scholarly journals Reversible myocardial oedema due to acute myocardial infarction as differential diagnosis of cardiac transthyretin amyloidosis

2020 ◽  
Vol 7 (4) ◽  
pp. 1987-1991
Author(s):  
Nina Makivic ◽  
Claudia Stöllberger ◽  
Thomas Nakuz ◽  
Birke Schneider ◽  
Christine Schmid ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Acute Myocardial Infarction ◽  
Differential Diagnosis ◽  
Myocardial Oedema ◽  
Transthyretin Amyloidosis

Fibrinolysis of an Acute Myocarditis Mimicking an Acute Myocardial Infarction

2020 ◽  
Author(s):  
Safir Soukaina
Keyword(s):  
Myocardial Infarction ◽  
Acute Myocardial Infarction ◽  
Differential Diagnosis ◽  
Cardiac Magnetic Resonance ◽  
Magnetic Resonance ◽  
Acute Myocarditis ◽  
Clinical Signs ◽  
Acute Onset ◽  
St Segment Elevation ◽  
The Difference

Background: Acute myocarditis and acute myocardial infarction have frequently similar clinical presentations and poses an important clinical challenge in the differential diagnosis. In both cases, the electrocardiographic ST-T changes and an increase in troponins can be noted. Differential diagnosis may be very challenging and requires invasive assessment of coronary arteries and other investigations especially cardiac magnetic resonance. Case Presentation: In this report, we report a rare case of acute myocarditis misdiagnosed to an acute myocardial infarction in a patient presented to the emergency department for an acute onset of chest pain with ST-segment elevation on electrocardiogram for which he received urgent fibrinolysis. The confirmation of acute myocarditis was confirmed posteriori after a normal coronary angiogram using cardiac Magnetic Resonance Imaging cMRI. Conclusions: Clinical signs as long with Electrocardiogram may mimick a ST elevation myocardial infarction in the presence of an authentic acute myocarditis,Hence, cardiac magnetic resonance could present an intersting tools to make the difference even in acute phase.

scholarly journals MANIFESTATION OF COVID-19 IN THE FORM OF ACUTE MYOCARDIAL INFARCTION (case report)

2020 ◽  
Vol 7 (4) ◽  
pp. 180-183
Author(s):  
Olga Kadykova ◽  
M. Koshkina
Keyword(s):  
Myocardial Infarction ◽  
Acute Myocardial Infarction ◽  
Differential Diagnosis ◽  
Clinical Picture ◽  
Myocardial Damage ◽  
Cardiovascular Complications ◽  
Objective Data ◽  
Myocardial Mass ◽  
St Segment ◽  
Complicated Course

Acute myocardial infarction is necrosis of any myocardial mass due to ischemia. COVID-19 can be complicated by thrombosis and myocardial damage, which can lead to the deployment of a clinical picture similar to acute myocardial infarction. The material of this article is presented on the example of a clinical case. A woman aged 37 was diagnosed with an acute myocardial infarction, which later turned out to be a manifestation of a complicated course of coronavirus COVID-19 infection. This case drew attention to the absence of a clinical picture specific to this infection in the form of a damage to the respiratory system or intoxication. The case is also distinguished by the presence of a single uncharacteristic clinical manifestation of COVID-19 in the form of a cardiovascular event with elevations of the ST segment on the cardiogram and other objective data and additional research methods characteristic of acute myocardial infarction. The work also analyzed the pathogenetic mechanisms of acute myocardial infarction and cardiovascular complications of COVID-19, examined the general links of pathogenesis of these two pathological units and analyzed the causes of difficulties in their differential diagnosis. In this regard, there are unquestionably complications of differential diagnosis and the prescription of timely correct therapy. A deeper understanding of these data may improve the algorithms for diagnosing acute myocardial infarction and cardiovascular complications of COVID-19.

P3690Plasma levels of cardiac-specific micro-RNA mir-1 and mir-133a differ in patients with acute myocardial infarction and takotsubo cardiomyopathy

2019 ◽  
Vol 40 (Supplement_1) ◽  
Author(s):  
V Novosadov ◽  
T N Vlasik ◽  
M Y A Ruda ◽  
D V Pevsner ◽  
I N Rybalkin ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Acute Myocardial Infarction ◽  
Differential Diagnosis ◽  
Takotsubo Cardiomyopathy ◽  
Plasma Levels ◽  
Heart Attack ◽  
Mrna Levels ◽  
Coronary Syndrome ◽  
Technical Specifications ◽  
And Control

Abstract Background Takotsubo cardiomyopathy (TTC) is an acute, life-threatening condition which is typically induced by stress and manifested by chest pain and ECG changes. The TTC prevalence among patients (pts) with acute coronary syndrome is 1.7–2.2%. The mortality rate from TTC is up to 8%. TTC is clinically indistinguishable from acute myocardial infarction (AIM). Differential diagnosis of TTC and AIM remains an unresolved problem. Recent studies have shown the differences in profiles of plasma microRNAs inTTC and AIM. Purpose To evaluate the possibility of differentiating TTC and AIM using a PCR-based semi-quantitative analysis of mRNAs, the plasma levels of which had been shown to be increased in patients with AIM (miR-1, miR-208a, miR-133a, miR-499a) and TTC (miR-16, miR-26a). Methods Plasma from 38 pts was used: 13 pts with confirmed TTC (12 women, 1 man), 25 pts with AIM (9w, 16m). For 10 pts with AIM, blood was collected twice: at 6 and 24 hours after the heart attack. The control arm comprised 40 healthy people from the same age group (12w, 28m). Plasma was obtained using the Cell-Free DNA blood collection tubes. Nucleic acids were separated using a modified Boom method. A semi-quantitative assessment of the mRNA levels was performed using dCq method with stem-loop qRT-PCR. Normalization for spiked synthetic cel-miR-39 and endogenous miR-23a was performed. Control of hemolysis was performed by measuring the ratio of miR-451 (specific for RBCs) and miR-23a (absent from RBCs). The statistical significance of differences between mRNA levels was assessed using Mann–Whitney test. Results No significant differences in the levels of miR-16, miR-26a and miR-208a in TTC group and control group have been found. Pts with AIM significantly differed from pts with TTC (p=0.0038 and 0.0002, respectively) and control pts (p=3.1x10–9 and 2,66x10–10) with the increased levels of cardiac-specific miR-1 and miR-133a. As compared to plasma levels at 6 hours after the heart attack, at 24-hour point the levels of these mRNAs were markedly reduced in 9 of 10 pts (mean reduction was 22.3-fold for miR-133a and 7.5-fold for miR-1). The correlation between changes in the levels of these mRNAs was high (Spearman correlation coefficient=0.89). Significant differences in plasma levels of miR-133a between pts with AIM and TTC were maintained even if blood was collected after 24 hours (p=0.007). For miR-16 and miR-26a, no significant differences between pts with AIM and TTC were found. The results of analysis of these mRNAs are affected to a substantial degree by the residual hemolysis due to their high content in blood cells. Conclusions It was shown that measuring the plasma levels of mRNAs miR-1 and miR-133a allows to distinguish TTC from AIM by excluding the diagnosis of TTC. The differential diagnosis is possible only within several hours after acute clinical symptoms and requires proper normalization and full compliance with the technical specifications.

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