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acute coronary syndrome with normal coronary artery

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https://www.readbyqxmd.com/read/29785166/takotsubo-syndrome-induced-by-malignant-pheochromocytoma-in-a-patient-with-type-2-papillary-renal-cell-carcinoma-a-case-report
#1
Anca Diana Demea, Dan-Grigore Dunca, Roxana Adina Radu, Lucia Agoşton-Coldea
The clinical presentation of the Takotsubo syndrome mimics an acute coronary syndrome with chest pain, ischemia-like ECG changes, mild to moderate myocardial enzyme elevation, and apical ballooning on echocardiography and ventriculography. On coronary angiography, epicardial coronary arteries are either normal or exhibit minimal atherosclerotic changes. Primary Takotsubo syndrome usually occurs in postmenopausal women in whom symptoms are triggered by emotional or physical stress, associated with catecholamine surges...
2018: Clujul Medical (1957)
https://www.readbyqxmd.com/read/29754654/dual-antiplatelet-therapy-for-perioperative-myocardial-infarction-following-cabg-surgery
#2
Alice Wang, Angie Wu, Daniel Wojdyla, Renato D Lopes, L Kristin Newby, Mark F Newman, Peter K Smith, John H Alexander
OBJECTIVES: Perioperative myocardial infarction (MI) after coronary artery bypass graft surgery (CABG) has been associated with adverse outcome. Whether perioperative MI should be treated with dual antiplatelet therapy (DAPT) is unknown. We compared the effect of DAPT versus aspirin alone on short-term outcomes among patients with perioperative MI following CABG. METHODS: We used data from 3 clinical trials that enrolled patients undergoing isolated CABG: PREVENT IV (2002-2003), MEND-CABG II (2004-2005), and RED-CABG (2009-2010) (n = 9117)...
May 2018: American Heart Journal
https://www.readbyqxmd.com/read/29741292/microrna-150-restores-endothelial-cell-function-and-attenuates-vascular-remodeling-by-targeting-ptx3-through-the-nf-%C3%AE%C2%BAb-signaling-pathway-in-mice-with-acute-coronary-syndrome
#3
Xian-Yuan Luo, Xiao-Qing Zhu, Ying Li, Xue-Bin Wang, Wei Yin, Yi-Shan Ge, Wei-Min Ji
MicroRNAs have been known to function as important regulators in the vascular system, with various physiopathological effects such as vascular remodeling and hypertension modulation. We aimed to explore whether microRNA-150 (miR-150) regulates endothelial cell function and vascular remodeling in acute coronary syndrome (ACS), and the involvement of PTX3 and NF-κB signaling pathway. Ten normal mice and sixty ApoE-/- mice were chosen, and their coronary artery tissues and endothelial cells were extracted. ApoE-/- mice were injected with a series of inhibitors or mimics for miR-150, or siRNA against PTX3...
May 9, 2018: Cell Biology International
https://www.readbyqxmd.com/read/29736108/acute-coronary-syndrome-with-normal-coronary-arteries-a-case-of-spontaneous-spasm-lysis
#4
Vogiatzis Ioannis, Koutsambasopoulos Konstantinos, Samaras Antonios, Bostanitis Ioannis
Introduction: Patients suffering from Myocardial Infarction with Non-Obstructive Coronary Arteries (MINOCA) are found with no obstructive coronary artery disease on coronary arteriography. The Aim of this interesting case report is to present a patient with acute chest pain, temporal ST-segment elevation and MINOCA. Case report: A case of a young woman who presented with acute chest pain suggestive of angina, with temporal ST-segment elevation, accidentally recorded and not rising of myocardial necrosis biomarkers in blood tests is described...
April 2018: Medical Archives
https://www.readbyqxmd.com/read/29729688/comparison-of-serum-levels-of-il-6-il-8-tgf-%C3%AE-and-tnf-%C3%AE-in-coronary-artery-diseases-stable-angina-and-participants-with-normal-coronary-artery
#5
Zahra Sepehri Sepehri, Mohammad Masoomi, Fatemeh Ruzbehi, Zohreh Kiani, Ali Akbar Nasiri, Farhad Kohan, Mahmood Sheikh Fathollahi, Mohammad Kazemi Arababadi, Derek Kennedy, Gholamreza Asadikaram Asadikaram
Cytokines, which typically regulate the immune responses, play a role in cardiovascular diseases such as coronary artery diseases (CAD) and ischemic heart diseases (IHD). The aims of this study were to evaluate serum levels of IL-6, IL-8, TGF-β and TNF-α in patients with or without CAD, as well as stable angina, and to assess the effects of drug administration on the serum levels of these cytokines. Serum levels of the cytokines were analyzed in the three groups: patients with acute coronary syndrome, stable angina and participants with normal coronary arteries as controls...
April 30, 2018: Cellular and Molecular Biology
https://www.readbyqxmd.com/read/29717990/-minoca-in-iceland-acute-coronary-syndrome-in-patients-with-normal-or-nonobstructive-coronary-arteries
#6
Saevar Thor Vignisson, Ingibjorg Jona Gudmundsdottir, Thorarinn Gudnason, Ragnar Danielsen, Marianna Gardarsdottir, Karl Andersen
INTRODUCTION: The classical pathophysiological process underlying acute coronary syndromes has been considered to be plaque rup-ture followed by platelet activation and aggregation and subsequent thrombus formation leading to myocardial ischemia and infarction. A substantial number of patients with acute coronary syndromes appear to have normal or near normal (<50% stenosis) coronary arteries on angiography. Recently, this clinical entity has been coined MINOCA (Myocardial Infarction with Non-Obstructive Coronary Arteries)...
May 2018: Læknablađiđ
https://www.readbyqxmd.com/read/29691183/intravascular-imaging-for-cardiac-arrest-with-normal-coronary-arteriography
#7
Tawfiq Choudhury, Amir Solomonica, Rodrigo Bagur, Shahar Lavi
Spontaneous coronary artery dissection (SCAD) is an under-recognised presentation of acute coronary syndrome. A high index of suspicion is essential. If diagnostic doubt is high, intracoronary imaging, performed carefully, can be useful, although it can result in worsening of the clinical condition. The current report exemplifies the complexity of diagnosis and management of SCAD in a patient with out-of-hospital cardiac arrest and non-diagnostic angiography.
April 14, 2018: Cardiovascular Revascularization Medicine: Including Molecular Interventions
https://www.readbyqxmd.com/read/29664430/-kounis-syndrome-a-paradoxal-non-st-elevation-myocardial-infarction-case-after-triamcinolone-treatment-for-dermatitis
#8
Mücahid Yılmaz, Hasan Korkmaz
Kounis syndrome is defined as the clinical development of acute coronary syndrome caused by the activation of inflammatory cells due to an allergy, hypersensitivity, anaphylaxis, or anaphylactic reaction. Corticosteroids that are used in the treatment of many inflammatory conditions may paradoxically cause allergic reactions and even anaphylaxis. This article is a description of the case of a 52-yearold female patient who had a non-ST elevation myocardial infarction after the administration of triamcinolone that was relieved with antihistaminic treatment...
April 2018: Türk Kardiyoloji Derneği Arşivi: Türk Kardiyoloji Derneğinin Yayın Organıdır
https://www.readbyqxmd.com/read/29655952/population-level-incidence-and-outcomes-of-myocardial-infarction-with-non-obstructive-coronary-arteries-minoca-insights-from-the-alberta-contemporary-acute-coronary-syndrome-patients-invasive-treatment-strategies-coapt-study
#9
Kevin R Bainey, Robert C Welsh, Wendimagegn Alemayehu, Cynthia M Westerhout, Dean Traboulsi, Todd Anderson, Neil Brass, Paul W Armstrong, Padma Kaul
BACKGROUND: Myocardial infarction with non-obstructive coronary arteries (MINOCA) is a known clinical conundrum with limited investigation. Using a large population-based cohort, we examined the incidence, demographic profile, use of evidence-based medicines (EBM) and clinical outcomes of MINOCA patients. METHODS: Patients hospitalized with a primary diagnosis of MI who underwent coronary angiography between 01/04/2002 and 31/03/2014 in Alberta, Canada, were included in the study...
April 4, 2018: International Journal of Cardiology
https://www.readbyqxmd.com/read/29606415/effect-of-alirocumab-on-coronary-atheroma-volume-in-japanese-patients-with-acute-coronary-syndromes-and-hypercholesterolemia-not-adequately-controlled-with-statins-odyssey-j-ivus-rationale-and-design
#10
Junya Ako, Kiyoshi Hibi, Ken Kozuma, Katsumi Miyauchi, Yoshihiro Morino, Toshiro Shinke, Kenichi Tsujita, Kiyoko Uno, Yumiko Kawabata, Takafumi Hiro
BACKGROUND: Serial intravascular ultrasound (IVUS) imaging can be used to evaluate the effect of cholesterol-lowering on coronary atheroma progression and plaque volume, with evidence of potential incremental effects with more aggressive lipid-lowering treatments. Alirocumab is a highly specific, fully human monoclonal antibody to proprotein convertase subtilisin/kexin type 9 (PCSK9). This study will investigate the effect of alirocumab on coronary artery plaque volume in Japanese patients with a recent acute coronary syndrome (ACS) and hypercholesterolemia while on stable statin therapy...
March 29, 2018: Journal of Cardiology
https://www.readbyqxmd.com/read/29573083/serum-albumin-level-and-abnormal-qtc-interval-in-patients-with-coronary-artery-disease-and-chronic-kidney-disease
#11
Cheng-Ching Wu, Yung-Chuan Lu, Teng-Hung Yu, Chao-Ping Wang, Wei-Chin Hung, Wei-Hua Tang, I-Ting Tsai, Fu-Mei Chung, Yau-Jiunn Lee, Jin-Jia Hu
BACKGROUND: Lower concentrations of serum albumin appear to be associated with an increased risk of all-cause and cardiovascular mortality, coronary heart disease, heart failure, and stroke. However, little is known about the relationship between serum albumin level and prolonged QT interval. AIM: The aim of this study was to investigate whether lower serum albumin is associated with prolonged QT interval by recording 12-lead electrocardiography in patients with coronary artery disease (CAD) and chronic kidney disease (CKD)...
March 23, 2018: Internal Medicine Journal
https://www.readbyqxmd.com/read/29552570/myocardial-infarction-presenting-as-ear-fullness-and-pain
#12
Israel Ugalde, Ibrar Anjum, Saberio Lo Presti, Alfonso Tolentino
Acute coronary syndrome usually presents with retrosternal chest pain, nausea, vomiting, sweating, and jaw and arm pain. Some patients only present with neck, epigastric, or ear discomfort. A 47-year-old male with a history of hypertension and coronary artery disease presented to the emergency department complaining of bilateral otalgia. He never felt chest pain, jaw pain, nausea, diaphoresis, or shortness of breath. He had a history of 2 acute coronary events and had a stress test 2 months prior to admission, which was unremarkable...
January 2018: Journal of Investigative Medicine High Impact Case Reports
https://www.readbyqxmd.com/read/29540892/myocarditis-mimicking-acute-coronary-syndrome-the-role-of-cardiac-magnetic-resonance-imaging-in-the-diagnosis
#13
Fateh Ali Tipoo Sultan, Ghufran Adnan
Myocarditis is an inflammatory disease of myocardium with a wide range of clinical presentations. Myocarditis may mimic acute coronary syndrome (ACS) and adequate differential diagnosis is not possible by conventional tests. Cardiac magnetic resonance (CMR) has emerged as a leading imaging modality in the diagnosis of myocarditis in such patients. Here, we report three cases of myocarditis mimicking ACS with normal coronary arteries. CMR was used for confirming the diagnosis of myocarditis in all three patients presented here...
March 2018: JPMA. the Journal of the Pakistan Medical Association
https://www.readbyqxmd.com/read/29468911/reality-of-obesity-paradox-results-of-percutaneous-coronary-intervention-in-middle-eastern-patients
#14
Mohamad Jarrah, Ayman J Hammoudeh, Yousef Khader, Ramzi Tabbalat, Eyas Al-Mousa, Osama Okkeh, Imad A Alhaddad, Loai Issa Tawalbeh, Issa M Hweidi
Objective The aim of this study was to assess the baseline clinical characteristics, coronary angiographic features, and adverse cardiovascular events during hospitalization and at 1 year of follow-up in obese patients compared with overweight and normal/underweight patients. Methods A prospective, multicenter study of consecutive patients undergoing percutaneous coronary intervention was performed. Results Of 2425 enrolled patients, 699 (28.8%) were obese, 1178 (48.6%) were overweight, and 548 (22.6%) were normal/underweight...
April 2018: Journal of International Medical Research
https://www.readbyqxmd.com/read/29455773/takotsubo-syndrome
#15
REVIEW
Sanjiv Gupta, Madan Mohan Gupta
Takotsubo syndrome is a reversible acute heart failure frequently precipitated by an emotional or physical stress. The clinical presentation resembles acute coronary syndrome. Pathogenesis is complex and may involve brain-heart axis and neuro-hormonal stunning of the myocardium. Coronary angiography reveals normal epicardial arteries with no obstruction or spasm. NT-ProBNP maybe remarkably elevated. Regional wall motion akinesia (RWMA) of left ventricle extends beyond the territory of one coronary artery. Reduced left ventricle ejection fraction (LVEF) and RWMA recover in 6-12 weeks...
January 2018: Indian Heart Journal
https://www.readbyqxmd.com/read/29407007/new-insights-into-the-use-of-the-12-lead-electrocardiogram-for-diagnosing-acute-myocardial-infarction-in-the-emergency-department
#16
REVIEW
David F Miranda, Angie S Lobo, Brooks Walsh, Yader Sandoval, Stephen W Smith
The 12-lead electrocardiogram (ECG) remains the most immediately accessible and widely used initial diagnostic tool for guiding management in patients with suspected myocardial infarction (MI). Although the development of high-sensitivity cardiac troponin assays has improved the rule-in and rule-out and risk stratification of acute MI without ST elevation, the immediate management of the subset of acute MI with acute coronary occlusion depends on integrating clinical presentation and ECG findings. Careful interpretation of the ECG might yield subtle features suggestive of ischemia that might facilitate more rapid triage of patients with subtle acute coronary occlusion or, conversely, in identification of ST-elevation MI mimics (pseudo ST-elevation MI patterns)...
February 2018: Canadian Journal of Cardiology
https://www.readbyqxmd.com/read/29404272/type-i-kounis-syndrome-variant-a-case-report-and-literature-review
#17
Abdullah Haddad, Triston Smith, Aneel Bole, Moneal Shah, Mithun Chakravarthy
Kounis syndrome defined as the occurrence of acute coronary syndrome in the setting of allergic reaction due to mast cells activation and inflammatory mediators release that induces coronary vasospasm, plaque erosion, or even stent thrombosis. A 25-year-old postpartum female with asthma and recurrent episodes of chest pain was admitted with ST-segment elevation myocardial infarction in the setting of coronary artery spasms. The patient was started on calcium channel blockers and nitrite-based medication with no improvement...
January 2018: Avicenna Journal of Medicine
https://www.readbyqxmd.com/read/29401041/perivascular-epicardial-fat-stranding-at-coronary-ct-angiography-a-marker-of-acute-plaque-rupture-and-spontaneous-coronary-artery-dissection
#18
Sandeep Hedgire, Vinit Baliyan, Evan J Zucker, Daniel O Bittner, Pedro V Staziaki, Richard A P Takx, Jan-Erik Scholtz, Nandini Meyersohn, Udo Hoffmann, Brian Ghoshhajra
Purpose To evaluate the frequency and implications of perivascular fat stranding on coronary computed tomography (CT) angiograms obtained for suspected acute coronary syndrome (ACS). Materials and Methods This retrospective registry study was approved by the institutional review board. The authors reviewed the medical records and images of 1403 consecutive patients (796 men, 607 women; mean age, 52.8 years) who underwent coronary CT angiography at the emergency department from February 2012 to March 2016. Fat attenuation, length and number of circumferential quadrants of the affected segment, and attenuation values in the unaffected epicardial and subcutaneous fat were measured...
February 5, 2018: Radiology
https://www.readbyqxmd.com/read/29396517/percutaneous-coronary-intervention-versus-coronary-artery-bypass-graft-in-acute-coronary-syndrome-patients-with-renal-dysfunction
#19
Xiaojia Zhang, Liangping Hu, Wen Zheng
ACS patients with renal dysfunction tend to have a poorer prognosis than those with normal renal function. This retrospective cohort study was performed using The Second Drug-Eluting Stent Impact on Revascularization Registry, a retrospective registry, to evaluate the time-dependent relative risk of revascularization strategies in ACS patients with renal dysfunction. The study demonstrated that the short-term MACCE rate was lower after PCI than CABG. However, there was no significant difference in long-term MACCE rate...
February 2, 2018: Scientific Reports
https://www.readbyqxmd.com/read/29381028/current-evidence-for-the-safety-and-efficacy-of-the-bio-engineered-dual-therapy-combo-stent
#20
Deborah N Kalkman, Jaya Chandrasekhar, Robbert J de Winter, Roxana Mehran
The novel dual-therapy COMBO stent aims to promote vessel healing after percutaneous coronary intervention (PCI) in patients with coronary artery disease. The pro-healing technique consists of an anti-CD34+ antibody layer that attracts circulating endothelial progenitor cells (EPCs), which bind to the stent surface and allow rapid endothelialization by differentiation of the EPCs into normal endothelial cells. The COMBO stent combines this pro-healing technique with an abluminal drug elution of sirolimus. The promise of this dual-therapy stent is that it may safely allow a shortened duration of dual-antiplatelet therapy (DAPT) after stent placement...
January 29, 2018: Minerva Cardioangiologica
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