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https://www.readbyqxmd.com/read/28791184/acute-myocardial-infarction-caused-by-an-anomalous-right-coronary-artery-occlusion-presenting-with-precordial-st-elevation
#1
Bruno da Silva Matte, Alexandre Damiani Azmus
Acute coronary syndrome with precordial ST segment elevation is usually related to left anterior descending artery occlusion, although isolated right ventricular infarction has been described as a cause of ST elevation in V1-V3 leads. We present a case of a patient with previous inferior wall infarction and new acute ST elevation myocardial infarction (STEMI) due to proximal right coronary thrombotic occlusion resulting in right ventricular infarction with precordial ST elevation and sinus node dysfunction...
2017: Case Reports in Cardiology
https://www.readbyqxmd.com/read/28779859/double-right-coronary-artery-in-primary-pci-finding-the-hidden-treasure%C3%A2
#2
Luciano Candilio, Roberto Nerla, Jonathan Byrne
Double Right Coronary Artery (RCA) is one of the rarest congenital coronary anomalies. Although it can be regarded as a benign condition in the vast majority of cases, it has been associated with acute and life-threatening presentations, including inferior ST-segment elevation myocardial infarction (STEMI), cardiogenic shock and complete heart block, tachyarrhythmias, or even sudden death. However, the role of a double RCA in these conditions is yet to be clarified as more recent data prove no statistically significant association between prevalence of significant atherosclerosis in anomalous coronary arteries in comparison to normal coronary arteries...
July 5, 2017: Cardiovascular Revascularization Medicine: Including Molecular Interventions
https://www.readbyqxmd.com/read/28774770/the-misleading-electrocardiogram-midventricular-takotsubo-masquerading-as-anterior-wall-stemi
#3
Sonal Pruthi, Semaan Kobrossi, Rajeev Bartaula, Debanik Chaudhuri
Midventricular Takotsubo cardiomyopathy (TC) is a relatively rare variant of stress induced cardiomyopathy, wherein there is akinesis of only the mid-ventricular segment with or without hyperkinesis of apical and basal ventricular segments. The ECG findings of TC typically do not include ST segment elevation in V1-V2 and are unlikely to be associated with reciprocal changes in inferior leads. The presence of these changes argues strongly in favor of anterior wall STEMI. In our patient, the ECG had changes strongly suggestive of STEMI, however had normal coronaries on cardiac catheterization...
July 27, 2017: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28693891/an-alarming-trend-change-in-the-risk-profile-of-patients-with-st-elevation-myocardial-infarction-over-the-last-two-decades
#4
Amgad Mentias, Elizabeth Hill, Amr F Barakat, Mohammad Q Raza, Dalia Youssef, Kinjal Banerjee, Abhishek C Sawant, Stephen Ellis, E Murat Tuzcu, Samir R Kapadia
BACKGROUND: Coronary artery disease (CAD) is the leading cause of mortality around the world. We sought to study changes in the risk profile of patients presenting with ST elevation myocardial infarction (STEMI). METHODS: We retrospectively studied all patients presenting with STEMI to our center between 1995 and 2014. Patients were divided into four quartiles, 5years each. Baseline risk factors and comorbidities were recorded. Sub-analysis was done for patients with established CAD and their household incomes...
July 7, 2017: International Journal of Cardiology
https://www.readbyqxmd.com/read/28684393/critical-aortic-stenosis-presenting-as-stemi
#5
Ying X Gue, Sanjay S Bhandari, Damian J Kelly
A 73-year-old male was brought into hospital with chest pain and inferior ST elevation on ECG. The patient immediately proceeded to the catheter lab for primary percutaneous coronary intervention. Angiography did not identify any culprit lesions to account for the patient's electrocardiographic changes and ongoing symptoms of chest pain. Bedside echocardiography revealed critical aortic stenosis. Intra-aortic balloon pump (IABP) was inserted, resulting in resolution of chest pain and ST-segment changes. The patient underwent successful aortic valve (AV) replacement without the need for coronary intervention...
September 2017: Echo Research and Practice
https://www.readbyqxmd.com/read/28673761/primary-percutaneous-coronary-intervention-as-treatment-for-st-elevation-myocardial-infarction-in-a-centenarian-choosing-carefully
#6
Justin M Cloutier, Shelley Zieroth, Basem Elbarouni
We report on a 105-year-old woman presenting with inferior ST-elevation myocardial infarction (STEMI). She was managed with primary percutaneous intervention (PCI) to the right coronary artery with a single bare-metal stent. There were no acute complications, although she experienced delirium and functional decline requiring prolonged hospital admission. She was discharged home and celebrated her 106th birthday. This report describes the oldest centenarian with STEMI found in the literature and managed with PCI...
May 8, 2017: Canadian Journal of Cardiology
https://www.readbyqxmd.com/read/28617040/complete-atrioventricular-block-in-acute-coronary-syndrome-prevalence-characterisation-and-implication-on-outcome
#7
Silvia Aguiar Rosa, Ana Teresa Timóteo, Lurdes Ferreira, Ramiro Carvalho, Mario Oliveira, Pedro Cunha, André Viveiros Monteiro, Guilherme Portugal, Luis Almeida Morais, Pedro Daniel, Rui Cruz Ferreira
PURPOSE: The aim was to characterise acute coronary syndrome patients with complete atrioventricular block and to assess the effect on outcome. METHODS: Patients admitted with acute coronary syndrome were divided according to the presence of complete atrioventricular block: group 1, with complete atrioventricular block; group 2, without complete atrioventricular block. Clinical, electrocardiographic and echocardiographic characteristics and prognosis during one year follow-up were compared between the groups...
June 1, 2017: European Heart Journal. Acute Cardiovascular Care
https://www.readbyqxmd.com/read/28593057/clomiphene-associated-inferior-stemi-in-a-young-female-due-to-right-coronary-artery-dissection
#8
Feras Husain Abuzeyad, Eltigani Seedahmed Ibnaouf, Mudhaffar Al Farras
Nonatherosclerotic spontaneous coronary artery dissection (NA-SCAD) is an uncommon cause of myocardial infarction. It most commonly affects females in the perimenopausal age. NA-SCAD has been associated with many predisposing factors including pregnancy and hormonal therapy for both contraception and ovulation induction. The presented case is a previously healthy 41-year-old woman diagnosed with inferior ST-elevation myocardial infarction due to right descending coronary artery dissection associated with recent use of clomiphene monotherapy for ovulation induction (a previously fertile woman), which was not previously reported...
2017: Case Reports in Emergency Medicine
https://www.readbyqxmd.com/read/28577666/a-prospective-randomized-open-label-trial-of-6-month-versus-12-month-dual-antiplatelet-therapy-after-drug-eluting-stent-implantation-in-st-elevation-myocardial-infarction-rationale-and-design-of-the-dapt-stemi-trial
#9
RANDOMIZED CONTROLLED TRIAL
Elvin Kedhi, Enrico Fabris, Martin van der Ent, Mark W Kennedy, Pawel Buszman, Clemens von Birgelen, Stéphane Cook, Hans Wedel, Felix Zijlstra
BACKGROUND: The optimal duration of dual antiplatelet therapy (DAPT) after percutaneous coronary intervention with second-generation drug eluting stents (DESs) is unclear. Because prolonged DAPT is associated with higher bleeding risk and health care costs, establishing optimal DAPT duration is of paramount importance. No other randomized controlled trials have evaluated the safety of shorter DAPT duration in ST-elevation myocardial infarction (STEMI) patients treated with second-generation DESs and latest P2Y12 platelet receptor inhibitors...
June 2017: American Heart Journal
https://www.readbyqxmd.com/read/28485279/predicting-the-infarct-related-artery-in-stemi-from-the-surface-ecg-independent-validation-of-proposed-criteria
#10
Rob Eerdekens, Jose F Chavez, Justin M Fox, James D Flaherty, Lukas Rc Dekker, Nils P Johnson
AIMS: This study independently evaluated the diagnostic performance of electrocardiographic (ECG) criteria to predict the infarct related artery (IRA) in patients with an acute ST-segment elevation myocardial infarction (STEMI). While a number of ECG criteria have been proposed to predict the IRA in STEMI, many of these "rules" came from modestly sized populations and did not undergo external validation. Therefore, we evaluated popular criteria from the literature in an independent cohort...
May 9, 2017: EuroIntervention
https://www.readbyqxmd.com/read/28423233/ivabradine-versus-metoprolol-in-patients-with-acute-inferior-wall-myocardial-infarction-expanding-arena-for-ivabradine
#11
Rajendra K Go Khroo, K Priti, Bhanwar L Ranwa, Kamal Kishor, Devendra Bisht, Sajal Gupta
BACKGROUND: Atrioventricular (AV) blocks are of concern with the use of beta blockers in inferior wall myocardial infarction (MI). Ivabradine lowers heart rate with a lesser risk of AV blocks. OBJECTIVES: To compare ivabradine with metoprolol in acute inferior wall MI in terms of feasibility, tolerability and efficacy METHODS: It was a prospective double blind single centre randomized controlled study. Of 1032 patients with acute inferior wall MI, 468 eligible patients were randomized in 1:1 manner to ivabradine (group A) and metoprolol (group B)...
April 19, 2017: Cardiovascular Therapeutics
https://www.readbyqxmd.com/read/28414682/a-left-main-coronary-artery-thrombus-presenting-as-a-non-st-elevation-mi
#12
U Ezema, D Daberkow, T Delord, L Guidry, N R Sells
INTRODUCTION: Left main coronary artery (LMCA); thrombus with an acute myocardial infarction identified with coronary angiography is a clinically rare condition with an extremely high mortality rate. We present a case of LMCA thrombus that presented as a non-ST elevation myocardial infarction (NSTEMI);. CASE: A 45-year-old woman with a history of tobacco use and hyperlipidemia presented with a complaint of 10/10 "hard pain" across her chest radiating to her left shoulder and breast which woke her from sleep...
March 2017: Journal of the Louisiana State Medical Society: Official Organ of the Louisiana State Medical Society
https://www.readbyqxmd.com/read/28318811/st-elevation-myocardial-infarction-after-penetrating-thoracic-trauma
#13
Kiran Faryar, Michael P Flaherty, Martin Huecker
BACKGROUND: ST-segment elevation myocardial infarction (STEMI) may complicate penetrating thoracic trauma. CASE REPORT: This report describes a 42-year-old man who sustained a self-inflicted gunshot wound to the left chest. Electrocardiogram showed ST elevation in the inferior leads. Emergent catheterization was not recommended and conservative management was initiated. Cardiac catheterization 4 days later showed no perturbation of the coronary arteries, neither atherosclerotic nor traumatic...
March 17, 2017: Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28250684/acute-st-segment-elevation-myocardial-infarction-the-prognostic-importance-of-lead-augmented-vector-right-and-leads-v7-v9
#14
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/28185396/primary-percutaneous-coronary-intervention-of-native-chronic-total-occlusions-to-treat-st-elevation-myocardial-infarction-secondary-to-acute-vein-graft-occlusion
#15
Pierre Deharo, Julian W Strange, Abdul Mozid
Primary percutaneous coronary intervention (PCI) is the treatment modality of choice in patients presenting with ST elevation myocardial infarction (STEMI). Clinical outcomes have dramatically improved with the wide adoption of primary PCI in patients with STEMI because of acute thrombotic native coronary artery occlusion. However, patients with prior coronary artery bypass graft (CABG) surgery who present with STEMI because of acute saphenous vein graft (SVG) occlusion continue to have worse outcomes because of poor acute and long-term results of SVG stenting...
February 10, 2017: Catheterization and Cardiovascular Interventions
https://www.readbyqxmd.com/read/27999129/ascending-aortic-dissection-presented-as-inferior-myocardial-infarction-a-clinical-and-diagnostic-mimicry
#16
Ali A Alsaad, Olufunso W Odunukan, John Norman Patton
Acute ST segment elevation myocardial infarction (STEMI) is typically associated with acute coronary thrombosis or plaque rupture. Rarely, STEMI can be associated with ascending aortic dissection, which represents the majority of acute aortic syndrome aetiologies and carries dreadful outcomes. Routine cardiac intervention with emergent cardiac catheterisation may lead to a higher mortality rate in this group of patients. We present a case of painless inferior STEMI in the setting of ascending aortic dissection...
December 20, 2016: BMJ Case Reports
https://www.readbyqxmd.com/read/27936877/-a-rare-ecg-manifestation-of-left-sided-pneumothorax-inferior-stemi-with-precordial-brugada-pattern
#17
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/27933193/outcomes-of-ischaemic-mitral-regurgitation-in-anterior-versus-inferior-st-elevation-myocardial-infarction
#18
Amgad Mentias, Mohammad Q Raza, Amr F Barakat, Elizabeth Hill, Dalia Youssef, Amar Krishnaswamy, Milind Y Desai, Brian Griffin, Stephen Ellis, Venu Menon, E Murat Tuzcu, Samir R Kapadia
BACKGROUND: Ischaemic mitral regurgitation (IMR) is a detrimental complication of ST elevation myocardial infarction (STEMI). OBJECTIVE: We sought to determine patient characteristics and outcomes of patients with IMR with focus on anterior or inferior location of STEMI. METHODS: All patients presenting with STEMI complicated by IMR to our centre who underwent primary percutaneous coronary intervention within the first 12 hours of presentation from 1995 to 2014 were included...
2016: Open Heart
https://www.readbyqxmd.com/read/27793397/prognostic-significance-of-ischemic-mitral-regurgitation-on-outcomes-in-acute-st-elevation-myocardial-infarction-managed-by-primary-percutaneous-coronary-intervention
#19
Amgad Mentias, Mohammad Q Raza, Amr F Barakat, Elizabeth Hill, Dalia Youssef, Amar Krishnaswamy, Milind Y Desai, Brian Griffin, Stephen Ellis, Venu Menon, E Murat Tuzcu, Samir R Kapadia
Ischemic mitral regurgitation (IMR) has been associated with worse outcome myocardial infarction. However, severity of mitral regurgitation (MR) and its impact on patients with ST-elevation myocardial infarction (STEMI) undergoing primary percutaneous coronary intervention (PCI) remains unknown. We sought to determine impact of increasing severity of IMR on outcomes in patients with STEMI undergoing primary PCI. All patients presenting with STEMI who underwent primary PCI within 12 hours of symptoms from 1994 to 2014 were included...
January 1, 2017: American Journal of Cardiology
https://www.readbyqxmd.com/read/27774856/st-depression-in-right-precordial-leads-with-inferior-stemi-and-occluded-right-coronary-artery-intertwined-anatomy-and-ischemic-areas
#20
Luisa De Gennaro, Natale Daniele Brunetti, Massimo Ruggiero, David Rutigliano, Nicola Locuratolo, Matteo Di Biase, Pasquale Caldarola
Right coronary artery (RCA) occlusion in inferior acute myocardial infarction is usually heralded by ST-elevation both in inferior and in right precordial leads. We report the case of a 68-year-old male, who presented marked ST-elevation in inferior leads, mirrored by ST-depression in anterior-septal and lateral leads. Right precordial lead electrocardiogram unexpectedly showed ST-depression V1R-V5R leads. Coronary angiography showed mid-left anterior descending (LAD) coronary near-complete occlusion with distal wrapping LAD...
October 23, 2016: Acta Clinica Belgica
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