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https://www.readbyqxmd.com/read/28423233/ivabradine-versus-metoprolol-in-patients-with-acute-inferior-wall-myocardial-infarction-expanding-arena-for-ivabradine
#1
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
#2
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
#3
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
#4
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
#5
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
#6
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
#7
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
#8
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
#9
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
#10
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
https://www.readbyqxmd.com/read/27739264/st-segment-elevated-acute-myocardial-infarction-changing-profile-over-last-24-years
#11
Trinath Kumar Mishra, Biswajit Das
BACKGROUND: Coronary artery disease (CAD) is rising in epidemic proportions with India not being an exception. CAD in Indian scenario has its onset at a younger age with multitude of risk factors. OBJECTIVE: This study was carried out to obtain complete information about demographic profile, risk factors, clinical scenario, therapeutic modalities, natural course, outcome and changing profile of acute ST-segment elevated myocardial infarction (STEMI) patients. METHODS: This cross-sectional study was conducted in 45,122 acute STEMI patients admitted 1st March 1990 to 1st March 2014...
June 2016: Journal of the Association of Physicians of India
https://www.readbyqxmd.com/read/27617370/contemporary-management-of-st-elevation-myocardial-infarction
#12
REVIEW
Ashleigh Dind, Usaid Allahwala, Kaleab N Asrress, Sanjit S Jolly, Ravinay Bhindi
Recent advances have caused a major shift in the way ST-elevation myocardial infarctions are managed. This review explores the pharmacological and interventional techniques that have evidence for improving outcomes and the landmark trials that have sparked change. The new P2Y12 inhibitors, ticagrelor and prasugrel, have been shown to be superior to clopidogrel in STEMI patients undergoing primary percutaneous coronary intervention. Concurrently, many technical aspects of percutaneous coronary intervention have been further clarified by trial data, with bare-metal stents, routine thrombus aspiration and femoral access showing evidence of inferiority...
February 2017: Heart, Lung & Circulation
https://www.readbyqxmd.com/read/27586500/association-of-the-right-ventricle-impairment-with-electrocardiographic-localization-and-related-artery-in-patients-with-st-elevation-myocardial-infarction
#13
Jan Kanovsky, Petr Kala, Tomas Novotny, Klara Benesova, Maria Holicka, Jiri Jarkovsky, Lumir Koc, Monika Mikolaskova, Tomas Ondrus, Marek Malik
INTRODUCTION: The right ventricular myocardial infarction (RVMI) has traditionally been mainly related to inferior wall ST elevation myocardial infarction (STEMI). This study assessed the RVMI electrocardiographic (ECG-RVMI) signs in relationship to ECG-based STEMI localization and to the infarct related artery in patients treated with primary percutaneous coronary intervention (pPCI). METHODS: Three hundred consecutive adult patients (107 females) were referred to catheterization laboratory with the acute STEMI diagnosis...
November 2016: Journal of Electrocardiology
https://www.readbyqxmd.com/read/27577194/pericardial-tamponade-due-to-haemorrhagic-pericardial-effusion-as-a-complication-of-prasugrel-a-case-report
#14
Fathima Aaysha Cader, M Maksumul Haq, Sahela Nasrin, Md Rezaul Karim
BACKGROUND: Striking an adequate balance between bleeding risks and prevention of stent thrombosis can be challenging in the setting of percutaneous coronary intervention (PCI) with drug eluting stents (DES) in acute myocardial infarction (MI). This is more pronounced in patients treated with both low molecular weight heparin (LMWH) and dual antiplatelet therapy (DAPT). Prasugrel, a second generation thienopyridine with more potent platelet inhibition capability, is associated with significant bleeding risks...
August 30, 2016: BMC Cardiovascular Disorders
https://www.readbyqxmd.com/read/27503306/-preclinical-fibrinolysis-in-patients-with-st-segment-elevation-myocardial-infarction-in-a-rural-region
#15
T Viergutz, J Grüttner, T Walter, C Weiss, B Haaff, G Pollach, C Madler, T Luiz
BACKGROUND: In the current guidelines for the treatment of patients with ST-segment elevation myocardial infarction (STEMI), the European Society of Cardiology (ESC) recommends preclinical fibrinolysis as a reperfusion therapy if, due to long transportation times, no cardiac catheterisation is available within 90-120 min. However, there is little remaining in-depth expertise in this method because fibrinolysis is presently only rarely indicated. METHODS: In a rural area in southwestern Germany, where an emergency primary percutaneous coronary intervention was not routinely available within 90-120 min, 156 STEMI patients underwent fibrinolysis with the plasminogen activator reteplase, performed by trained emergency physicians...
September 2016: Der Anaesthesist
https://www.readbyqxmd.com/read/27412903/ecg-criteria-to-differentiate-between-takotsubo-stress-cardiomyopathy-and-myocardial-infarction
#16
Antonio H Frangieh, Slayman Obeid, Jelena-Rima Ghadri, Yoichi Imori, Fabrizio D'Ascenzo, Marc Kovac, Frank Ruschitzka, Thomas F Lüscher, Firat Duru, Christian Templin
BACKGROUND: ECG criteria differentiating Takotsubo cardiomyopathy (TTC) from mainly anterior myocardial infarction (MI) have been suggested; however, this was in small patient populations. METHODS AND RESULTS: Twelve-lead admission ECGs of consecutive 200 TTC and 200 MI patients were compared in dichotomized groups based on the presence or absence of ST-elevation MI (STEMI versus STE-TTC and non-ST elevation MI versus non ST-elevation-TTC). When comparing STEMI and STE-TTC, ST-elevation in -aVR was characteristic of STE-TTC with a sensitivity/specificity of 43% and 95%, positive predictive value (PPV) 91%, and a negative predictive value (NPV) 62% (P<0...
June 13, 2016: Journal of the American Heart Association
https://www.readbyqxmd.com/read/27403139/vessel-healings-after-stenting-with-different-polymers-in-stemi-patients
#17
Qin-Hua Jin, Yun-Dai Chen, Feng Tian, Jun Guo, Jing Jing, Zhi-Jun Sun
BACKGROUND: Different stents implantation in ST-segment elevation myocardial infarction (STEMI) patients may influence the long term prognosis by affecting vessel healings after stenting. The aim of this study was to evaluate the vessel healings after implantation of drug eluting stents (DES) with biodegradable or durable polymer or of bare-metal stents (BMS) in patients with acute STEMI. METHODS: This study included 50 patients, who underwent follow up angiogram and optical coherence tomography (OCT) assessment about one year after percutaneous coronary intervention (PCI) for STEMI...
May 2016: Journal of Geriatric Cardiology: JGC
https://www.readbyqxmd.com/read/27358099/acute-st-elevation-myocardial-infarction-in-fulminant-systemic-p-anca-vasculitis-a-rare-catastrophic-complication
#18
Kanupriya Mathur, Aditya Saini, Tonjeh Bah, Pavan Katikaneni
A 45-year-old Caucasian man presented to the hospital with a 3-month history of fatigue, bilateral upper and lower limb paresthesias and gradually worsening ascending paralysis. A few weeks later, he developed acute renal failure requiring haemodialysis. Investigations revealed presence of myeloperoxidase (MPO) perinuclear antineutrophil cytoplasmic antibodies (ANCA). Renal biopsy was conclusive for rapidly progressive glomerulonephritis with crescents. Treatment for ANCA positive vasculitis was initiated with pulsed steroids, cyclophosphamide and plasmapheresis...
June 29, 2016: BMJ Case Reports
https://www.readbyqxmd.com/read/27348525/regional-longitudinal-myocardial-deformation-provides-incremental-prognostic-information-in-patients-with-st-segment-elevation-myocardial-infarction
#19
Tor Biering-Sørensen, Jan Skov Jensen, Sune H Pedersen, Søren Galatius, Thomas Fritz-Hansen, Jan Bech, Flemming Javier Olsen, Rasmus Mogelvang
BACKGROUND: Global longitudinal systolic strain (GLS) has recently been demonstrated to be a superior prognosticator to conventional echocardiographic measures in patients after myocardial infarction (MI). The aim of this study was to evaluate the prognostic value of regional longitudinal myocardial deformation in comparison to GLS, conventional echocardiography and clinical information. METHOD: In total 391 patients were admitted with ST-Segment elevation myocardial infarction (STEMI), treated with primary percutaneous coronary intervention and subsequently examined by echocardiography...
2016: PloS One
https://www.readbyqxmd.com/read/27318741/new-st-segment-algorithms-to-determine-culprit-artery-location-in-acute-inferior-myocardial-infarction
#20
Xin Huang, Sachin K Ramdhany, Yong Zhang, Zuyi Yuan, Gary S Mintz, Ning Guo
OBJECTIVES: In acute inferior ST-segment elevation myocardial infarction (STEMI), multiple criteria have been proposed to predict the culprit artery based on the 12-lead electrocardiogram (ECG). We assessed the utilities of 11 traditional and 2 new criteria to devise a new ECG algorithm to localize the culprit artery in acute inferior STEMI. METHODS: We analyzed electrocardiographic and angiographic findings of 194 consecutive patients with acute inferior STEMI to devise a new ECG algorithm, further validated in another cohort of 80 patients with acute inferior STEMI...
September 2016: American Journal of Emergency Medicine
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