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https://www.readbyqxmd.com/read/28993840/impact-of-right-ventricular-diastolic-dysfunction-on-clinical-outcomes-in-inferior-stemi
#1
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
#2
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
#3
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
#4
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
#5
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...
August 16, 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
#6
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
#7
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
#8
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
#9
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
#10
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
#11
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
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
#12
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...
December 1, 2017: International Journal of Cardiology
https://www.readbyqxmd.com/read/28684393/critical-aortic-stenosis-presenting-as-stemi
#13
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
#14
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...
August 2017: Canadian Journal of Cardiology
https://www.readbyqxmd.com/read/28617040/complete-atrioventricular-block-in-acute-coronary-syndrome-prevalence-characterisation-and-implication-on-outcome
#15
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
#16
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
#17
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
#18
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
#19
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
#20
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
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