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https://www.readbyqxmd.com/read/29420570/qt-interval-evaluation-in-primary-percutaneous-coronary-intervention-of-st-segment-elevation-myocardial-infarction-for-prediction-of-myocardial-salvage-index
#1
Andrea Igoren Guaricci, Patrizia Carità, Valentina Lorenzoni, GraziaPia Casavecchia, Mark Rabbat, Riccardo Ieva, Natale Daniele Brunetti, Daniele Andreini, Matteo Di Biase, Giancarlo Marenzi, Antonio Bartorelli, Mauro Pepi, Gianluca Pontone
Assessing the efficacy of revascularization therapy in patients with ST-segment elevation myocardial infarction (STEMI) is extremely important in order to guide subsequent management and assess prognosis. We aimed to determine the relationship between corrected QT-interval (QTc) changes on standard sequential ECG and myocardial salvage index in anterior STEMI patients after successful primary percutaneous coronary intervention. Fifty anterior STEMI patients treated by primary percutaneous coronary intervention underwent quantitative ECG analysis and cardiac magnetic resonance...
2018: PloS One
https://www.readbyqxmd.com/read/29402396/total-occlusion-of-the-left-main-coronary-artery-presenting-as-st-elevation-myocardial-infarction
#2
Yun-Tao Zhao, Hang Zhou, Ruiqi Shi, Bin Wang
An ECG pattern of widespread ST depression in six or more precordial and inferior leads, accompanied by ST-segment elevation in the aVR and/or V1 leads, is typical of the non-ST-segment elevation myocardial infarction (NSTEMI) pattern associated left main (LM) artery occlusion, but this ECG pattern is really associated with a subocclusion of the LM, or in the case that the LM was occluded with the presence of collateral circulation. There are few reports of ST-elevation myocardial infarction (STEMI) due to acute total LM occlusion...
February 2, 2018: Journal of Electrocardiology
https://www.readbyqxmd.com/read/29348386/st-elevation-in-lead-avr-and-its-association-with-clinical-outcomes
#3
Eka Ginanjar, Yulianto Yulianto
The purpose of this case repots are to evaluate the role of ST elevation in aVR lead and to make analysis between both cases. There are some atypical electrocardiogram (ECG) presentations which need prompt management in patient with ischemic clinical manifestation such as ST elevation in aVR lead. In this case study, we report a 68-year old woman with chief symptoms of shortness of breath and chest discomfort. She was diagnosed with cardiogenic shock, with Killip class IV, and TIMI score of 8. The second case is a 57-year-old man with typical chest pain at rest which could not be relieved with nitrate treatment...
October 2017: Acta Medica Indonesiana
https://www.readbyqxmd.com/read/29317980/a-history-of-kawasaki-disease-from-childhood-and-coronary-artery-ectasia-with-recurrent-st-elevation-myocardial-infarction-a-therapeutic-challenge
#4
Ashraf Abugroun, Daniel Vilchez, Osama Hallak, Anahita Shahrrava
Coronary artery ectasia (CAE) is an uncommon anomaly, usually found in 1.2-2% of patients undergoing coronary angiography, defined as a segment of the coronary artery that has a diameter of more than 1.5 times the normal adjacent segments. Atherosclerosis is considered as the cause of half of the CAE cases. We herein present a 65-year-old Asian male with past medical history of Kawasaki disease (KD) who developed recurrent episodes of inferior wall ST-elevation myocardial infarction (STEMI) despite treatment with dual antiplatelet therapy (DAPT)...
December 2017: Cardiology Research
https://www.readbyqxmd.com/read/29243292/effects-of-endovascular-cooling-on-infarct-size-in-st-segment-elevation-myocardial-infarction-a-patient-level-pooled-analysis-from-randomized-trials
#5
Michael Dae, William O'Neill, Cindy Grines, Simon Dixon, David Erlinge, Marko Noc, Michael Holzer, Anne Dee
OBJECTIVES: This study sought to examine the relationship between temperature at reperfusion and infarct size. BACKGROUND: Hypothermia consistently reduces infarct size when administered prior to reperfusion in animal studies, however, clinical results have been inconsistent. METHODS: We performed a patient-level pooled analysis from six randomized control trials of endovascular cooling during primary percutaneous coronary intervention (PCI) for ST-segment elevation myocardial infarction (STEMI) in 629 patients in which infarct size was assessed within 1 month after randomization by either single-photon emission computed tomography (SPECT) or cardiac magnetic resonance imaging (cMR)...
December 14, 2017: Journal of Interventional Cardiology
https://www.readbyqxmd.com/read/29174706/electrocardiographic-scores-of-severity-and-acuteness-of-myocardial-ischemia-predict-myocardial-salvage-in-patients-with-anterior-st-segment-elevation-myocardial-infarction
#6
Yama Fakhri, Maria Sejersten, Mikkel Malby Schoos, Henrik Steen Hansen, Jean-Luc Dubois-Rande, Trygve S Hall, Alf-Inge Larsen, Svend Eggert Jensen, Henrik Engblom, Hakon Arheden, Jens Kastrup, Dan Atar, Peter Clemmensen
BACKGROUND: Terminal "QRS distortion" on the electrocardiogram (ECG) (based on Sclarovsky-Birnbaum's Grades of Ischemia Score) is a sign of severe ischemia, associated with adverse cardiovascular outcome in ST-segment elevation myocardial infarction (STEMI). In addition, ECG indices of the acuteness of ischemia (based on Anderson-Wilkins Acuteness Score) indicate myocardial salvage potential. We assessed whether severe ischemia with or without acute ischemia is predictive of infarct size (IS), myocardial salvage index (MSI) and left ventricular ejection fraction (LVEF) in anterior versus inferior infarct locations...
November 13, 2017: Journal of Electrocardiology
https://www.readbyqxmd.com/read/29139601/utility-of-the-acc-aha-lesion-classification-as-a-predictor-of-procedural-30-day-and-12-month-outcomes-in-the-contemporary-percutaneous-coronary-intervention-era
#7
James Theuerle, Matias B Yudi, Omar Farouque, Nick Andrianopoulos, Peter Scott, Andrew E Ajani, Angela Brennan, Stephen J Duffy, Christopher M Reid, David J Clark
BACKGROUND: Correlations between the ACC/AHA coronary lesion classification and clinical outcomes in the contemporary percutaneous coronary intervention (PCI) era are not well established. METHODS: We analyzed clinical characteristics and outcomes according to ACC/AHA lesion classification (A, B1, B2, C) in 13,701 consecutive patients from the Melbourne Interventional Group (MIG) registry. Patients presenting with STEMI, cardiogenic shock and out-of-hospital cardiac arrest were excluded...
November 15, 2017: Catheterization and Cardiovascular Interventions
https://www.readbyqxmd.com/read/29108788/peri-procedural-st-segment-resolution-during-primary-percutaneous-coronary-intervention-ppci-for-acute-myocardial-infarction-predictors-and-clinical-consequences
#8
Grigoris V Karamasis, Paul Russhard, Firas Al Janabi, Michael Parker, John R Davies, Thomas R Keeble, Gerald J Clesham
OBJECTIVE: ECG ST segment resolution (STR) has been used to assess myocardial perfusion in STEMI patients undergoing PPCI. However, in most of the studies ECGs recorded at different time points after the actual procedure have been used, limiting the options of therapeutic interventions while the patient is still in the catheterisation laboratory. The aim of this study was to investigate the presence and clinical consequences of intra-procedural STR during PPCI. METHODS: We analysed 12 lead ECGs recorded at the onset and the end of the PPCI procedure, measuring STR in the lead with maximum ST elevation on the initial recording...
October 5, 2017: Journal of Electrocardiology
https://www.readbyqxmd.com/read/29046758/coronary-artery-ectasia-presenting-with-acute-inferior-wall-myocardial-infarction-in-a-young-adult
#9
Htun Latt, Sammy Aung, Kyaw Kyaw, Richard Seher
Coronary artery ectasia (CAE), a variant of coronary artery anomalies, is a rare clinical entity. Although atherosclerotic coronary artery disease (CAD) is the most common cause of acute coronary syndrome (ACS), CAE also conveys a relatively high risk for potentially life-threatening cardiac events. We report a case of a 35-year-old male with two-vessel CAE, who presented with acute inferior wall ST election myocardial infarction (STEMI). After initiating medical therapy including bivalirudin, emergent percutaneous coronary intervention (PCI) with stenting of postero-lateral branch of right coronary artery (RCA) was performed...
October 2017: Journal of Community Hospital Internal Medicine Perspectives
https://www.readbyqxmd.com/read/28993840/impact-of-right-ventricular-diastolic-dysfunction-on-clinical-outcomes-in-inferior-stemi
#10
B Altıntaş, B Yaylak, H Ede, R Altındağ, E Baysal, Ö Bilge, H Çiftçi, M Ş Adıyaman, M Z Karahan, I Kaya, K Çevik
BACKGROUND: The aim of this study was to investigate the prognostic value of restrictive right ventricular filling pattern (RRVFP) in patients with the first acute inferior wall myocardial infarction (IWMI) complicated by right ventricular myocardial infarction (RVMI) undergoing primary percutaneous coronary intervention (p-PCI). METHOD: A total of 152 patients with acute IWMI complicated by RVMI undergoing p‑PCI were divided into two groups according to the presence of RRVFP...
October 9, 2017: Herz
https://www.readbyqxmd.com/read/28980409/stress-test-to-stemi-utility-of-coronary-cta-in-the-diagnosis-and-management-of-anomalous-right-coronary-artery-from-the-left-coronary-cusp
#11
Anshuman Das, Ajay Joseph, Neeraj Jolly, Dinesh K Kalra
A 42-year-old woman presented to the emergency department with chest pain. Acute coronary syndrome was ruled out. During dobutamine stress echocardiography (DSE), she developed chest pain and inferior ST elevation. Emergent coronary angiography revealed no culprit lesions but did show an anomalous right coronary artery (RCA). Coronary CT angiography (CCTA) confirmed an anomalous RCA arising from the left coronary cusp with a slit-like ostium and interarterial course (ARCA-LCC-IA). Herein, we review the extant literature on ARCA-LCC-IA, its clinical presentation, the vital role of CTA and MRI in its diagnosis, as well as challenges and controversies surrounding management...
October 2017: Echocardiography
https://www.readbyqxmd.com/read/28936441/correlation-between-electrocardiographic-changes-and-coronary-findings-in-patients-with-acute-myocardial-infarction-and-single-vessel-disease
#12
Abdallah Sanaani, Srikanth Yandrapalli, George Jolly, Rajiv Paudel, Howard A Cooper, Wilbert S Aronow
BACKGROUND: Correlation of ST-segment elevation on the 12-lead electrocardiogram (ECG) with the expected affected coronary territory is established in patients with ST-elevation myocardial infarction (STEMI). In patients with non-ST-elevation myocardial infarction (NSTEMI), correlation of ischemic ECG abnormalities with the affected coronary territory has not been well-established. We sought to investigate the correlation of electrocardiographic abnormalities with the location of 1-vessel obstructive coronary artery disease (CAD) in patients with both STEMI and NSTEMI...
September 2017: Annals of Translational Medicine
https://www.readbyqxmd.com/read/28928186/recombinant-human-tnk-tissue-type-plasminogen-activator-rhtnk-tpa-versus-alteplase-rt-pa-as-fibrinolytic-therapy-for-acute-st-segment-elevation-myocardial-infarction-china-tnk-stemi-protocol-for-a-randomised-controlled-non-inferiority-trial
#13
Hai-Bo Wang, Ping Ji, Xing-Shan Zhao, Haiyan Xu, Xiao-Yan Yan, Qin Yang, Chen Yao, Run-Lin Gao, Yang-Feng Wu, Shu-Bin Qiao
AIM: To evaluate the efficacy and safety of recombinant human TNK tissue-type plasminogen activator (rhTNK-tPA) in lowering major adverse cardiovascular and cerebrovascular events (MACCEs) in Chinese acute ST-segment elevation myocardial infarction (STEMI) patients. METHODS AND ANALYSIS: The study is designed as a multicentre, randomised, controlled non-inferiority phase IV trial with balanced randomisation (1:1) in patients with STEMI. The planned sample size is 6200 participants (or 3100 per arm)...
September 18, 2017: BMJ Open
https://www.readbyqxmd.com/read/28918213/myocardium-at-risk-assessed-by-electrocardiographic-scores-and-cardiovascular-magnetic-resonance-a-mitocare-substudy
#14
Maria Sejersten, Yama Fakhri, Marianne Pape, Svend Eggert Jensen, Einar Heiberg, Henrik Engblom, Trygve S Hall, Dan Atar, Peter Clemmensen
INTRODUCTION: The myocardium at risk (MaR) represents the quantitative ischemic area destined to myocardial infarction (MI) if no reperfusion therapy is initiated. Different ECG scores for MaR have been developed, but there is no consensus as to which should be preferred. OBJECTIVE: Comparisons of ECG scores and Cardiac Magnetic Resonance (CMR) for determining MaR. METHODS: MaR was determined by 3 different ECG scores, and by CMR in ST-segment elevation MI (STEMI) patients from the MITOCARE cardioprotection trial...
November 2017: Journal of Electrocardiology
https://www.readbyqxmd.com/read/28892952/correlation-of-reciprocal-changes-and-qrs-amplitude-in-ecg-to-left-ventricular-dysfunction-wall-motion-score-and-clinical-outcome-in-first-time-st-elevation-myocardial-infarction
#15
Silpita Katragadda, Murali Alagesan, Shanmugasundaram Rathakrishnan, Deepalakshmi Kaliyaperumal, Anith Kumar Mambatta
INTRODUCTION: Electrocardiogram (ECG) is the simplest tool for diagnosing ST Elevation Myocardial Infarction (STEMI). We can use a12 lead ECG for prognostication purposes also. AIM: The aim of the study was to find out the role of ECG as a prognostic marker in terms of clinical outcome and wall motion abnormality. MATERIALS AND METHODS: It was a prospective study done in PSG Institute of Medical Sciences and Research, Coimbatore, Tamil Nadu, India, from January 2014 to September 2014...
July 2017: Journal of Clinical and Diagnostic Research: JCDR
https://www.readbyqxmd.com/read/28891183/primary-percutaneous-coronary-intervention-for-inferior-st-segment-elevation-myocardial-infarction-in-a-patient-supported-by-the-heartware-left-ventricular-assist-device
#16
Roberto Spina, Maithri Siriwardena, Nicole Bart, Mayooran Namasivayam, Mark Connellan, Paul Jansz, Philip Spratt, Christopher S Hayward, Eugene Kotlyar, Brendan Gunalingam
A 63-year-old man with an ischaemic cardiomyopathy, supported by the HeartWare left ventricular assist device (LVAD), presented with ventricular tachycardia and inferior ST-elevation myocardial infarction (STEMI) with associated acute right ventricular (RV) dysfunction. He underwent primary percutaneous coronary intervention with balloon angioplasty and placement of three drug-eluting stents in the proximal-to-mid right coronary artery. Post-procedure, ventricular arrhythmias abated, RV systolic dysfunction resolved and RV size normalised...
September 2017: Internal Medicine Journal
https://www.readbyqxmd.com/read/28889769/orsiro-cobalt-chromium-sirolimus-eluting-stent-present-and-future-perspectives
#17
Juan F Iglesias, Marco Roffi, Sophie Degrauwe, Gioel Gabrio Secco, Adel Aminian, Stephan Windecker, Thomas Pilgrim
New-generation drug-eluting stents (DES) represent the current standard of care in patients undergoing percutaneous coronary intervention (PCI). Biodegradable polymer DES (BP-DES) were recently developed to overcome current limitations of newer-generation durable polymer DES (DP-DES) attributed to sustained inflammatory responses induced by permanent polymers. The Orsiro DES (Biotronik AG, Bülach, Switzerland) is a novel thin-strut cobalt-chromium sirolimus-eluting stent with biodegradable polymer that features some of the latest developments in DES technology...
September 19, 2017: Expert Review of Medical Devices
https://www.readbyqxmd.com/read/28791184/acute-myocardial-infarction-caused-by-an-anomalous-right-coronary-artery-occlusion-presenting-with-precordial-st-elevation
#18
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
#19
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
#20
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...
October 2017: American Journal of Emergency Medicine
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