scholarly journals An Experimental Series Investigating the Effects of Hyperinsulinemic Euglycemia on Myocardial Blood Flow Reserve in Healthy Individuals and on Myocardial Perfusion Defect Size following ST-Segment Elevation Myocardial Infarction

2020 ◽  
Vol 33 (7) ◽  
pp. 868-877.e6
Author(s):  
Michael C.Y. Nam ◽  
Annelise L. Meneses ◽  
Christopher D. Byrne ◽  
Tuppence Richman ◽  
Jing Xian Quah ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Perfusion Defect ◽  
Defect Size ◽  
Healthy Individuals ◽  
Myocardial Perfusion Defect ◽  
St Segment Elevation ◽  
Segment Elevation Myocardial Infarction ◽  
Flow Reserve ◽  
St Segment ◽  
Myocardial Blood Flow Reserve

scholarly journals Prevalence of ECGs Exceeding Thresholds for ST‐Segment–Elevation Myocardial Infarction in Apparently Healthy Individuals: The Role of Ethnicity

2020 ◽  
Vol 9 (13) ◽  
Author(s):  
C. Cato ter Haar ◽  
Jan A. Kors ◽  
Ron J. G. Peters ◽  
Michael W. T. Tanck ◽  
Marieke B. Snijder ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Healthy Subjects ◽  
Urban Setting ◽  
Healthy Individuals ◽  
European Descent ◽  
St Segment Elevation ◽  
Segment Elevation Myocardial Infarction ◽  
St Segment ◽  
Western European ◽  
Apparently Healthy

Background Early prehospital recognition of critical conditions such as ST‐segment–elevation myocardial infarction (STEMI) has prognostic relevance. Current international electrocardiographic STEMI thresholds are predominantly based on individuals of Western European descent. However, because of ethnic electrocardiographic variability both in health and disease, there is a need to reevaluate diagnostic ST‐segment elevation thresholds for different populations. We hypothesized that fulfillment of ST‐segment elevation thresholds of STEMI criteria (STE‐ECGs) in apparently healthy individuals is ethnicity dependent. Methods and Results HELIUS (Healthy Life in an Urban Setting) is a multiethnic cohort study including 10 783 apparently healthy subjects of 6 different ethnicities (African Surinamese, Dutch, Ghanaian, Moroccan, South Asian Surinamese, and Turkish). Prevalence of STE‐ECGs across ethnicities, sexes, and age groups was assessed with respect to the 2 international STEMI thresholds: sex and age specific versus sex specific. Mean prevalence of STE‐ECGs was 2.8% to 3.4% (age/sex‐specific and sex‐specific thresholds, respectively), although with large ethnicity‐dependent variability. Prevalences in Western European Dutch were 2.3% to 3.0%, but excessively higher in young (<40 years) Ghanaian males (21.7%–27.5%) and lowest in older (≥40 years) Turkish females (0.0%). Ethnicity (sub‐Saharan African origin) and other variables (eg, younger age, male sex, high QRS voltages, or anterolateral early repolarization pattern) were positively associated with STE‐ECG occurrence, resulting in subgroups with >45% STE‐ECGs. Conclusions The accuracy of diagnostic tests partly relies on background prevalence in healthy individuals. In apparently healthy subjects, there is a highly variable ethnicity‐dependent prevalence of ECGs with ST‐segment elevations exceeding STEMI thresholds. This has potential consequences for STEMI evaluations in individuals who are not of Western European descent, putatively resulting in adverse outcomes with both over‐ and underdiagnosis of STEMI.

scholarly journals ST-Segment Elevation Myocardial Infarction and Normal Coronary Arteries after Consuming Energy Drinks

2017 ◽  
Vol 2017 ◽  
pp. 1-5 ◽  
Author(s):  
S. Michael Gharacholou ◽  
Nkechinyere Ijioma ◽  
Emma Banwart ◽  
Freddy Del Carpio Munoz
Keyword(s):  
Myocardial Infarction ◽  
Microvascular Disease ◽  
Energy Drinks ◽  
Cardiac Events ◽  
Additional Energy ◽  
St Segment Elevation ◽  
Segment Elevation Myocardial Infarction ◽  
Flow Reserve ◽  
Doppler Study ◽  
St Segment

The use of energy drinks, which often contain stimulants, is common among young persons, yet there have been few reports of adverse cardiac events. We report the case of a 27-year-old man who was admitted to our facility with an acute ST-segment elevation myocardial infarction in the setting of using energy drinks. Angiography revealed no obstructive coronary disease. The patient had elevation of cardiac troponin. Noninvasive testing with echocardiography and cardiac magnetic resonance imaging demonstrated both abnormalities in resting wall motion at the anterior apex along with late gadolinium enhancement of the anterior wall, respectively. The patient also underwent formal invasive evaluation with an intracoronary Doppler study demonstrating normal coronary flow reserve and acetylcholine provocation that excluded endothelial dysfunction and microvascular disease. The patient recovered and has abstained from consuming additional energy drinks with no reoccurrence of symptoms. A review of some of the potential cardiac risks associated with consuming energy drinks is presented.

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