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Itsuro Kazama, Toshiyuki Nakajima
We report a case of right bundle branch block, in which the patient's symptoms and the electrocardiogram findings mimicked those of acute coronary syndrome. In this case report, we stress the significance of apparent ST segment elevation in right bundle branch block. The differential diagnosis is important because right bundle branch block is often complicated with acute coronary syndrome. In addition, right bundle branch block with an ST segment elevation in the specific leads can be a predictor of sudden cardiac death...
2019: SAGE Open Medical Case Reports
Safri, Wan Nishfa Dewi, Erwin
OBJECTIVE: Electrocardiogram (ECG) is currently considered as an important diagnostic tool to monitor and evaluate patients with cardiovascular disease. This study aims to determine and analyze ECG recording patients with cardiovascular disease and analyze the specific characteristics of ECG for each cardiovascular diseases with and without complication. METHOD: This study applied descriptive study with 23 samples of outpatients with cardiovascular disease with and without complication selected using purposive sampling technique...
February 16, 2019: Enfermería Clínica
Moon-Seung Soh, Jin-Sun Park, Kyoung-Woo Seo, Hyoung-Mo Yang, Hong-Seok Lim, Byoung-Joo Choi, So-Yeon Choi, Myeong-Ho Yoon, Gyo-Seung Hwang, Seung-Jea Tahk, Joon-Han Shin
Elevated visit-to-visit blood pressure variability (BPV), independent of mean BP, has been associated with cardiovascular events. However, its impact after ST-elevation myocardial infarction (STEMI) has not been established. This study aimed to investigate the prognostic impact of BPV on patients after STEMI. We analyzed the data and clinical outcomes of STEMI survivors who underwent successful primary coronary intervention from 2003 to 2009. BP was measured at discharge and at 1, 3, 6, 12, 24, and 36 months, and we calculated BPV as the intra-individual standard deviations (SDs) of systolic BP (SBP) across these measurements...
February 18, 2019: Journal of Human Hypertension
Sophie Z Gu, Weiliang Qiu, Jonathan A Batty, Hannah Sinclair, Murugapathy Veerasamy, Salvatore Brugaletta, Dermot Neely, Gary Ford, Patrick A Calvert, Gary S Mintz, Vijay Kunadian
AIMS: The association of frailty with coronary plaque phenotype among older patients with non-ST-elevation acute coronary syndrome (NSTEACS) is not known and was evaluated in this study. METHODS AND RESULTS: Older patients with NSTEACS for invasive angiography were recruited. Frailty was measured using Fried Frailty Score. Following angiography, patients underwent grey scale and virtual histology intravascular ultrasound (VH-IVUS). Of the 90 patients, 26 (28.9%) were robust, 49 (54...
February 19, 2019: EuroIntervention
Kenneth Mangion, David Carrick, Guillaume Clerfond, Christopher Rush, Christie McComb, Keith G Oldroyd, Mark C Petrie, Hany Eteiba, Mitchell Lindsay, Margaret McEntegart, Stuart Hood, Stuart Watkins, Andrew Davie, Daniel A Auger, Xiaodong Zhong, Frederick H Epstein, Caroline E Haig, Colin Berry
OBJECTIVE: We hypothesized that Displacement Encoding with Stimulated Echoes (DENSE) and feature-tracking derived circumferential strain would provide incremental prognostic value over the extent of infarction for recovery of segmental myocardial function. METHODS: Two hundred and sixty-one patients (mean age 59 years, 73% male) underwent MRI 2 days post-ST elevation myocardial infarction (STEMI) and 241 (92%) underwent repeat imaging 6 months later. The MRI protocol included cine, 2D-cine DENSE, T2 mapping and late enhancement...
March 2019: European Journal of Radiology
Yang Fu, Xin-Shun Gu, Guo-Zhen Hao, Yun-Fa Jiang, Wei-Ze Fan, Yan-Ming Fan, Qing-Min Wei, Xiang-Hua Fu, Yong-Jun Li
OBJECTIVE: To evaluate efficacy, safety and feasibility of targeted intracoronary injection using pro-urokinase combined with anisodamine (TCA) versus thrombus aspiration (TA) in ST-elevation myocardial infarction (STEMI) patients with high thrombus loads. BACKGROUND: The best method of avoiding thrombus detachment and stroke in PCI patients with high thrombus loads has not yet been established. METHODS: STEMI patients receiving coronary artery angiography or percutaneous coronary intervention (CAG/PCI) with thrombus grade ≥ 3 from January 1, 2017 to June 30, 2018 were randomly assigned to targeted intracoronary thrombolysis (pro-urokinase and anisodamine via catheter (TCA) group), or the TA group which followed the standard thrombus aspiration procedure...
February 17, 2019: Catheterization and Cardiovascular Interventions
Michael Andrews, Javaid Iqbal, Joshua J Wall, Dawn Teare, Magdi El-Omar, Farzin Fath-Ordoubadi, Julian Gunn
BACKGROUND: Primary percutaneous coronary intervention (PPCI) is the default treatment for patients with ST elevation myocardial infarction (STEMI) and carries a higher risk of adverse outcomes when compared with elective and urgent PCI. Conventional PCI risk scores tend to be complex and may underestimate the risk associated with PPCI due to under-representation of patients with STEMI in their datasets. This study aimed to develop a simple, practical and contemporary risk model to provide risk stratification in PPCI...
December 27, 2018: Cardiovascular Revascularization Medicine: Including Molecular Interventions
Mahek Shah, Shantanu Patil, Soumya Patnaik, Manyoo Agrawal, Brijesh Patel, Byomesh Tripathi, Ulrich Jorde, Carl Lavie
We reviewed 54,044 adult cases of cardiogenic shock (CS) accompanying acute coronary syndrome from the 2005 to 2014 Nationwide Inpatient Sample. We evaluated outcomes among patients who were nonobese, obese (body mass index 30.0 to 39.9 kg/m2 ) and extremely-obese (body mass index ≥40 kg/m2 ). A multivariate analysis was performed to assess their impact on in-hospital mortality. There were 3,602 (6.6%) and 1,610 (2.9%) admissions among patients who were obese and extremely-obese. Those obese and extremely-obese were younger compared with the nonobese (62...
January 24, 2019: American Journal of Cardiology
Khola Tahir, Eric Pauley, Xuming Dai, Sidney C Smith, Craig Sweeney, George A Stouffer
ST elevation myocardial infarction (STEMI) occurring in patients hospitalized for a noncardiac condition is associated with a high mortality rate and thus we sought to determine the mechanisms underlying STEMI in this patient population. This is a single center retrospective study of 70 patients who had STEMI while hospitalized on a noncardiac service and underwent coronary angiography. Thrombotic in-hospital STEMI was defined by angiographic or intravascular imaging evidence of intracoronary thrombus, plaque rupture, or stent thrombosis...
February 7, 2019: American Journal of Cardiology
Sophie Z Gu, Benjamin Beska, Danny Chan, Dermot Neely, Jonathan A Batty, Jennifer Adams-Hall, Helen Mossop, Weiliang Qiu, Vijay Kunadian
Background Dementia is a growing health burden of an aging population. This study aims to evaluate the prevalence of cognitive impairment and the predictors of cognitive decline at 1 year in older patients with non-ST-elevation acute coronary syndrome undergoing invasive care. Methods and Results Older patients with non-ST-elevation acute coronary syndrome were recruited into the ICON1 study. Cognition was evaluated using Montreal Cognitive Assessment. The composite major adverse cardiovascular events comprised death, myocardial infarction, unplanned revascularization, stroke, and significant bleeding at 1 year...
February 19, 2019: Journal of the American Heart Association
Hans-Josef Feistritzer, Ingo Eitel, Alexander Jobs, Suzanne de Waha-Thiele, Thomas Stiermaier, Mohamed Abdel-Wahab, Philipp Lurz, Sebastian J Reinstadler, Martin Reindl, Gert Klug, Bernhard Metzler, Steffen Desch, Holger Thiele
Data derived from several studies suggest a better survival in smokers with acute myocardial infarction, a phenomenon referred to as the 'smoker's paradox'. We aimed to investigate the association of smoking with cardiac magnetic resonance (CMR) imaging determined infarct severity and major adverse cardiac events (MACE) defined as the occurrence of death, reinfarction, and congestive heart failure at 12 months in patients with non-ST-elevation myocardial infarction (NSTEMI) reperfused by early percutaneous coronary intervention (PCI)...
February 15, 2019: International Journal of Cardiovascular Imaging
A H Tavenier, R S Hermanides, J P Ottervanger, S Rasoul, R J Slingerland, R Tolsma, S van Workum, E Kedhi, A W J van 't Hof
BACKGROUND: Fast and accurate platelet inhibition is an important therapeutic goal in the acute treatment of patients with ST-elevation myocardial infarction (STEMI). Platelet inhibitory effects induced by oral P2Y12-receptor antagonists are delayed in STEMI patients undergoing primary percutaneous coronary intervention (PCI) due to haemodynamic changes and delayed gastro-intestinal absorption. Concomitant use of opioids, although recommended in the American College of Cardiology/American Heart Association and European Society of Cardiology STEMI guidelines, further delays gastro-intestinal absorption...
February 14, 2019: Netherlands Heart Journal
Iain Mactier, Jonathan R Dalzell, David Carrick
CLINICAL INTRODUCTION: A 50-year-old woman presented with an inferoposterior ST-elevation myocardial infarction (STEMI) and underwent emergency percutaneous coronary intervention (PCI). Angiography revealed acute occlusion of the circumflex and right coronary (RCA) arteries. PCI was uncomplicated. Her medical history included asthma, hypertension and chronic sinusitis.Three months later, she presented with a non-STEMI (NSTEMI), and angiogram showed a new focal stenosis in the left anterior descending artery...
February 14, 2019: Heart: Official Journal of the British Cardiac Society
Alexandra Saunders, Robert S Stevenson
A 70-year-old man with known coronary artery disease presented with crushing chest pain, diaphoresis, and pallor after consuming a marijuana lollipop; the pain began within 30 minutes of consumption. His troponin T increased from 94 ng/L to 216 ng/L, with slight ST changes but no gross ST elevations. Discharge diagnosis was non-ST-elevation myocardial infarction, and subsequent nuclear medicine wall motion studies showed worsening ejection fraction (40% to 31%). He also described worsening functional status and exercise capacity after the event...
February 2019: Canadian Journal of Cardiology
Graham C Wong, Michelle Welsford, Craig Ainsworth, Wael Abuzeid, Christopher B Fordyce, Jennifer Greene, Thao Huynh, Laurie Lambert, Michel Le May, Sohrab Lutchmedial, Shamir R Mehta, Madhu Natarajan, Colleen M Norris, Christopher B Overgaard, Michele Perry Arnesen, Ata Quraishi, Jean François Tanguay, Mouheiddin Traboulsi, Sean van Diepen, Robert Welsh, David A Wood, Warren J Cantor
Rapid reperfusion of the infarct-related artery is the cornerstone of therapy for the management of acute ST-elevation myocardial infarction (STEMI). Canada's geography presents unique challenges for timely delivery of reperfusion therapy for STEMI patients. The Canadian Cardiovascular Society/Canadian Association of Interventional Cardiology STEMI guideline was developed to provide advice regarding the optimal acute management of STEMI patients irrespective of where they are initially identified: in the field, at a non-percutaneous coronary intervention-capable centre or at a percutaneous coronary intervention-capable centre...
February 2019: Canadian Journal of Cardiology
Xianjun Xue, Jing Kan, Jun-Jie Zhang, Nailiang Tian, Fei Ye, Song Yang, Hong Qu, Shao-Liang Chen
BACKGROUND: Differences in the predictors between ventricular septal rupture (VSR) and free wall rupture (FWR) have not been fully studied. Data on the prevalence and clinical outcome of heart rupture are limited. HYPOTHESIS: This study aimed to investigate heart rupture incidence and clinical results in patients with acute myocardial infarction (AMI). METHODS: Of 9265 AMI patients in the MOODY registry between March 1999 and October 2016, a total of 146 were studied...
January 23, 2019: Cardiovascular Revascularization Medicine: Including Molecular Interventions
Asad Shabbir, Lampson Fan, Gregory Fraser, Mark Philip Cassar, Jon Swinburn
The latest European Society of Cardiology guideline on the management of acute coronary syndromes without persistent ST-elevation stipulates several acceptable pathways through which patients presenting with chest pain can be assessed for unstable coronary disease. This article reviews the data behind the "rule-in and rule-out algorithm," which can exclude acute myocardial infarction within 1 hour of presentation through the use of fifth generation high-sensitivity troponin assays.
March 2019: Critical Pathways in Cardiology
Amer Harky, Mohamad Bashir, Ciaran Grafton-Clarke, Martin Lees, Sarah Fendius, Neil Roberts
Intraventricular conduction abnormalities following cardiac surgery have been thoroughly described, especially after valvular surgery. It is also widely known that several anesthetic factors can cause autonomic disturbances resulting in the unmasking of sinus node dysfunction, significant bradycardia, and cardiovascular collapse during the intraoperative period. However, little is known about asymptomatic episodes, especially those occurring prior to coronary artery bypass grafting (CABG). We report a rare occurrence of an intraventricular conduction defect that presented in an asymptomatic patient following non-ST-elevation myocardial infarction prior to urgent CABG...
July 2018: Journal of Tehran Heart Center
Ji Quan Samuel Koh, Himawan Fernando, Karlheinz Peter, Dion Stub
BACKGROUND: Traditionally, opioids have been the analgesia of choice for patients with ST-Elevation Myocardial Infarction (STEMI). Recent studies, however, have raised the possibility of harmful effects of opioid administration through delayed onset of antiplatelet agents. OBJECTIVE: To perform a systematic review of the effects of parenteral opioids in patients presenting with STEMI. METHODS: Medical databases were systematically searched to 28 February 2018...
February 1, 2019: Heart, Lung & Circulation
Sarah R Blake, Adeel Shahzad, Suneil K Aggarwal, Abhishek Kumar, Adnan Khan, Rod H Stables
BACKGROUND: Recent randomized controlled trials comparing femoral and radial access in primary percutaneous coronary intervention (PPCI) have shown conflicting results regarding the incidence of major adverse cardiovascular events (MACE) and major bleeding. METHODS: Using data from the HEAT-PPCI trial, we compared the primary efficacy (all-cause mortality, stroke, new myocardial infarction or unplanned repeat revascularization) and safety (major bleeding BARC 3-5) outcomes at 28 days, by final access site used (radial or femoral) and by default operator type...
January 16, 2019: American Heart Journal
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