sup Song, Charles S White
BACKGROUND: The CT finding of "vulnerable plaque" is widely regarded as similar to that of a culprit lesion in an acute coronary syndrome (ACS). However, this hypothesis may not be accurate, since "vulnerable plaques" may substantially change their morphology when they rupture to cause an ACS. METHODS: We retrospectively evaluated coronary CT angiography data sets of 25 patients with ACS who had vulnerable (n = 10) or culprit plaques (n = 15). We analyzed CT features including positive remodeling (PR), low attenuation plaque (LAP), the napkin ring sign (NRS), degree of stenosis (normal, <50%, 50-99%, 100%), and myocardial hypoperfusion in the left ventricle...
January 5, 2018: Journal of Cardiovascular Computed Tomography
https://www.readbyqxmd.com/read/29317021/proposed-clinical-scale-for-the-diagnosis-of-acute-coronary-syndrome-in-patients-with-an-inconclusive-electrocardiogram-and-myocardial-injury-biomarkers
#2
F J Montero-Pérez, F B Quero-Espinosa, M J Clemente-Millán, J A Castro-Giménez, J de Burgos-Marín, M Á Romero-Moreno
RATIONALE: Acute coronary syndrome (ACS) requires improved diagnostic accuracy through useful, safe and easy-to-apply tools. OBJECTIVES: To obtain an assessment scale for the diagnosis of ACS in patients with chest pain and nondiagnostic electrocardiogram and troponin concentrations. METHODS: A prospective cohort study included 286 patients treated in the emergency department for chest pain, with normal electrocardiogram and troponin levels...
January 6, 2018: Revista Clínica Española
https://www.readbyqxmd.com/read/29297976/platelet-responses-to-pharmacological-and-physiological-interventions-in-middle-aged-men-with-different-habitual-physical-activity-levels
#3
M H Lundberg Slingsby, L Gliemann, M Thrane, N Rytter, J Egelund, M V Chan, P C Armstrong, T D Warner, Y Hellsten
The current guidelines following an acute coronary syndrome recommend dual anti-platelet therapy (aspirin plus a P2Y12 antagonist) alongside lifestyle modifications, including more regular physical activity. It is currently unknown if regular exercise affects the pharmacology of dual anti-platelet therapy. AIM: To explore how exercise-induced improvements in vascular and platelet function affect the efficacy of dual anti-platelet therapy, in a cross-sectional study of men with different physical activity level (training status)...
January 3, 2018: Acta Physiologica
https://www.readbyqxmd.com/read/29239886/acute-coronary-artery-dissection-a-review-of-the-literature-and-current-evidence
#4
Syed Raza Shah, Richard Alweis
Acute coronary artery dissection is a rare, complex disease occurring particularly in young women without traditional cardiovascular risk factors. The pathophysiology and treatment are different from acute coronary syndrome caused by plaque rupture or erosion. Its clinical presentation may vary from unstable angina to sudden cardiac death. Hence, early detection is crucial to manage the dissection and reduce the mortality and morbidity rates. Most coronary dissections will heal spontaneously, and conservative treatment is recommended for uncomplicated cases...
December 12, 2017: Cardiology in Review
https://www.readbyqxmd.com/read/29208886/coronary-angiography-findings-and-its-determinants-in-patients-presenting-with-acute-coronary-syndrome-a-descriptive-analysis-from-asian-population
#5
M Chourasiya, S Satheesh, R Selvaraj, B Jayaraman, A A Pillai
The aim was to study the angiographic profile in patients presented as acute coronary syndrome and its relation with risk factors and comparison between genders. This prospective observational study was performed on total 352 patients of acute coronary syndrome were analyzed for various risk factors, angiographic pattern in Jawaharlal Institute of Postgraduate Medical Education and Research (JIPMER), Puducherry, South India from January 2015 to July 2016. Mean age of presentation was 52.62±11.63 years. Male were 271(77...
October 2017: Mymensingh Medical Journal: MMJ
https://www.readbyqxmd.com/read/29187206/multi-modality-imaging-evaluation-of-recurrent-tako-tsubo-syndrome-in-a-patient-with-coronary-artery-fibromuscular-dysplasia
#6
Yun Cheng, Chenying Lu, Kan Liu
BACKGROUND: Integrated bedside and sophisticated cardiac imaging techniques help characterize the discrepancy between myocardial injury and mechanic dysfunction in acute myocardial infarction. CASE PRESENTATION: A 57 year-old woman presented with sudden onset chest pain and ventricular fibrillation after hearing of her brother's death. The electrocardiography indicated "anterior wall ST segment elevation myocardial infarction". Coronary angiography ruled out obstructive lesion in the major coronary arteries, but revealed fibromuscular dysplasia of the distal left anterior descending artery...
November 30, 2017: Cardiovascular Ultrasound
https://www.readbyqxmd.com/read/29184434/manifestation-of-non-st-elevation-myocardial-infarction-due-to-hyperthyroidism-in-an-anomalous-right-coronary-artery
#7
Vicken Zeitjian, Carmel Moazez, Mehrdad Saririan, David L August, Ranjini Roy
Introduction: Anomalous origin of the right coronary artery (RCA) from the left coronary cusp of the aorta is a moderately rare but potentially life-threatening incident. Myocardial infarction (MI) and sudden cardiac death have been described with this anomaly, especially in those who engage in excessive exercise. However, this case study shows this incidence in association with hyperthyroidism. Case description: A previously healthy 51-year-old female with history of hypothyroidism presented with acute onset chest pain for 1 day...
2017: International Journal of General Medicine
https://www.readbyqxmd.com/read/29167415/ticagrelor-leads-to-statin-induced-rhabdomyolysis-a-case-report
#8
Simone M Mrotzek, Tienush Rassaf, Matthias Totzeck
BACKGROUND Following acute coronary intervention in cardiology patients, the combined medical therapy with the platelet inhibitory drug ticagrelor and a statin medication (e.g., simvastatin) is recommended according to international guidelines. Yet combined therapeutic regimens have the potential of pharmacological interaction with both ticagrelor and simvastatin being metabolized by CYP3A4. Rhabdomyolysis is a known side-effect of statin therapy and combined therapy increases the susceptibility to this complication...
November 23, 2017: American Journal of Case Reports
https://www.readbyqxmd.com/read/29122277/influence-of-body-mass-index-on-long-term-survival-after-cardiac-catheterization
#9
Barak Zafrir, Ronen Jaffe, Ronen Rubinshtein, Basheer Karkabi, Moshe Y Flugelman, David A Halon
We examined 18,654 patients who underwent cardiac catheterization in a single center to clarify the association between catheterization indication, body mass index (BMI), and long-term survival over a mean follow-up of 81 months. Patients were grouped by indication for catheterization: (a) acute coronary syndromes (ACS), 7,426 patients; (b) coronary artery disease (CAD) evaluation in stable clinical presentation, 6,911 patients; and (c) primarily non-CAD cardiac evaluations, 4,317 patients. Compared with normal weight, overweight and obesity (but not morbid obesity) was associated with lower risk of long-term mortality...
January 1, 2018: American Journal of Cardiology
https://www.readbyqxmd.com/read/29105303/myocarditis-and-kawasaki-disease
#10
Audrey Dionne, Nagib Dahdah
Kawasaki disease (KD) is the most common vasculitis of childhood. Coronary artery aneurysms and myocarditis are common cardiovascular complications of KD. While evidence of myocarditis can be found in all patients with KD on histology specimens, only a minority of patients are clinically symptomatic. Occasionally children can present with KD shock syndrome and hemodynamic instability as a result of decreased systolic function and vasoplegia. Several children with KD have depressed shortening fraction on echocardiography...
November 3, 2017: International Journal of Rheumatic Diseases
https://www.readbyqxmd.com/read/29079359/the-copeptin-response-after-physical-activity-is-not-associated-with-cardiac-biomarkers-or-asymptomatic-coronary-artery-disease
#11
Kristin M Aakre, Øyunn Kleiven, Øyvind Skadberg, Magnus F Bjørkavoll-Bergseth, Tor Melberg, Heidi Strand, Tor-Arne Hagve, Stein Ørn
BACKGROUND: Copeptin concentrations increase both during acute coronary syndrome and following physical exercise. The relationship between copeptin increase following physical exercise and coronary artery disease (CAD) is uncertain. The aim of this study was to 1) describe the copeptin response following strenuous physical exercise, and 2) investigate the determinants of exercise induced copeptin concentrations, particularly in relation to cardiac biomarkers and CAD. METHODS: Serum samples were collected from 97 recreational cyclists 24h before, and immediately, 3 and 24h after a 91-km bike race...
October 25, 2017: Clinical Biochemistry
https://www.readbyqxmd.com/read/29076052/assessment-of-acute-myocarditis-by-cardiac-magnetic-resonance-imaging-comparison-of-qualitative-and-quantitative-analysis-methods
#12
Massimo Imbriaco, Carmela Nappi, Marta Puglia, Marco De Giorgi, Serena Dell'Aversana, Renato Cuocolo, Andrea Ponsiglione, Igino De Giorgi, Maria Vincenza Polito, Michele Klain, Federico Piscione, Leonardo Pace, Alberto Cuocolo
BACKGROUND: To compare cardiac magnetic resonance (CMR) qualitative and quantitative analysis methods for the noninvasive assessment of myocardial inflammation in patients with suspected acute myocarditis (AM). METHODS: A total of 61 patients with suspected AM underwent coronary angiography and CMR. Qualitative analysis was performed applying Lake-Louise Criteria (LLC), followed by quantitative analysis based on the evaluation of edema ratio (ER) and global relative enhancement (RE)...
October 26, 2017: Journal of Nuclear Cardiology: Official Publication of the American Society of Nuclear Cardiology
https://www.readbyqxmd.com/read/29032363/25-year-old-man-with-chest-pain
#13
Dhara Singh, Rachana Bhat, Shyam S Kothari
CLINICAL INTRODUCTION: A 25-year-old man presented with complaints of acute-onset chest pain for 2 hours associated with diaphoresis and generalised weakness. He had history of smoking for 10 years. There was no history of hypertension, diabetes, family history of premature coronary artery disease or drug abuse. On evaluation, his heart rate was 76/min, blood pressure 130/90 mm Hg and oxygen saturation 97% on room air. Cardiovascular examination was normal. The ECG is shown in figure 1.heartjnl;104/1/72/F1F1F1Figure 1...
January 2018: Heart: Official Journal of the British Cardiac Society
https://www.readbyqxmd.com/read/29029035/long-term-survival-and-causes-of-death-in-patients-with-st-elevation-acute-coronary-syndrome-without-obstructive-coronary-artery-disease
#14
Hedvig Bille Andersson, Frants Pedersen, Thomas Engstrøm, Steffen Helqvist, Morten Kvistholm Jensen, Erik Jørgensen, Henning Kelbæk, Sune Bernd Emil Werner Räder, Kari Saunamäki, Eric Bates, Peer Grande, Lene Holmvang, Peter Clemmensen
Aims: We aimed to study survival and causes of death in patients with ST-elevation acute coronary syndrome (STE-ACS) with and without obstructive coronary artery disease (CAD). Methods and results: We included 4793 consecutive patients with STE-ACS triaged for acute coronary angiography at a large cardiac invasive centre (2009-2014). Of these, 88% had obstructive CAD (stenosis ≥50%), 6% had non-obstructive CAD (stenosis 1-49%), and 5% had normal coronary arteries...
September 23, 2017: European Heart Journal
https://www.readbyqxmd.com/read/28938508/-angina-pectoris-in-a-young-woman-with-lupus-erythematosus
#15
Simon Braumann, Malte P Bartram, Roman Pfister, Guido Michels
History and clinical findings We present a 31-year old woman with a 6-year history of cutaneous lupus erythematosus (CLE) who presented to the emergency room with typical chest pain. ECG and transthoracic echocardiography were normal. Her working diagnosis of pericarditis was made due to systemic progression of her lupus erythematosus (LE). Treatment with NSAIDs was initiated and her immunosuppressive regimen intensified. The patient was discharged after resolution of her symptoms. A week later, the patient was seen at the rheumatology clinic with recurrence and aggravation of her symptoms...
September 2017: Deutsche Medizinische Wochenschrift
https://www.readbyqxmd.com/read/28932553/the-relationship-between-apnoea-hypopnoea-index-and-gensini-score-in-patients-with-acute-myocardial-infarction-undergoing-emergency-primary-percutaneous-coronary-intervention
#16
Cai-Ping Zhu, Tao-Ping Li, Xiao Wang, Yu-Hua Zhao, Shi-Xi Zhou, Yan Fu, Yi-Wei Jiang, Xue-Ping Xiao
BACKGROUND: Sleep apnoea hypopnoea syndrome (SAHS) is characterised by repetitive nocturnal hypoxemia and has a high prevalence among patients with acute myocardial infarction (AMI). But there are few studies on patients with AMI undergoing emergency primary percutaneous coronary intervention (pPCI). In this study, we want to find the prevalence of SAHS among patients with AMI undergoing emergency pPCI and determine whether SAHS would worsen the condition among these people, and especially affect the damage degree of the coronary artery...
August 2017: Journal of Thoracic Disease
https://www.readbyqxmd.com/read/28902642/the-association-between-apelin-gene-polymorphism-and-coronary-artery-disease-in-young-patients-with-acute-obstructive-coronary-syndrome
#17
Ramazan Güven, Kamil Can Akyol, Nermin Bayar, Mustafa Keşaplı, Muhammed İkbal Şaşmaz, Asım Arı, Şakir Arslan
OBJECTIVE: The purpose of this study was to evaluate the association between V103V, 6140AG, TGA-Stop-TAA Stop, and 6016CA polymorphisms of the apelin (APLN) gene detected for the first time among young patients with acute coronary syndrome (ACS) and coronary artery disease (CAD). METHODS: This was a prospective cross-sectional study. The study population was divided into 2 groups. The first group included 132 patients who were found to have critical lesions in their coronary arteries, while the control group consisted of 41 patients who were found to have normal coronary arteries or non-critical atherosclerotic lesions...
September 2017: Türk Kardiyoloji Derneği Arşivi: Türk Kardiyoloji Derneğinin Yayın Organıdır
https://www.readbyqxmd.com/read/28893450/emergency-medicine-evaluation-and-management-of-the-end-stage-renal-disease-patient
#18
REVIEW
Brit Long, Alex Koyfman, Courtney M Lee
BACKGROUND: End stage renal disease (ESRD) is increasing in the U.S., and these patients demonstrate greater all-cause mortality, cardiovascular events, and hospitalization rates when compared to those with normal renal function. These patients may experience significant complications associated with loss of renal function and dialysis. OBJECTIVE: This review evaluates complications of ESRD including cardiopulmonary, neurologic, infectious disease, vascular, and access site complications, as well as medication use in this population...
December 2017: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28870153/myocardial-infarction-during-anaphylaxis-in-a-young-healthy-male-with-normal-coronary-arteries-is-epinephrine-the-culprit
#19
W D Jayamali, H M M T B Herath, Aruna Kulathunga
BACKGROUND: Anaphylaxis is an acute, potentially fatal medical emergency. Myocardial injury or infarction in the setting of an anaphylaxis can be due the anaphylaxis itself, when it is known as Kounis syndrome or it can also be due to the effect of epinephrine treatment. Epinephrine is considered as the cornerstone in management of anaphylaxis. Myocardial infarction secondary to therapeutic doses of adrenaline is a rare occurrence and only a few cases have been reported in literature...
September 4, 2017: BMC Cardiovascular Disorders
https://www.readbyqxmd.com/read/28854264/oral-glucose-tolerance-test-predicts-increased-carotid-plaque-burden-in-patients-with-acute-coronary-syndrome
#20
Thorarinn A Bjarnason, Steinar O Hafthorsson, Linda B Kristinsdottir, Erna S Oskarsdottir, Thor Aspelund, Sigurdur Sigurdsson, Vilmundur Gudnason, Karl Andersen
BACKGROUND: Type 2 diabetes and prediabetes are established risk factors for atherosclerosis. The aim of this study was to evaluate the atherosclerotic plaque burden in the carotid arteries of patients with acute coronary syndrome according to their glycemic status. METHODS: Patients with acute coronary syndrome and no previous history of type 2 diabetes were consecutively included in the study. Glucose metabolism was evaluated with fasting glucose in plasma, HbA1c and a standard two-hour oral glucose tolerance test...
2017: PloS One
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