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acute coronary syndrome with normal coronary artery

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https://www.readbyqxmd.com/read/27932153/a-heartbreaking-renal-transplantation-is-norepinephrine-the-culprit-to-blame
#1
M G Vailas, S Vernadakis, K Kakavia, I Paizis, J Bokos, J Boletis, G Zavos
INTRODUCTION: Takotsubo cardiomyopathy (TCM), also known as "broken heart syndrome," "apical ballooning syndrome," and "stress-induced cardiomyopathy," was first described in Japanese patients in 1990 by Sato et al. TCM is an increasingly recognized syndrome characterized by transient and reversible systolic dysfunction of the apical and middle segments of the left ventricle. This syndrome resembles acute myocardial infarction in the absence of evident coronary artery occlusion. Herein, we present a case of a 51-year-old male who underwent his second deceased-donor renal transplantation for end-stage-renal-disease due to a work-related accident...
November 2016: Transplantation Proceedings
https://www.readbyqxmd.com/read/27928263/a-36-year-old-woman-with-coronary-artery-dissection-two-weeks-after-abortion
#2
Arsalan Salari, Mahboobe Gholipur, Maedeh Rezaeidanesh, Anoosh Barzigar, Shahram Rahmani, Mohadeseh Pursadeghi, Hannan Ebrahimi
Spontaneous coronary artery dissection is a rare cause of acute coronary syndrome and sudden cardiac death. We report coronary artery dissection in a 36-year-old woman with retrosternal chest pain 2 weeks after abortion. Electrocardiography showed ST elevation in leads V2-V4 and ST depression in the inferior leads. Lab data were normal. Cardiac catheterization showed a suspicious thrombotic lesion at the proximal portion of the left anterior descending artery with a smooth contour consistent with distal haziness and dissection site...
April 13, 2016: Journal of Tehran Heart Center
https://www.readbyqxmd.com/read/27923390/the-rapid-ctca-trial-rapid-assessment-of-potential-ischaemic-heart-disease-with-ctca-a-multicentre-parallel-group-randomised-trial-to-compare-early-computerised-tomography-coronary-angiography-versus-standard-care-in-patients-presenting-with-suspected-or-confirmed
#3
Alasdair J Gray, Carl Roobottom, Jason E Smith, Steve Goodacre, Katherine Oatey, Rachel O'Brien, Robert F Storey, Lumine Na, Steff C Lewis, Praveen Thokala, David E Newby
BACKGROUND: Emergency department attendances with chest pain requiring assessment for acute coronary syndrome (ACS) are a major global health issue. Standard assessment includes history, examination, electrocardiogram (ECG) and serial troponin testing. Computerised tomography coronary angiography (CTCA) enables additional anatomical assessment of patients for coronary artery disease (CAD) but has only been studied in very low-risk patients. This trial aims to investigate the effect of early CTCA upon interventions, event rates and health care costs in patients with suspected/confirmed ACS who are at intermediate risk...
December 7, 2016: Trials
https://www.readbyqxmd.com/read/27896904/contrast-induced-encephalopathy-following-cardiac-catheterization
#4
Roberto Spina, Neil Simon, Romesh Markus, David Wm Muller, Krishna Kathir
OBJECTIVES: To describe the epidemiology, pathophysiology, clinical presentation, and management of contrast-induced encephalopathy (CIE) following cardiac catheterization. BACKGROUND: CIE is an acute, reversible neurological disturbance directly attributable to the intra-arterial administration of iodinated contrast medium. METHODS: The PubMed database was searched and all cases in the literature were retrieved and reviewed. RESULTS: 52 reports of CIE following cardiac catheterization were found...
November 29, 2016: Catheterization and Cardiovascular Interventions
https://www.readbyqxmd.com/read/27894059/left-ventricular-diastolic-dysfunction-in-patients-with-st-elevation-myocardial-infarction-following-early-and-late-reperfusion-by-coronary-intervention
#5
Xianghui Chen, Fucheng Liu, Honggui Xu, Daogang Zha, Jiancheng Xiu, Jun Guo, Aidong Zhang
BACKGROUND: This study prospectively assessed the left ventricular (LV) diastolic function changes in patients with ST-elevation myocardial infarction (STEMI) and determined if the early revascularization of the infarct-related coronary artery in acute phase achieve a better recovery of diastolic function than late recanalization. METHODS: Forty-five consecutive patients (61.20±11.37years, 8 females) presenting with STEMI and treated with PCI were prospectively enrolled in this study...
November 24, 2016: International Journal of Cardiology
https://www.readbyqxmd.com/read/27882321/micrornas-in-coronary-heart-disease-ready-to-enter-the-clinical-arena
#6
REVIEW
Elena Cavarretta, Giacomo Frati
Coronary artery disease (CAD) and its complication remain the leading cause of mortality in industrialized countries despite great advances in terms of diagnosis, prognosis, and treatment options. MicroRNAs (miRNAs), small noncoding RNAs, act as posttranscriptional gene expression modulators and have been implicated as key regulators in several physiological and pathological processes linked to CAD. Circulating miRNAs have been evaluated as promising novel biomarkers of CAD, acute coronary syndromes, and acute myocardial infarction, with prognostic implications...
2016: BioMed Research International
https://www.readbyqxmd.com/read/27881559/safety-and-tolerability-of-csl112-a-reconstituted-infusible-plasma-derived-apolipoprotein-a-i-after-acute-myocardial-infarction-the-aegis-i-trial-apoa-i-event-reducing-in-ischemic-syndromes-i
#7
C Michael Gibson, Serge Korjian, Pierluigi Tricoci, Yazan Daaboul, Megan Yee, Purva Jain, John H Alexander, P Gabriel Steg, A Michael Lincoff, John J P Kastelein, Roxana Mehran, Denise M D'Andrea, Lawrence I Deckelbaum, Bela Merkely, Maciej Zarebinski, Ton Oude Ophuis, Robert A Harrington
BACKGROUND: -Human or recombinant apolipoprotein A-I (apoA-I) has been shown to increase high-density lipoprotein-mediated cholesterol efflux capacity and to regress atherosclerotic disease in animal and clinical studies. CSL112 is an infusible, plasma-derived apoA-I that has been studied in normal subjects or those with stable coronary artery disease. This study aimed to characterize the safety, tolerability, pharmacokinetics, and pharmacodynamics of CSL112 in patients with a recent acute myocardial infarction...
November 15, 2016: Circulation
https://www.readbyqxmd.com/read/27846010/does-uric-acid-level-provide-additional-risk-stratification-information-in-emergency-patients-with-symptoms-of-possible-acute-coronary-syndrome
#8
Harry Jin, Jaimi H Greenslade, William A Parsonage, Tracey Hawkins, Martin Than, Louise Cullen
OBJECTIVE: Elevated uric acid levels have been associated with the presence and severity of coronary artery disease (CAD). This study aimed to assess the clinical utility of serum uric acid levels to identify patients at high risk of acute coronary syndrome (ACS) in those who presented to the emergency department (ED) with chest pain. METHODS: This was a prospective observational study of 951 adult patients who were being evaluated for ACS in a single ED. Serum uric acid was taken on presentation...
December 2016: Critical Pathways in Cardiology
https://www.readbyqxmd.com/read/27843778/acute-severe-thrombocytopenia-occurring-after-administration-of-eptifibatide-postpones-emergent-coronary-artery-surgery
#9
Brent T Boettcher, Timothy J Olund, Paul S Pagel
INTRODUCTION: Eptifibatide is a platelet glycoprotein IIb/IIIa (GP IIb/IIIa) receptor antagonist that inhibits fibrinogen binding to the activated GP IIb/IIIa site and prevents platelet-platelet interaction and clot formation. GP IIb/IIIa inhibitors improve outcome in patients undergoing percutaneous coronary intervention for acute coronary syndrome. Thrombocytopenia is a complication of GP IIb/IIIa inhibitors, but severe thrombocytopenia is unusual. Most reported cases of severe thrombocytopenia after eptifibatide occurred in patients with acute coronary syndrome...
August 2016: Anesthesiology and Pain Medicine
https://www.readbyqxmd.com/read/27836168/the-olson-method-for-detection-of-acute-myocardial-ischemia-in-patients-with-coronary-occlusion
#10
Thomas Lindow, Charles W Olson, Cees A Swenne, Sumche Man, Olle Pahlm
: An automated ECG-based method may provide diagnostic support in the management of patients with acute coronary syndrome. The Olson method has previously proved to accurately identify the culprit artery in patients with acute coronary occlusion. METHODS: The Olson method was applied to 360 patients without acute myocardial ischemia and 52 patients with acute coronary occlusion. RESULTS: This study establishes the normal variation of the Olson wall scores in patients without acute myocardial ischemia, which provides the basis for implementation of the Olson method for triage of patients with acute coronary syndrome...
October 19, 2016: Journal of Electrocardiology
https://www.readbyqxmd.com/read/27831644/study-on-the-levels-of-uric-acid-and-high-sensitivity-c-reactive-protein-in-acs-patients-and-their-relationships-with-the-extent-of-the-coronary-artery-lesion
#11
Q-Q Ma, X-J Yang, N-Q Yang, L Liu, X-D Li, K Zhu, Q Fu, P Wei
OBJECTIVE: We evaluated uric acid (UA) and high-sensitivity C-reactive protein (hs-CRP) levels in different clinical types of acute coronary syndromes (ACS) and in relationship with the severity of coronary artery lesions. Furthermore, we explored its clinical significance. PATIENTS AND METHODS: From June 2013 to January 2015, we studied patients in their first onset of symptoms and hospitalization for coronary angiography. According to coronary angiography results, we divided patients into two groups: 93 patients with ACS and 30 patients with normal coronary arteries as the control group...
October 2016: European Review for Medical and Pharmacological Sciences
https://www.readbyqxmd.com/read/27817849/-cardiac-rehabilitation-in-women
#12
M Ghannem, L Ghannem, S Lamouchi, K D Justin, P Meimoun, L Ghannem
Coronary artery disease (CAD) occurs later in life in women when compared to men (10 years later). The FAST-MI study has shown that the profile of women with CAD has changed in the past 15 years, they are younger, more obese, and usually smokers. Whatever the age at which CAD occurs in women, the prognosis tends to be worse than in men, despite a higher frequency of acute coronary syndrome (ACS) with angiographically normal coronary arteries in women. In women without significant lesion at coronary angiography, the WISE study has shown abnormalities of the coronary vasomotricy...
November 3, 2016: Annales de Cardiologie et D'angéiologie
https://www.readbyqxmd.com/read/27814787/relation-between-renal-function-and-coronary-plaque-morphology-from-the-assessment-of-dual-antiplatelet-therapy-with-drug-eluting-stents-virtual-histology-intravascular-ultrasound-substudy
#13
Chee Yang Chin, Gary S Mintz, Shigeo Saito, Bernhard Witzenbichler, D Christopher Metzger, Michael J Rinaldi, Ernest L Mazzaferri, Peter L Duffy, Giora Weisz, Thomas D Stuckey, Bruce R Brodie, Claire Litherland, Ajay J Kirtane, Gregg W Stone, Akiko Maehara
We sought to examine the relation between various degrees of renal function and coronary plaque morphology by grayscale and virtual histology intravascular ultrasound (IVUS). ADAPT-DES was a prospective, multicenter registry of 8,582 consecutive patients treated using coronary drug-eluting stents with a prespecified grayscale and virtual histology-IVUS substudy. A lesion-level analysis of study participants was performed by comparing IVUS parameters of culprit and nonculprit lesions across tertiles of estimated creatinine clearance (CrCl)...
October 7, 2016: American Journal of Cardiology
https://www.readbyqxmd.com/read/27814786/usefulness-of-mean-platelet-volume-to-predict-significant-coronary-artery-disease-in-patients-with-non-st-elevation-acute-coronary-syndromes
#14
Tuncay Taskesen, Harsimran Sekhon, Igor Wroblewski, Mikhail Goldfarb, Muhammad B Ahmad, Quang T Nguyen, Ibtihaj A M Fughhi, Adi Gidron, Shahriar Dadkhah
Acute coronary syndrome (ACS) is characterized by unstable plaque with thrombotic process involving central role of platelets. The diagnosis and prediction of significant coronary artery disease (CAD) in non-ST-elevation ACS (NSTE-ACS) can be challenging. The central role of platelets in acute atherothrombosis in NSTE-ACS spurred appreciable interest in the diagnostic and predictive role of platelet activity. Mean platelet volume (MPV) is one of the most promising laboratory markers in patients with CAD. This retrospective study was designed to investigate the diagnostic and predictive value of high MPV levels in patients with NSTE-ACS with significant CAD...
October 8, 2016: American Journal of Cardiology
https://www.readbyqxmd.com/read/27805707/assessment-of-indirect-inflammatory-markers-in-patients-with-myocardial-bridging
#15
Levent Cerit
INTRODUCTION: Myocardial bridging (MB) is a congenital variant of the coronary artery in which a portion of the epicardial coronary artery takes an intramuscular course. Although it is considered a benign anomaly, it may lead to such complications as myocardial ischaemia, acute coronary syndrome, coronary spasm, exercise-induced dysrhythmias or even sudden death. MB may be related to increased inflammatory and atherosclerotic processes. This study was conducted with the aim of evaluating the relationship between neutrophil/lymphocyte ratio (NLR) and MB...
August 19, 2016: Cardiovascular Journal of Africa
https://www.readbyqxmd.com/read/27788352/mri-optical-dual-modality-imaging-of-vulnerable-atherosclerotic-plaque-with-an-osteopontin-targeted-probe-based-on-fe3o4-nanoparticles
#16
Hongyu Qiao, Yabin Wang, Ruohan Zhang, Quansheng Gao, Xiao Liang, Lei Gao, Zhenhua Jiang, Ruirui Qiao, Dong Han, Yan Zhang, Ya Qiu, Jie Tian, Mingyuan Gao, Feng Cao
Rupture of vulnerable atherosclerotic plaque is the major pathological cause of luminal thrombosis in acute coronary syndromes. Since foamy macrophages have been identified as a prominent component in vulnerable atherosclerotic lesions and osteopontin (OPN) is reported to be highly expressed in foamy macrophages, OPN could be a potential target for vulnerable atherosclerotic plaque imaging. The current study designed an OPN-specific MRI/optical dual-modality probe to detect vulnerable plaques. Fluorescence imaging revealed that 24 h after injection of the Cy5...
October 11, 2016: Biomaterials
https://www.readbyqxmd.com/read/27773995/amiodarone-induced-pulmonary-toxicity-a-frequently-missed-complication
#17
Alexander J Sweidan, Navneet K Singh, Natasha Dang, Vinh Lam, Jyoti Datta
INTRODUCTION: Amiodarone is often used in the suppression of tachyarrhythmias. One of the more serious adverse effects includes amiodarone pulmonary toxicity (APT). Several pulmonary diseases can manifest including interstitial pneumonitis, organizing pneumonia, acute respiratory distress syndrome, diffuse alveolar hemorrhage, pulmonary nodules or masses, and pleural effusion. Incidence of APT varies from 5-15% and is correlated to dosage, age of the patient, and preexisting lung disease...
2016: Clinical Medicine Insights. Case Reports
https://www.readbyqxmd.com/read/27759750/pheochromocytoma-presenting-as-a-mimic-of-acute-coronary-syndrome
#18
Yasmin Hakim, Anna Forbes, Momina Khan, Benjamin C Whitelaw
Chest pain with elevated serum troponin is a common clinical presentation and is normally managed as suspected myocardial infarction or acute coronary syndrome (ACS). We report a 49 year old man who presented with central chest pain sweating and breathlessness. He had a significantly elevated serum troponin I level and a subsequent angiogram showed near normal coronary arteries. He was subsequently investigated for fever and found to have a 3cm right sided adrenal mass consistent with a pheochromocytoma. After confirmation and appropriate blockade laparoscopic adrenalectomy was performed...
2016: Acute Medicine
https://www.readbyqxmd.com/read/27752607/subarachnoid-hemorrhage-mimicking-st-segment-elevation-myocardial-infarction-after-return-of-spontaneous-circulation
#19
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
https://www.readbyqxmd.com/read/27734652/takotsubo-cardiomyopathy-masquerading-as-acute-coronary-syndrome
#20
Shankar Iyer, Subhash Shivtarkar, Ameya Udyavar
Takotsubo cardiomyopathy, also called transient left ventricular apical ballooning syndrome or Gebrochenes-Herz-Syndrome, is a rare entity which may masquerade as acute coronary syndrome (ACS) with sudden onset of chest pain and/or dyspnea, transient left ventricle apical akinesia, electrocardiographic changes typical of ACS and mild increase in cardiac enzymes in the background of normal coronary arteries. Here, we present a case of a 45 year old female who presented with acute onset dyspnea and chest pain with severe ischemic changes on the ECG and raised troponin levels...
April 2016: Journal of the Association of Physicians of India
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