75 results on '"Inferior Wall Myocardial Infarction etiology"'
Search Results
2. Acute inferior myocardial infarction due to a large thrombus in the Left coronary sinus of valsalva.
- Author
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Vadalà G, Sucato V, Micari A, and Galassi AR
- Subjects
- Aged, Humans, Inferior Wall Myocardial Infarction physiopathology, Male, Sinus of Valsalva physiopathology, Thrombosis physiopathology, Inferior Wall Myocardial Infarction etiology, Sinus of Valsalva abnormalities, Thrombosis complications
- Published
- 2022
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3. Papillary Muscle Rupture After Acute Inferior Myocardial Infarction.
- Author
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Singam NSV and Ghafghazi S
- Subjects
- Humans, Papillary Muscles diagnostic imaging, Heart Rupture, Heart Rupture, Post-Infarction diagnostic imaging, Heart Rupture, Post-Infarction etiology, Inferior Wall Myocardial Infarction diagnosis, Inferior Wall Myocardial Infarction etiology, Inferior Wall Myocardial Infarction therapy, Mitral Valve Insufficiency
- Published
- 2021
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4. Concomitant acute myocardial infarction and acute pulmonary embolism caused by paradoxical embolism: a case report.
- Author
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Chen W, Yu Z, Li S, Wagatsuma K, Du B, and Yang P
- Subjects
- Anticoagulants therapeutic use, Embolism, Paradoxical diagnostic imaging, Embolism, Paradoxical prevention & control, Female, Foramen Ovale, Patent diagnostic imaging, Foramen Ovale, Patent therapy, Humans, Inferior Wall Myocardial Infarction diagnostic imaging, Inferior Wall Myocardial Infarction prevention & control, Middle Aged, Pulmonary Embolism diagnostic imaging, Pulmonary Embolism prevention & control, Recurrence, ST Elevation Myocardial Infarction diagnostic imaging, ST Elevation Myocardial Infarction prevention & control, Secondary Prevention, Treatment Outcome, Embolism, Paradoxical etiology, Foramen Ovale, Patent complications, Inferior Wall Myocardial Infarction etiology, Pulmonary Embolism etiology, ST Elevation Myocardial Infarction etiology
- Abstract
Background: Due to its low incidence and diverse manifestations, paradoxical embolism (PDE) is still under-reported and is not routinely considered in differential diagnoses. Concomitant acute myocardial infarction (AMI) and acute pulmonary embolism (PE) caused by PDE has rarely been reported., Case Presentation: A 45-year-old woman presented with acute chest pain and difficulty with breathing. Multiple imaging modules including ECG, echocardiography, emergency cardioangiogram (CAG), and CT angiography of the pulmonary arteries showed acute occlusion of the posterolateral artery and acute PE. After coronary aspiration, no residual stenosis was observed. One month later, a bubble study showed inter-atrial communication via a patent foramen ovale (PFO). The AMI in this patient was finally attributed to PDE via the PFO. PFO closure was performed, and long-term anticoagulation was prescribed to prevent recurrent thromboembolic events., Conclusions: PDE via PFO is a rare etiology of AMI, especially in patients with concomitant AMI and PE. Clinicians should be vigilant of this possibility and close the inter-atrial channel for secondary prevention.
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- 2021
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5. Coronavirus disease 2019 (COVID-19) and simultaneous acute anteroseptal and inferior ST-segment elevation myocardial infarction.
- Author
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Yolcu M, Gunesdogdu F, Bektas M, Bayirli DT, and Serefhanoglu K
- Subjects
- Anterior Wall Myocardial Infarction diagnostic imaging, Anterior Wall Myocardial Infarction therapy, COVID-19 diagnosis, COVID-19 therapy, Heart Disease Risk Factors, Humans, Inferior Wall Myocardial Infarction diagnostic imaging, Inferior Wall Myocardial Infarction therapy, Prognosis, ST Elevation Myocardial Infarction diagnostic imaging, ST Elevation Myocardial Infarction therapy, Anterior Wall Myocardial Infarction etiology, COVID-19 complications, Inferior Wall Myocardial Infarction etiology, ST Elevation Myocardial Infarction etiology
- Abstract
Coronavirus disease 2019 (COVID-19) is a recently recognised pandemic spreading rapidly from Wuhan, Hubei, to other provinces in China and to many countries around the world. The number of COVID-19-related deaths is steadily increasing. Acute ST-segment elevation myocardial infarction (STEMI) is a disease with high morbidity and mortality rates, and primary percutaneous coronary intervention is usually recommended for the treatment. A patient with diabetes mellitus and hypertension for five years was admitted to the emergency unit with symptoms of fever, cough and dyspnoea. These symptoms were consistent with viral pneumonia and a COVID PCR test was performed, which tested positive three days later. The patient had chest pain on the eighth day of hospitalisation. On electrocardiography, simultaneous acute inferior and anterior STEMI were identified. High levels of stress and increased metabolic demand in these patients may lead to concomitant thrombosis of different coronary arteries, presenting with two different STEMIs.
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- 2020
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6. Type 2 Myocardial Infarction Resulted from the Left Thoracic Stomach.
- Author
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Shi Y and Zong Y
- Subjects
- Acute Disease, Aged, Benzamides therapeutic use, Coronary Stenosis diagnostic imaging, Coronary Stenosis drug therapy, Coronary Stenosis etiology, Electrocardiography, Esophagectomy methods, Esophagus diagnostic imaging, Gastric Dilatation diagnostic imaging, Gastric Dilatation drug therapy, Gastrointestinal Agents therapeutic use, Gastroparesis diagnostic imaging, Gastroparesis drug therapy, Gastroparesis etiology, Humans, Inferior Wall Myocardial Infarction diagnosis, Male, Morpholines therapeutic use, Stomach diagnostic imaging, Stomach Neoplasms surgery, Thoracic Cavity diagnostic imaging, Anastomosis, Surgical adverse effects, Esophagus surgery, Gastric Dilatation etiology, Inferior Wall Myocardial Infarction etiology, Stomach surgery
- Abstract
The universal definition of myocardial infarction (MI) provides five subtypes of acute myocardial infarction (AMI). We present an interesting case of a type 2 myocardial infarction caused by the dilation of the left thoracic stomach.
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- 2020
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7. Acute inferior myocardial infarction: the dilemma between anatomic-pathological classification and electrocardiographic diagnosis.
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Chia BL, Yip J, and Poh KK
- Subjects
- Coronary Artery Disease complications, Electrocardiography, Heart Ventricles anatomy & histology, Humans, Inferior Wall Myocardial Infarction classification, Inferior Wall Myocardial Infarction etiology, Inferior Wall Myocardial Infarction pathology, ST Elevation Myocardial Infarction classification, ST Elevation Myocardial Infarction etiology, ST Elevation Myocardial Infarction pathology, Coronary Artery Disease pathology, Heart Ventricles pathology, Inferior Wall Myocardial Infarction diagnosis, ST Elevation Myocardial Infarction diagnosis
- Published
- 2019
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8. Electrocardiographic Distinction of Left Circumflexand Right Coronary Artery Occlusion in PatientsWith Inferior Acute Myocardial Infarction.
- Author
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Vives-Borrás M, Maestro A, García-Hernando V, Jorgensen D, Ferrero-Gregori A, Moustafa AH, Solé-González E, Noriega FJ, Álvarez-García J, and Cinca J
- Subjects
- Case-Control Studies, Coronary Angiography, Coronary Occlusion complications, Female, Follow-Up Studies, Humans, Inferior Wall Myocardial Infarction etiology, Male, Middle Aged, Reproducibility of Results, Retrospective Studies, ST Elevation Myocardial Infarction etiology, Algorithms, Coronary Occlusion diagnosis, Coronary Vessels diagnostic imaging, Electrocardiography methods, Inferior Wall Myocardial Infarction diagnosis, ST Elevation Myocardial Infarction diagnosis
- Abstract
Previously reported electrocardiographic (ECG) criteria to distinguish left circumflex (LCCA) and right coronary artery (RCA) occlusion in patients with acute inferior ST-segment elevation myocardial infarction (STEMI) afford a modest diagnostic accuracy. We aimed to develop a new algorithm overcoming limitations of previous studies. Clinical, ECG, and coronary angiographic data were analyzed in 230 nonselected patients with acute inferior STEMI who underwent primary percutaneous coronary intervention. A decision-tree analysis was used to develop a new ECG algorithm. The diagnostic accuracy of reported ECG criteria was reviewed. LCCA occlusion occurred in 111 cases and RCA in 119. We developed a 3-step algorithm that identified LCCA and RCA occlusion with a sensitivity of 77%, specificity of 86%, accuracy of 82%, and Youden index of 0.63. The area under the ROC curve was 0.85 and resulted 0.82 after a 10-fold cross validation. The key leads for LCCA occlusion were V3 (ST depression in V3/ST elevation in III >1.2) and V6 (ST elevation ≥0.1 mV or greater than III). The key leads for RCA occlusion were I and aVL (ST depression ≥ 0.1 mV). Fifteen of 21 reviewed studies had less than 20 cases of LCCA occlusion, only 48% performed primary percutaneous coronary intervention, and previous infarction or multivessel disease were often excluded. The diagnostic accuracy of reported ECG criteria decreased when applied to our study population. In conclusion, we report a simple and highly discriminative 3-step ECG algorithm to differentiate LCCA and RCA occlusion in an "all comers" population of patients with acute inferior STEMI. The diagnostic key ECG leads were V3 and V6 for LCCA and I and aVL for RCA occlusion., (Copyright © 2019. Published by Elsevier Inc.)
- Published
- 2019
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9. Trespassing stent.
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Papitsas M, Walker N, Theodoropoulos KC, Monaghan MJ, and Papachristidis A
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- Aged, Aortic Dissection etiology, Coronary Angiography, Coronary Artery Bypass, Coronary Artery Disease complications, Coronary Artery Disease surgery, Coronary Vessels injuries, Coronary Vessels surgery, Device Removal, Echocardiography, Humans, Iatrogenic Disease, Inferior Wall Myocardial Infarction diagnosis, Inferior Wall Myocardial Infarction etiology, Inferior Wall Myocardial Infarction surgery, Prosthesis Failure adverse effects, Recovery of Function, Reoperation, ST Elevation Myocardial Infarction diagnosis, ST Elevation Myocardial Infarction etiology, ST Elevation Myocardial Infarction surgery, ST Elevation Myocardial Infarction therapy, Aortic Dissection surgery, Blood Vessel Prosthesis Implantation adverse effects, Coronary Artery Disease therapy, Inferior Wall Myocardial Infarction therapy, Stents adverse effects, Stroke etiology
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- 2019
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10. Leukemic Blast Clot Causing ST-Segment Elevation Myocardial Infarction.
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Skalidis E, Anastasiou I, Konstantinou I, Petousis S, Papadaki E, Drakos E, and Parthenakis F
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- Humans, Inferior Wall Myocardial Infarction diagnostic imaging, Inferior Wall Myocardial Infarction therapy, Leukemia, Myeloid, Acute pathology, Leukemia, Myeloid, Acute therapy, Male, Middle Aged, ST Elevation Myocardial Infarction diagnostic imaging, ST Elevation Myocardial Infarction therapy, Treatment Outcome, Inferior Wall Myocardial Infarction etiology, Leukemia, Myeloid, Acute complications, Myeloid Cells pathology, Neoplastic Cells, Circulating pathology, ST Elevation Myocardial Infarction etiology
- Published
- 2018
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11. Recurrent myocardial infarction in an aneurysmal coronary artery managed with stent grafts.
- Author
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Beijk MA, Henriques JPS, de Winter RJ, and Piek JJ
- Subjects
- Coronary Aneurysm complications, Coronary Aneurysm diagnostic imaging, Coronary Angiography, Humans, Inferior Wall Myocardial Infarction diagnostic imaging, Inferior Wall Myocardial Infarction etiology, Male, Middle Aged, Recurrence, ST Elevation Myocardial Infarction diagnostic imaging, ST Elevation Myocardial Infarction etiology, Treatment Outcome, Coronary Aneurysm surgery, Drug-Eluting Stents, Inferior Wall Myocardial Infarction surgery, Percutaneous Coronary Intervention instrumentation, ST Elevation Myocardial Infarction surgery
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- 2018
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12. A case report of acute inferior myocardial infarction in a patient with severe hemophilia A after recombinant factor VIII infusion.
- Author
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Zupančić-Šalek S, Vodanović M, Pulanić D, Skorić B, Matytsina I, and Klovaite J
- Subjects
- Adult, Humans, Male, Obesity, Morbid complications, Factor VIII therapeutic use, Hemophilia A complications, Hemophilia A drug therapy, Inferior Wall Myocardial Infarction diagnosis, Inferior Wall Myocardial Infarction etiology
- Abstract
Rationale: The extent of protective effects of hemophilia against thrombotic events such as myocardial infarction (MI) and other acute coronary syndromes remains to be determined, as major risk factors for cardiovascular disease exist despite factor VIII (FVIII) deficiency. We present a case report of a 41-year-old male with severe hemophilia A and several cardiovascular risk factors., Patient Concerns: This morbidly obese patient developed chest pressure, followed by chest pain and difficulty in breathing shortly after receiving on-demand treatment with intravenous recombinant FVIII (rFVIII) (turoctocog alfa) dosed per body weight., Diagnoses: An electrocardiogram revealed a diagnosis of inferior ST-segment elevation MI., Interventions: The patient underwent an urgent coronary angiography using a radial artery approach. During the next 12 months, he received dual antiplatelet treatment, acetylsalicylic acid 100 mg, and clopidogrel 75 mg daily. His treatment for severe hemophilia A was changed to plasma-derived FVIII replacement therapy., Outcomes: During this 12-month period, he experienced several small bleeds in his elbows., Conclusions: The temporal relationship between rFVIII infusion and onset of the MI suggests a possible association; however, apart from obesity, the patient also had other major risk factors for arterial thrombosis, such as hypertension and smoking. Furthermore, atherosclerotic disease and underlying atherosclerotic changes could not be excluded with certainty. This case highlights the importance of studies assessing the impact of excess body weight on rFVIII dosing., (Copyright © 2017 The Authors. Published by Wolters Kluwer Health, Inc. All rights reserved.)
- Published
- 2017
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13. Double right coronary artery in primary PCI: Finding the hidden treasure….
- Author
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Candilio L, Nerla R, and Byrne J
- Subjects
- Coronary Angiography, Coronary Occlusion complications, Coronary Occlusion diagnostic imaging, Coronary Vessel Anomalies diagnostic imaging, Drug-Eluting Stents, Female, Humans, Incidental Findings, Inferior Wall Myocardial Infarction diagnostic imaging, Inferior Wall Myocardial Infarction etiology, Middle Aged, ST Elevation Myocardial Infarction diagnostic imaging, ST Elevation Myocardial Infarction etiology, Treatment Outcome, Angioplasty, Balloon, Coronary instrumentation, Coronary Occlusion therapy, Coronary Vessel Anomalies complications, Inferior Wall Myocardial Infarction therapy, ST Elevation Myocardial Infarction therapy
- Abstract
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. Here we present a case of inferior STEMI in the context of double RCA, in which one of the two component branches was accidentally found after an "unexpected" jump of the coronary guidewire to treat what was initially considered the main vessel., (Copyright © 2017 Elsevier Inc. All rights reserved.)
- Published
- 2017
- Full Text
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14. Electrocardiogram in patients with acute inferior myocardial infarction due to occlusion of circumflex artery.
- Author
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Li Q, Wang DZ, and Chen BX
- Subjects
- Aged, Brugada Syndrome complications, Brugada Syndrome diagnostic imaging, Bundle-Branch Block complications, Cardiac Conduction System Disease, Coronary Disease complications, Coronary Disease diagnostic imaging, Coronary Occlusion complications, Coronary Vessels diagnostic imaging, Female, Heart Conduction System diagnostic imaging, Humans, Inferior Wall Myocardial Infarction etiology, Male, Middle Aged, Predictive Value of Tests, Retrospective Studies, Risk Factors, ST Elevation Myocardial Infarction etiology, Sensitivity and Specificity, Bundle-Branch Block diagnostic imaging, Coronary Occlusion diagnostic imaging, Electrocardiography methods, Inferior Wall Myocardial Infarction diagnostic imaging, ST Elevation Myocardial Infarction diagnostic imaging
- Abstract
To investigate the diagnostic value of electrocardiographic (ECG) ST-segment in acute inferior myocardial infarction (AIMI) caused by the left circumflex branch (LCX).A total of 240 clinical cases with AIMI in our hospital were retrospectively analyzed. All of them had received percutaneous coronary intervention (PCI) within 12 hours after symptom onset. The clinical features, ECG manifestations, and coronary artery lesion characteristics of the patients were collected.The right coronary artery (RCA) was shown to be the infarct-related artery (IRA) in 177 patients, while LCX was responsible for AIMI in 63 cases. There was no significant difference in the risk factors of coronary heart disease (CHD) (P > .05 for all) between the 2 groups. ST-segment elevation in lead II, III, and AVF could be found in all patients. Moreover, ST-segment depression in lead I (STD I), ST-segment elevation in lead III (STE III), STE III-STE II, STE AVF, STD AVL, STD AVL-STD I and STE v6 lead ST-segment deviation exhibited significant difference in 2 groups (P < .05 for all). The changes of STD I, STE III < STEII, STD AVL < STD I could discriminate between LCX and RCA in AIMI patients with high sensitivity and specificity.ECG may be an effective tool to predict the IRA in patient with AIMI.
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- 2017
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15. The "Chimney Sweep Technique" and Recurrent Coronary Artery Dissections.
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Kelly SC, Khan S, Sheikh M, Stys T, and Stys A
- Subjects
- Aged, Angioplasty, Balloon, Coronary adverse effects, Coronary Angiography, Coronary Restenosis diagnostic imaging, Coronary Restenosis etiology, Coronary Thrombosis diagnostic imaging, Coronary Thrombosis etiology, Coronary Vessel Anomalies diagnostic imaging, Female, Hematoma diagnostic imaging, Hematoma etiology, Humans, Inferior Wall Myocardial Infarction diagnostic imaging, Inferior Wall Myocardial Infarction etiology, Recurrence, Retreatment, ST Elevation Myocardial Infarction diagnostic imaging, ST Elevation Myocardial Infarction etiology, Time Factors, Treatment Outcome, Ultrasonography, Interventional, Vascular Diseases complications, Vascular Diseases diagnostic imaging, Angioplasty, Balloon, Coronary instrumentation, Coronary Restenosis therapy, Coronary Thrombosis therapy, Coronary Vessel Anomalies complications, Drug-Eluting Stents, Hematoma therapy, Inferior Wall Myocardial Infarction therapy, ST Elevation Myocardial Infarction therapy, Vascular Diseases congenital
- Abstract
We are reporting a case of a 65-year-old female who experienced three ST elevation myocardial infarctions (STEMI) during the course of 3 weeks. The first infarct was related to intramural coronary hematoma that propagated proximally after stenting, the second involved progression of this hematoma with obstruction of the vessel lumen, and the third caused subacute stent thrombosis that required "stent cleaning" using the inflated balloon technique., Competing Interests: Conflict of Interest Disclosure The authors have completed and submitted the Methodist DeBakey Cardiovascular Journal Conflict of Interest Statement and none were reported.
- Published
- 2017
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16. An Unusual Cause of ST-Segment Elevation Myocardial Infarction.
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Ferré Vallverdú M, Heredia Cambra T, Sanz Sánchez J, and Díez Gil JL
- Subjects
- Aged, Computed Tomography Angiography, Coronary Aneurysm diagnostic imaging, Coronary Aneurysm surgery, Coronary Angiography methods, Coronary Artery Bypass, Female, Humans, Inferior Wall Myocardial Infarction diagnostic imaging, Inferior Wall Myocardial Infarction surgery, Ligation, ST Elevation Myocardial Infarction diagnostic imaging, ST Elevation Myocardial Infarction surgery, Treatment Outcome, Coronary Aneurysm complications, Inferior Wall Myocardial Infarction etiology, ST Elevation Myocardial Infarction etiology
- Published
- 2017
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17. Pathologically dissimilar acute stent thromboses in a metal allergic patient.
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Konishi T, Hotta D, Funayama N, Yamamoto T, Nishihara H, and Tanaka S
- Subjects
- Aged, Biopsy, Coronary Angiography, Coronary Artery Disease complications, Coronary Artery Disease diagnostic imaging, Coronary Thrombosis diagnostic imaging, Humans, Hypersensitivity diagnosis, Hypersensitivity immunology, Inferior Wall Myocardial Infarction diagnostic imaging, Inferior Wall Myocardial Infarction etiology, Male, Metals immunology, Patch Tests, Prosthesis Design, Treatment Outcome, Ultrasonography, Interventional, Angioplasty, Balloon, Coronary adverse effects, Angioplasty, Balloon, Coronary instrumentation, Coronary Artery Disease therapy, Coronary Thrombosis etiology, Hypersensitivity etiology, Inferior Wall Myocardial Infarction therapy, Metals adverse effects, Stents adverse effects
- Published
- 2017
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18. Recurrent Vasospastic Myocardial Infarctions and Hand Necrosis.
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Rey F, Roffi M, Bouvet C, Bréguet R, Jandus P, and Rigamonti F
- Subjects
- Adult, Anterior Wall Myocardial Infarction diagnostic imaging, Anterior Wall Myocardial Infarction therapy, Cocaine-Related Disorders diagnosis, Coronary Angiography, Coronary Vasospasm diagnostic imaging, Drug-Eluting Stents, Hand pathology, Humans, Inferior Wall Myocardial Infarction diagnostic imaging, Inferior Wall Myocardial Infarction therapy, Male, Necrosis, Percutaneous Coronary Intervention instrumentation, Recurrence, Risk Factors, ST Elevation Myocardial Infarction diagnostic imaging, ST Elevation Myocardial Infarction therapy, Thromboangiitis Obliterans diagnostic imaging, Thromboangiitis Obliterans therapy, Time Factors, Tomography, Optical Coherence, Treatment Outcome, Anterior Wall Myocardial Infarction etiology, Cocaine-Related Disorders complications, Coronary Vasospasm etiology, Hand blood supply, Inferior Wall Myocardial Infarction etiology, ST Elevation Myocardial Infarction etiology, Thromboangiitis Obliterans etiology
- Published
- 2017
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19. Spontaneous coronary dissection: Optical coherence tomography insights before and after stenting.
- Author
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Homorodean C, Spinu M, Ober MC, Olinic M, and Olinic DM
- Subjects
- Coronary Angiography, Coronary Vessel Anomalies complications, Female, Humans, Inferior Wall Myocardial Infarction diagnostic imaging, Inferior Wall Myocardial Infarction etiology, Middle Aged, Predictive Value of Tests, ST Elevation Myocardial Infarction diagnostic imaging, ST Elevation Myocardial Infarction etiology, Treatment Outcome, Vascular Diseases complications, Vascular Diseases diagnostic imaging, Vascular Diseases therapy, Coronary Vessel Anomalies diagnostic imaging, Coronary Vessel Anomalies therapy, Drug-Eluting Stents, Percutaneous Coronary Intervention instrumentation, Tomography, Optical Coherence, Vascular Diseases congenital
- Published
- 2017
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20. Ascending aortic dissection presented as inferior myocardial infarction: a clinical and diagnostic mimicry.
- Author
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Alsaad AA, Odunukan OW, and Patton JN
- Subjects
- Aged, Aortic Dissection diagnosis, Aortic Aneurysm, Thoracic diagnosis, Coronary Angiography, Diagnosis, Differential, Echocardiography, Doppler, Electrocardiography, Female, Humans, Inferior Wall Myocardial Infarction diagnosis, Tomography, X-Ray Computed, Aortic Dissection complications, Aortic Aneurysm, Thoracic complications, Inferior Wall Myocardial Infarction etiology
- Abstract
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. The patient had an inferior STEMI due to the involvement of the right coronary artery as an extension of the ascending aortic dissection. In this era of protocol-driven practice and the pressure to fulfil quality measures, we aim to alert emergency physicians, cardiologists and interventionalists of the possible presentation of painless ascending aortic dissection as an STEMI. The two pathologies characterise by crucial differences in their initial and ultimate management., Competing Interests: Conflicts of Interest: None declared., (2016 BMJ Publishing Group Ltd.)
- Published
- 2016
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21. Kounis syndrome presenting with acute inferior wall myocardial infarction and cardiogenic shock secondary to intravenous ampicillin/sulbactam administration.
- Author
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Keskin M, Hayıroğlu Mİ, Onuk T, Keskin Ü, and Ekmekçi A
- Subjects
- Adult, Ampicillin administration & dosage, Ampicillin adverse effects, Anti-Bacterial Agents administration & dosage, Anti-Bacterial Agents adverse effects, Humans, Kounis Syndrome complications, Male, Myocardial Infarction, Sulbactam administration & dosage, Sulbactam adverse effects, Inferior Wall Myocardial Infarction etiology, Kounis Syndrome diagnosis, Shock, Cardiogenic etiology
- Published
- 2016
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22. Blunt traumatic dissection of right coronary artery presenting with acute inferior wall myocardial infarction: Dilemma in management.
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Pande A, Patra S, Jena M, and Chakraborty R
- Subjects
- Adult, Aortic Dissection diagnosis, Aortic Dissection surgery, Angioplasty, Balloon, Coronary methods, Coronary Aneurysm diagnosis, Coronary Aneurysm surgery, Coronary Angiography, Coronary Vessels diagnostic imaging, Diagnosis, Differential, Electrocardiography, Humans, Inferior Wall Myocardial Infarction diagnosis, Male, Stents, Thoracic Injuries diagnosis, Ultrasonography, Interventional, Wounds, Nonpenetrating diagnosis, Aortic Dissection complications, Coronary Aneurysm complications, Coronary Vessels injuries, Disease Management, Inferior Wall Myocardial Infarction etiology, Thoracic Injuries complications, Wounds, Nonpenetrating complications
- Abstract
Thirty-nine year male had a history of road traffic accident with polytrauma. At emergency room he started having chest pain with ventricular tachycardia. He was subsequentially diagnosed with right coronary artery dissection secondary to blunt trauma which is an extremely rare cause of inferior wall myocardial infarction. After some dilemmas, he was ultimately treated with intravascular ultrasound guided coronary angioplasty with stenting and had an uneventful recovery., (Copyright © 2016. Published by Elsevier B.V.)
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- 2016
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23. Ruptured intracardiac hydatid cyst presenting as acute coronary syndrome.
- Author
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Sharma P, Lakhia K, Malhotra A, and Garg P
- Subjects
- Acute Coronary Syndrome diagnosis, Acute Coronary Syndrome surgery, Albendazole therapeutic use, Anticestodal Agents therapeutic use, Cardiopulmonary Bypass, Coronary Angiography, Coronary Artery Bypass, Echinococcosis diagnosis, Echinococcosis drug therapy, Echinococcosis parasitology, Electrocardiography, Heart Diseases diagnosis, Heart Diseases drug therapy, Heart Diseases parasitology, Humans, Inferior Wall Myocardial Infarction diagnosis, Inferior Wall Myocardial Infarction surgery, Magnetic Resonance Imaging, Male, Middle Aged, Predictive Value of Tests, Rupture, Spontaneous, Treatment Outcome, Acute Coronary Syndrome etiology, Echinococcosis complications, Heart Diseases complications, Inferior Wall Myocardial Infarction etiology
- Abstract
Hydatid disease is a parasitic infection caused by the larvae of Echinococcus granulosus, which is still endemic in many developing countries. Cardiac involvement is rare but potentially very serious on account of various clinical presentations and nonspecific symptoms that occasionally mimic acute coronary syndrome. We describe a case of ruptured left ventricular hydatid cyst presenting as acute inferolateral myocardial infarction with electrocardiographic changes. Because coronary angiography revealed normal coronary arteries, the final diagnosis was made on the basis of echocardiography and magnetic resonance imaging. On-pump surgical resection followed by albendazole therapy yielded an excellent outcome., (© The Author(s) 2015.)
- Published
- 2016
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24. Two Cases of Pseudo Inferior Myocardial Infarction.
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Bhagwat N and Sahasrabuddhe S
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- Aged, Diabetes Complications diagnosis, Female, Humans, Hyperkalemia complications, Inferior Wall Myocardial Infarction etiology, Male, Middle Aged, Potassium blood, Electrocardiography, Heart Ventricles physiopathology, Hyperkalemia diagnosis, Inferior Wall Myocardial Infarction diagnosis
- Abstract
We report two cases of pseudo inferior wall myocardial infarction where ST segment elevation in inferior leads was caused by hyperkalemia and atrial tachycardia respectively. Only one case of pseudo inferior Ml caused by hyperkalemia has been reported so far and atrial tachycardia as a cause has hitherto been unreported., (© Journal of the Association of Physicians of India 2011.)
- Published
- 2016
25. A case of enoxaparin-induced thrombocytopaenia during treatment of acute myocardial infarction.
- Author
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Lim SY, Lee SR, Kim YH, Kim JS, Kim SH, Ahn JC, and Song WH
- Subjects
- Aged, Coronary Angiography, Coronary Occlusion diagnostic imaging, Coronary Occlusion etiology, Coronary Thrombosis complications, Coronary Thrombosis diagnostic imaging, Female, Humans, Inferior Wall Myocardial Infarction diagnostic imaging, Inferior Wall Myocardial Infarction etiology, Platelet Aggregation Inhibitors therapeutic use, ST Elevation Myocardial Infarction diagnostic imaging, ST Elevation Myocardial Infarction etiology, Thrombocytopenia blood, Thrombocytopenia diagnosis, Treatment Outcome, Ultrasonography, Interventional, Angioplasty, Balloon, Coronary, Anticoagulants adverse effects, Coronary Occlusion therapy, Coronary Thrombosis drug therapy, Enoxaparin adverse effects, Inferior Wall Myocardial Infarction therapy, ST Elevation Myocardial Infarction therapy, Thrombectomy, Thrombocytopenia chemically induced
- Abstract
Heparin-induced thrombocytopaenia is a life-threatening complication, affecting the morbidity and mortality of the patient if not properly treated. We report a case of a 75-year-old female patient who experienced enoxaparininduced thrombocytopaenia during medical treatment of acute ST-segment elevation myocardial infarction due to thrombotic total occlusion in the large right coronary artery.
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- 2016
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26. [Inferior myocardial infarction with extension to right ventricle secondary to giant right coronary artery aneurysm].
- Author
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Ramos Villalobos LE, Illescas González EA, Rivera Rodríguez A, Quiroz Martínez Martínez VA, Cano Zárate R, and Meave González A
- Subjects
- Adult, Humans, Male, Coronary Aneurysm complications, Heart Ventricles, Inferior Wall Myocardial Infarction etiology
- Published
- 2016
- Full Text
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27. Cor triatriatum dexter: More than a simple membrane.
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Martínez-Quintana E and Rodríguez-González F
- Subjects
- Female, Humans, Cor Triatriatum complications, Inferior Wall Myocardial Infarction etiology, Pulmonary Embolism etiology
- Published
- 2016
- Full Text
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28. Sarcoidosis or acute coronary syndrome: Easily distinguishable?
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Marley WD, Booth K, and Jeganathan R
- Subjects
- Aneurysm, False surgery, Aortic Aneurysm diagnosis, Aortic Aneurysm surgery, Aortitis diagnosis, Aortitis surgery, Aortography methods, Autopsy, Diagnostic Errors, Fatal Outcome, Humans, Inferior Wall Myocardial Infarction diagnosis, Inferior Wall Myocardial Infarction therapy, Male, Middle Aged, Predictive Value of Tests, Sarcoidosis diagnosis, Tomography, X-Ray Computed, Aneurysm, False etiology, Aortic Aneurysm etiology, Aortitis etiology, Inferior Wall Myocardial Infarction etiology, Sarcoidosis complications, Sinus of Valsalva diagnostic imaging, Sinus of Valsalva pathology, Sinus of Valsalva surgery
- Abstract
Sinus of Valsalva aneurysm is a rare presenting feature of ST-elevation myocardial infarction. We describe such a case which resolved with thrombolysis, and on further investigation, the patient was found to have a large sinus of Valsalva aneurysm. Abnormal gross pathology at the time of surgery was suspected to be aortitis which was only confirmed on postmortem examination 6 months later. We highlight the importance of working closely with a pathologist when aortitis is suspected, because failure to treat it medically results in a poor outcome., (© The Author(s) 2014.)
- Published
- 2016
- Full Text
- View/download PDF
29. Cor triatriatum dexter in adults: Clinical implications.
- Author
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Hussain ST and Pettersson GB
- Subjects
- Female, Humans, Cor Triatriatum complications, Inferior Wall Myocardial Infarction etiology, Pulmonary Embolism etiology
- Published
- 2016
- Full Text
- View/download PDF
30. Coronary Embolization from a Left Atrial Myxoma Containing Malignant Lymphoma Cells.
- Author
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Pineda AM, Mihos CG, Nascimento FO, Santana O, Lamelas J, and Beohar N
- Subjects
- Angioplasty, Balloon, Coronary, Biomarkers, Tumor analysis, Biopsy, Coronary Angiography, Electrocardiography, Embolism diagnosis, Embolism therapy, Heart Atria pathology, Heart Neoplasms chemistry, Heart Neoplasms pathology, Heart Neoplasms surgery, Humans, Immunohistochemistry, Inferior Wall Myocardial Infarction diagnosis, Inferior Wall Myocardial Infarction therapy, Lymphoma chemistry, Lymphoma pathology, Lymphoma surgery, Male, Middle Aged, Myxoma chemistry, Myxoma pathology, Myxoma surgery, Neoplastic Cells, Circulating chemistry, Treatment Outcome, Embolism etiology, Heart Neoplasms complications, Inferior Wall Myocardial Infarction etiology, Lymphoma complications, Myxoma complications, Neoplasms, Multiple Primary, Neoplastic Cells, Circulating pathology
- Abstract
Systemic embolization from a primary cardiac tumor is a relatively frequent presentation. However, an acute myocardial infarction due to coronary embolization is rarely seen. We offer an unusual case of a 50-year-old man who presented with severe angina and was diagnosed with an inferolateral ST-segment-elevation myocardial infarction. Aside from otherwise healthy coronary arteries, his coronary angiogram revealed an acute occlusion of the first obtuse marginal branch, which was treated with balloon angioplasty. Because no residual plaque or dissection was found after the angioplasty, an embolic source was suspected. An echocardiogram then revealed a large mobile left atrial myxoma prolapsing into the left ventricle, so the patient underwent minimally invasive resection. Detailed pathologic examination of the myxoma revealed a concomitant high-grade B-cell lymphoma.
- Published
- 2015
- Full Text
- View/download PDF
31. A very late thrombosis in a bioresorbable vascular scaffold.
- Author
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Giacchi M, Pedrazzini G, Moccetti T, and Moccetti M
- Subjects
- Adult, Coronary Angiography, Coronary Thrombosis diagnosis, Drug-Eluting Stents, Humans, Inferior Wall Myocardial Infarction diagnosis, Inferior Wall Myocardial Infarction therapy, Male, Platelet Aggregation Inhibitors administration & dosage, Prosthesis Design, Recurrence, Retreatment, Sirolimus administration & dosage, Sirolimus analogs & derivatives, Thrombectomy, Time Factors, Tomography, Optical Coherence, Treatment Outcome, Absorbable Implants, Coronary Thrombosis therapy, Inferior Wall Myocardial Infarction etiology, Percutaneous Coronary Intervention adverse effects, Percutaneous Coronary Intervention instrumentation, Prosthesis Failure
- Published
- 2015
- Full Text
- View/download PDF
32. Echocardiographic assessment of global longitudinal right ventricular function in patients with an acute inferior ST elevation myocardial infarction and proximal right coronary artery occlusion.
- Author
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Hutyra M, Skála T, Horák D, Köcher M, Tüdös Z, Zapletalová J, Přeček J, Louis A, Smékal A, and Táborský M
- Subjects
- Aged, Area Under Curve, Coronary Occlusion complications, Coronary Occlusion pathology, Coronary Occlusion physiopathology, Female, Humans, Hypotension etiology, Hypotension physiopathology, Inferior Wall Myocardial Infarction etiology, Inferior Wall Myocardial Infarction pathology, Inferior Wall Myocardial Infarction physiopathology, Magnetic Resonance Imaging, Male, Middle Aged, Myocardium pathology, Predictive Value of Tests, Prognosis, Prospective Studies, ROC Curve, Recovery of Function, Time Factors, Ventricular Dysfunction, Right etiology, Ventricular Dysfunction, Right pathology, Ventricular Dysfunction, Right physiopathology, Coronary Occlusion diagnostic imaging, Echocardiography, Doppler, Inferior Wall Myocardial Infarction diagnostic imaging, Myocardial Contraction, Ventricular Dysfunction, Right diagnostic imaging, Ventricular Function, Right
- Abstract
Right ventricular (RV) myocardial infarction (MI) is a frequent concomitant of an acute inferior MI. We set out to determine the diagnostic value of speckle tracking echocardiography in comparison with cardiac magnetic resonance (CMR) for RV stunning and scar prediction. 55 patients (66 ± 11 years) with an acute inferior ST elevation MI who underwent percutaneous coronary intervention (PCI) of an occlusion in the proximal right coronary artery were prospectively enrolled. An echocardiography was done on the day of presentation and on the 5th day thereafter. A CMR was subsequently performed 1 month after the MI. The CMR was used to differentiate between the group with RV scar (n = 26) and without RV scar (n = 29). RV peak systolic longitudinal strain (RV-LS) at presentation determined RV scar (-21.1 ± 5.1% vs. -9.9 ± 4.6%, p < 0.0001). The RV-LS correlated with the scar extent (r = 0.83, p < 0.0001). RV-LS > -15.8% had a sensitivity of 92% and a specificity of 83% in RV scar prediction (AUC 0.93). RV-LS was superior to TAPSE and TDI in determining the presence of RV scar. According to RV-LS values at presentation and on the 5th day, 3 subgroups were defined: G1-normal deformation (RV-LS <-20%), G2-RV stunning (baseline RV-LS >-20%, 5th day RV-LS <-20%) and G3-persistent RV dysfunction (unchanged RV-LS > -20%). In G1, there was neither RV scar nor clinically relevant hypotension. In G2, 58% of patients developed RV scar and 36% had hypotension. In the G3, 83% developed RV scar and 55% had hypotension. The myocardial deformation analysis could provide an early prediction of RV scar. It allowed the patients to be divided into subgroups with normal RV function, stunning and persistent RV dysfunction.
- Published
- 2015
- Full Text
- View/download PDF
33. Cor triatriatum dexter: a rare cause of myocardial infarction and pulmonary embolism in a young adult.
- Author
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Hussain ST, Mawulawde K, Stewart RD, and Pettersson GB
- Subjects
- Cor Triatriatum diagnosis, Cor Triatriatum surgery, Echocardiography, Doppler, Color, Female, Humans, Inferior Wall Myocardial Infarction diagnosis, Pulmonary Embolism diagnosis, Treatment Outcome, Young Adult, Cor Triatriatum complications, Inferior Wall Myocardial Infarction etiology, Pulmonary Embolism etiology
- Published
- 2015
- Full Text
- View/download PDF
34. Acute inferior myocardial infarction after electrical weapon exposure: case report and review of the literature.
- Author
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Belen E, Tipi FF, Bayyiğit A, and Helvacı AŞ
- Subjects
- Acute Disease, Adult, Electrocardiography, Humans, Male, Conducted Energy Weapon Injuries etiology, Inferior Wall Myocardial Infarction etiology
- Abstract
The use of conducted electrical weapons (CEWs) by legal security forces and in civil society is rapidly increasing. While they are generally considered safe devices, and fatal complications are rare, it is possible to see a small number of complications. In the present case, we describe the detection of acute inferior myocardial infarction in a patient who experienced chest pain after being exposed to a CEW. In such cases, multiple factors should be considered, and the choice of treatment and follow-up should be decided accordingly.
- Published
- 2015
- Full Text
- View/download PDF
35. Acute myocardial infarction after Kawasaki disease.
- Author
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Kobayashi Y, Kobayashi Y, and Hirohata A
- Subjects
- Aged, Coronary Angiography methods, Coronary Occlusion diagnosis, Coronary Occlusion therapy, Female, Humans, Inferior Wall Myocardial Infarction diagnosis, Inferior Wall Myocardial Infarction therapy, Mucocutaneous Lymph Node Syndrome diagnosis, Percutaneous Coronary Intervention, Recurrence, Time Factors, Tomography, X-Ray Computed, Treatment Outcome, Ultrasonography, Interventional, Coronary Occlusion etiology, Inferior Wall Myocardial Infarction etiology, Mucocutaneous Lymph Node Syndrome complications
- Published
- 2014
- Full Text
- View/download PDF
36. Triad of emboli in acute flare of ulcerative colitis.
- Author
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Kelly ME, Dodd J, and Barry M
- Subjects
- Acute Disease, Adult, Anti-Inflammatory Agents, Non-Steroidal therapeutic use, Antibodies, Monoclonal therapeutic use, Ataxia etiology, Brain Infarction diagnosis, Chest Pain etiology, Colitis, Ulcerative drug therapy, Confusion etiology, Diplopia etiology, Drug Therapy, Combination, Endocardium pathology, Follow-Up Studies, Gastrointestinal Agents therapeutic use, Glucocorticoids therapeutic use, Humans, Inferior Wall Myocardial Infarction diagnosis, Infliximab, Intermittent Claudication etiology, Male, Occipital Lobe blood supply, Rare Diseases, Thromboembolism complications, Thromboembolism diagnosis, Treatment Outcome, Brain Infarction etiology, Colitis, Ulcerative complications, Femoral Artery, Inferior Wall Myocardial Infarction etiology, Popliteal Artery, Thromboembolism etiology
- Abstract
Arterial thrombosis is rare in ulcerative colitis (UC). Our case report described a triad of arterial emboli in a UC patient who presented with bilateral lower limb claudication associated acute chest pain, confusion, ataxia and diplopia. Investigations confirmed bilateral femoral and popliteal artery occlusion, occipital infarct and a sub-endocardial infarct secondary to embolic disease.
- Published
- 2014
37. Unusual ECG pattern of the acute inferior wall infarction due to RCA occlusion with concomitant LAD and LCX disease.
- Author
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Hirapur I, Veeranna RM, and Agrawal N
- Subjects
- Angioplasty, Balloon, Coronary, Coronary Occlusion therapy, Humans, Inferior Wall Myocardial Infarction etiology, Inferior Wall Myocardial Infarction therapy, Male, Middle Aged, Coronary Occlusion complications, Electrocardiography, Inferior Wall Myocardial Infarction physiopathology
- Published
- 2014
- Full Text
- View/download PDF
38. Dilated cardiomyopathy with inferior wall myocardial infarction: a rare presentation of Takayasu arteritis.
- Author
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Dwivedi SK, Kharwar RB, Mehrotra A, Saran M, Chandra S, and Saran RK
- Subjects
- Cardiomyopathy, Dilated diagnosis, Coronary Angiography, Diagnosis, Differential, Echocardiography, Humans, Inferior Wall Myocardial Infarction diagnosis, Male, Multidetector Computed Tomography, Takayasu Arteritis diagnosis, Young Adult, Cardiomyopathy, Dilated etiology, Inferior Wall Myocardial Infarction etiology, Takayasu Arteritis complications
- Published
- 2014
- Full Text
- View/download PDF
39. Primary percutaneous intervention in a patient with anterior and inferior wall myocardial infarction because of a rare coronary artery anomaly.
- Author
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Gupta MD, Girish MP, Pandit BN, and Tyagi S
- Subjects
- Adult, Coronary Angiography methods, Coronary Vessel Anomalies classification, Coronary Vessel Anomalies diagnostic imaging, Humans, Inferior Wall Myocardial Infarction diagnostic imaging, Inferior Wall Myocardial Infarction etiology, Male, Tomography, X-Ray Computed, Treatment Outcome, Coronary Vessel Anomalies complications, Inferior Wall Myocardial Infarction therapy, Percutaneous Coronary Intervention
- Published
- 2014
- Full Text
- View/download PDF
40. Acute inferior wall myocardial infarction secondary to ruptured sinus of Valsalva aneurysm in a 22-year-old man.
- Author
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Sun HP, Ma X, Bai X, Ujit K, and Ma YT
- Subjects
- Aortic Rupture diagnosis, Aortic Rupture surgery, Cardiac Surgical Procedures, Coronary Angiography, Humans, Inferior Wall Myocardial Infarction diagnosis, Inferior Wall Myocardial Infarction therapy, Male, Percutaneous Coronary Intervention, Thrombectomy, Treatment Outcome, Young Adult, Aortic Rupture complications, Inferior Wall Myocardial Infarction etiology, Sinus of Valsalva diagnostic imaging, Sinus of Valsalva surgery
- Published
- 2014
- Full Text
- View/download PDF
41. Acute myocardial infarction: an uncommon complication of takotsubo cardiomyopathy.
- Author
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Angulo-Llanos R, Sanz-Ruiz R, Solis J, and Fernández-Avilés F
- Subjects
- Aged, Coronary Angiography, Female, Humans, Inferior Wall Myocardial Infarction diagnosis, Inferior Wall Myocardial Infarction physiopathology, Inferior Wall Myocardial Infarction therapy, Magnetic Resonance Imaging, Takotsubo Cardiomyopathy diagnosis, Takotsubo Cardiomyopathy physiopathology, Takotsubo Cardiomyopathy therapy, Time Factors, Treatment Outcome, Inferior Wall Myocardial Infarction etiology, Takotsubo Cardiomyopathy complications
- Abstract
Transient left ventricular apical ballooning or Takotsubo syndrome (TS) is characterized by transient left ventricular dysfunction, electrocardiographic changes that mimic acute myocardial infarction (AMI), and minimal release of myocardial enzymes, with no evidence of obstructive coronary artery disease. Although prognosis and outcome are relatively good, reported complications include intraventricular thrombi and embolic events. We report an extremely rare case of AMI complicating the early in-hospital course of a patient with TS., (Copyright © 2013 Wiley Periodicals, Inc.)
- Published
- 2013
- Full Text
- View/download PDF
42. Takotsubo syndrome: a call to action.
- Author
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Tobis J
- Subjects
- Female, Humans, Inferior Wall Myocardial Infarction etiology, Takotsubo Cardiomyopathy complications
- Published
- 2013
- Full Text
- View/download PDF
43. A rare case of myocardial infarction related to diagnostic intravascular ultrasound.
- Author
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Otsuji K, Kamezaki F, Sonoda S, Kashiyama K, Muraoka Y, Tsuda Y, Araki M, Okazaki M, Takeuchi M, and Otsuji Y
- Subjects
- Aged, Anticoagulants therapeutic use, Biomarkers blood, Coronary Angiography, Coronary Occlusion blood, Coronary Occlusion diagnosis, Coronary Occlusion drug therapy, Coronary Thrombosis blood, Coronary Thrombosis diagnosis, Coronary Thrombosis drug therapy, Electrocardiography, Heparin therapeutic use, Humans, Inferior Wall Myocardial Infarction blood, Inferior Wall Myocardial Infarction diagnosis, Inferior Wall Myocardial Infarction drug therapy, Male, Time Factors, Tomography, Optical Coherence, Treatment Outcome, Troponin T blood, Coronary Occlusion etiology, Coronary Thrombosis etiology, Inferior Wall Myocardial Infarction etiology, Ultrasonography, Interventional adverse effects
- Abstract
A 71-year-old man underwent intracoronary stent implantation for acute inferior myocardial infarction (MI). Immediately after diagnostic intravascular ultrasound (IVUS) at 8 months' follow-up, an acute occlusion of the sinus node (SN) artery appeared, which developed sinus arrest with junctional escape rhythm. The serum level of high-sensitivity troponin T (TpT) was markedly elevated on the day after the procedure (2.1-32.5 ng/l), which was indicative of MI related to IVUS. Under continuous intravenous infusion of unfractionated heparin, the escape rhythm changed to lower atrial rhythm on the 4th day, and recovered to sinus rhythm on the 14th day. Coronary angiography (CAG) on 15th day showed a recanalization of the SN artery, but optical coherence tomography identified that disrupted plaque and white thrombus still existed in the ostium of the SN artery. The patient was discharged on maintenance anticoagulation therapy. We hypothesized from this case that IVUS-related myocardial injury may exist without clinical problems. Our retrospective investigation showed that the median levels of high-sensitivity TpT in 20 patients who underwent CAG and subsequent diagnostic IVUS significantly increased from 0.6 (interquartile range 0.3-1.1) to 1.6 (0.7-3.6) ng/l (P < 0.05), suggesting that IVUS may induce very low levels of myocardial injury. In conclusion, we experienced a rare case of IVUS-related MI caused by an acute occlusion of the SN artery. This case reaffirms that we should pay more attention to manipulation of IVUS catheters.
- Published
- 2013
- Full Text
- View/download PDF
44. Pathophysiology and ECG patterns of isolated right ventricular infarction with nondominant right coronary artery.
- Author
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Iannetta L, Puddu PE, Missiroli B, Morabito G, Grillo P, De Gregorio C, and Schiariti M
- Subjects
- Angioplasty, Balloon, Coronary instrumentation, Anterior Wall Myocardial Infarction diagnosis, Coronary Angiography, Coronary Vessel Anomalies diagnosis, Coronary Vessel Anomalies physiopathology, Diagnosis, Differential, Diagnostic Errors prevention & control, Humans, Inferior Wall Myocardial Infarction etiology, Inferior Wall Myocardial Infarction physiopathology, Inferior Wall Myocardial Infarction therapy, Male, Middle Aged, Predictive Value of Tests, Stents, Treatment Outcome, Coronary Vessel Anomalies complications, Electrocardiography, Heart Ventricles physiopathology, Inferior Wall Myocardial Infarction diagnosis, Ventricular Function, Right
- Abstract
The prevalence of isolated right ventricular infarction is 0.4-2.4% in autopsy series and may occur by at least three different mechanisms, of which occlusion of a nondominant right coronary artery is reviewed here. Although rare, as oxygen demand/supply of the right is lower than that of the left ventricle, due to the smaller muscular mass, and it has a good prognosis, sudden death and cardiac rupture have been reported. Differential diagnosis with anterior infarction is needed. ECG may help but specific criteria should be adopted: dome-like and decreasing ST segment elevation from V1 to V3 leads; rapid ST segment normalization and no Q wave evolution from V1 to V3 leads, either accompanied or not by modest ST segment elevation in DIII (but not aVF) evolving in no Q wave; ST segment elevation in right-sided leads which should be explored; absence of ST segment depression in aVL; absent concomitant ST segment elevation in all inferior leads (DII, DIII, aVF). Applying these criteria may prevent erroneous management of right ventricular infarction if it is confused with left ventricular infarction. Right ventricular function evaluation should always be performed by echocardiography. Magnetic resonance imaging should be useful. An illustrative case and an ECG flow-chart are presented.
- Published
- 2013
- Full Text
- View/download PDF
45. Kounis syndrome: inferior ST-segment elevation myocardial infarction following a bumblebee sting.
- Author
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Zanini G, Fontanella B, Racheli M, Bortolotti M, and Pasini GF
- Subjects
- Animals, Anti-Allergic Agents, Coronary Angiography, Coronary Vessels drug effects, Electrocardiography, Humans, Inferior Wall Myocardial Infarction diagnosis, Inferior Wall Myocardial Infarction etiology, Inferior Wall Myocardial Infarction immunology, Inferior Wall Myocardial Infarction therapy, Male, Middle Aged, Stents, Syndrome, Treatment Outcome, Allergens, Anaphylaxis drug therapy, Anaphylaxis etiology, Anaphylaxis immunology, Angioplasty, Balloon, Coronary methods, Bee Venoms immunology, Bees, Chlorpheniramine administration & dosage, Hydrocortisone administration & dosage, Insect Bites and Stings complications, Insect Bites and Stings immunology
- Abstract
The Kounis syndrome was first described in 1991 as'the allergic angina syndrome'which could progress to acute myocardial infarction which was named'allergic myocardial infarction. There are several causes underlying this syndrome including drugs, various conditions and a variety of environmental exposure factors such as animal stings. Hymenoptera stings can induce Kounis syndrome because hymenoptera venom contains allergenic proteins and peptides. The following case report describes a patient who experienced an anaphylactic shock associated with coronary artery ischaemia (inferior ST-segment elevation myocardial infarction) after a bumblebee sting.
- Published
- 2013
- Full Text
- View/download PDF
46. Correlation of severity of ST segment elevation with respect to the site of right coronary artery lesion.
- Author
-
Simkhada R
- Subjects
- Adult, Aged, Aged, 80 and over, Coronary Angiography, Coronary Artery Disease complications, Female, Humans, Inferior Wall Myocardial Infarction etiology, Male, Middle Aged, Severity of Illness Index, Coronary Artery Disease physiopathology, Coronary Vessels, Electrocardiography, Inferior Wall Myocardial Infarction physiopathology
- Abstract
Introduction: Electrocardiogram a widely available tool may predict infarct related artery in acute inferior wall myocardial infarction. Severity of ST segment elevation may correlate with proximity of lesion in right coronary artery., Methods: Patient with acute ST segment elevation inferior wall myocardial infarction who underwent coronary angiogram was studied. Differences in electrocardiogram among right coronary and left circumflex groups were evaluated. Severity of ST segments elevation in relation to site of lesion in right coronary was studied., Results: The mean age of presentation was 59.52 ± 11.01 years. Total 36 (72%) were men. A total of 42 (84%) had lesion in right and 8 (16%) in left circumflex. Age, sex,diabetes,hypertension, smoking, dyslipidemia and physical activity showed no correlation with lesion in right or circumflex coronary artery. ST segment elevation in III>II (P=0.01), ST segment depression in AVL> I (P<0.01) and ST elevation in V4R (P=0.04), correlated with right coronary lesion. Sum of ST elevation in inferior leads were 10.90 ±1.30 mm for proximal, 7.38±1.19 mm for mid and 5.50± 0.53 mm for distal right coronary with significant correlation (P<0.01)., Conclusions: Electrocardiogram was reliable tool to difference right and left circumflex lesion. Severity of sum of ST segment elevations in inferior leads correlated with the proximity of lesion in right coronary.
- Published
- 2013
47. Intracoronary thrombolytic therapy: a treatment option for failed mechanical thrombectomy.
- Author
-
Gallagher S, Jain AK, and Archbold RA
- Subjects
- Aged, Coronary Angiography, Coronary Thrombosis complications, Coronary Thrombosis diagnostic imaging, Coronary Thrombosis physiopathology, Female, Humans, Inferior Wall Myocardial Infarction diagnostic imaging, Inferior Wall Myocardial Infarction etiology, Inferior Wall Myocardial Infarction physiopathology, Injections, Intra-Arterial, Suction, Tenecteplase, Time Factors, Treatment Failure, Vascular Patency, Coronary Thrombosis therapy, Fibrinolytic Agents administration & dosage, Inferior Wall Myocardial Infarction therapy, Thrombectomy methods, Thrombolytic Therapy, Tissue Plasminogen Activator administration & dosage
- Abstract
The benefit of the routine application of aspiration thrombectomy in primary percutaneous coronary intervention (PPCI) is now well established. The optimal management of patients who have "failed" thrombectomy characterized by a large residual thrombus burden after repeated mechanical thrombectomy, however, is not known. We report a case of failed aspiration thrombectomy in a 66-year-old woman who was admitted to our institution with chest pain associated with inferior ST segment elevation. Coronary angiography showed a thrombotic occlusion of the right coronary artery. Aspiration thrombectomy did little to reduce thrombus load and so the patient was treated with intracoronary tenecteplase. Repeat coronary angiography 18 hr later revealed marked thrombus resolution with thrombolysis in myocardial infarction (TIMI) grade 3 anterograde flow and patency of the infarct-related artery was maintained at 2-month follow up. This case demonstrates the potential for intracoronary thrombolytic therapy as a treatment option for the management of patients following failed thrombectomy in PPCI., (Copyright © 2011 Wiley Periodicals, Inc.)
- Published
- 2012
- Full Text
- View/download PDF
48. Acute myocardial infarction following a possible direct intravenous bite of Russell's viper (Daboia russelli).
- Author
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Silva A, Pilapitiya S, and Siribaddana S
- Subjects
- Acute Disease, Adult, Animals, Fatal Outcome, Humans, Inferior Wall Myocardial Infarction physiopathology, Inferior Wall Myocardial Infarction therapy, Male, Snake Bites physiopathology, Snake Bites therapy, Sri Lanka, Inferior Wall Myocardial Infarction etiology, Daboia, Snake Bites complications, Viper Venoms
- Abstract
Background: Russell's viper (Daboia russelli) bites lead to high morbidity and mortality in South Asia. Although variety of clinical manifestations is reported in viper bite victims, myocardial ischemic events are rare., Case Presentation: We report a unique case of inferior wall ST elevation myocardial infarction due to a Russell's viper bite over a vein with possible direct intravenous envenoming, in a young male with no past history or family history suggestive of ischemic cardiac disease, from Sri Lanka. In addition, the possible mechanisms of myocardial ischemia in snake bite victims are also briefly discussed., Conclusion: Importance of the awareness of physicians on the rare, yet fatal manifestations of snake envenoming is highlighted.
- Published
- 2012
- Full Text
- View/download PDF
49. Single coronary artery from the right coronary sinus with proximal origin of the left anterior descending coronary artery and left circumflex as distal continuation of the right coronary artery: a rare variant.
- Author
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Subban V, Victor SM, Ajit MS, and Kalidoss L
- Subjects
- Aged, Coronary Angiography, Coronary Vessel Anomalies complications, Heart Defects, Congenital complications, Humans, Inferior Wall Myocardial Infarction etiology, Male, Percutaneous Coronary Intervention, Sinus of Valsalva diagnostic imaging, Coronary Vessel Anomalies diagnosis, Coronary Vessels diagnostic imaging, Heart Defects, Congenital diagnosis, Inferior Wall Myocardial Infarction diagnosis, Sinus of Valsalva abnormalities
- Abstract
A single coronary artery is a rare coronary anomaly. A 68-year-old male underwent coronary angiography for recent inferior wall myocardial infarction. It revealed a common coronary trunk arising from the right sinus of Valsalva and bifurcated into the right coronary artery (RCA) and anterior descending coronary arteries. The RCA, after its usual distribution in the right atrioventricular groove, continued as the left circumflex artery in the left atrioventricular groove. There were significant stenoses in the mid and distal RCA, which were treated percutaneously.
- Published
- 2012
- Full Text
- View/download PDF
50. Ectatic left circumflex artery with fistula to coronary sinus presenting with inferior wall myocardial infarction.
- Author
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Vivek G, Naha K, Ramachandran P, and Rajagopal KV
- Subjects
- Arterio-Arterial Fistula diagnosis, Coronary Angiography, Coronary Sinus, Diagnosis, Differential, Electrocardiography, Humans, Inferior Wall Myocardial Infarction diagnosis, Male, Middle Aged, Tomography, X-Ray Computed, Arterio-Arterial Fistula complications, Coronary Vessels, Inferior Wall Myocardial Infarction etiology
- Abstract
Coronary arteriovenous fistulae are a rare but potentially curable cause of ischaemic heart disease and should be considered as a differential diagnosis especially in patients lacking classical risk factors for coronary artery disease. We discuss one such case of cardiac ischaemia resulting from a coronary arteriovenous fistula. While there are sporadic case reports of similar patients in medical literature, our patient is the first reported case of ST-elevation myocardial infarction secondary to the fistulous connection.
- Published
- 2012
- Full Text
- View/download PDF
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