Apical hypertrophic cardiomyopathy treated as ST-elevation myocardial infarction

CJEM ◽  
2017 ◽  
Vol 20 (S2) ◽  
pp. S51-S55 ◽  
Author(s):  
Christopher J. Parr ◽  
Rajat Sharma ◽  
Philip J. Garber
Keyword(s):  
Myocardial Infarction ◽  
Hypertrophic Cardiomyopathy ◽  
St Elevation Myocardial Infarction ◽  
Apical Hypertrophic Cardiomyopathy ◽  
St Segment Elevation ◽  
Coronary Syndrome ◽  
Coronary Arterial Disease ◽  
St Segment ◽  
St Elevation ◽  
Electrocardiographic Findings

AbstractElectrocardiographic changes resulting from apical hypertrophic cardiomyopathy may mimic an acute coronary syndrome. A 67-year-old Sudanese male without cardiac risk factors presented to hospital with chest pain and electrocardiographic findings of septal ST-segment elevation, ST-segment depression in V4-V6, and diffuse T-wave inversion. He was treated as an acute ST-elevation myocardial infarction with thrombolytics. There was no cardiac biomarker rise and coronary angiography did not reveal evidence of significant coronary arterial disease. Ventriculography, transthoracic echocardiography, and cardiac magnetic resonance imaging were consistent with apical hypertrophic cardiomyopathy. The patient was discharged three days later with outpatient cardiology follow-up. We highlight the clinical and electrocardiographic findings of apical hypertrophic cardiomyopathy, with an emphasis on distinguishing this from acute myocardial infarction.

scholarly journals High risk electrocardiographic patterns in patients with acute coronary syndrome.

2020 ◽  
Vol 2 (1) ◽  
pp. 25-34
Author(s):  
Diego Echeverri- Marín ◽  
Cristhian Felipe Ramirez Ramos ◽  
Andrés Miranda-Arboleda ◽  
Gustavo Castilla-Agudelo ◽  
Clara Saldarriaga-Giraldo
Keyword(s):  
Myocardial Infarction ◽  
Acute Myocardial Infarction ◽  
Reperfusion Therapy ◽  
Early Reperfusion ◽  
St Segment Elevation ◽  
Coronary Syndrome ◽  
Acute Coronary Occlusion ◽  
St Segment ◽  
St Elevation ◽  
Electrocardiographic Findings

Acute myocardial infarction is the leading cause of death in the world and the electrocardiogram remains the diagnostic tool for determining an acute myocardial infarction with ST-segment elevation. In spite of this, only half of the patients present classic electrocardiogram findings compatible with the ST-elevation infarction criteria. There is a spectrum of electrocardiographic findings that may reflect a phenomenon of acute coronary occlusion, which should be promptly recognized by the clinician to offer early reperfusion therapy.

scholarly journals Trends and in-hospital mortality of Acute Coronary Syndrome at Shahid Gangalal National Heart Centre, Kathmandu, Nepal during 2001-2012

2014 ◽  
Vol 3 (1) ◽  
pp. 23-26
Author(s):  
Chandra Mani Adhikari ◽  
Deewakar Sharma ◽  
Rabi Malla ◽  
Sujeeb Rajbhandari ◽  
Roshan Raut ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Acute Coronary Syndrome ◽  
Hospital Mortality ◽  
Unstable Angina ◽  
St Elevation Myocardial Infarction ◽  
St Segment Elevation ◽  
Coronary Syndrome ◽  
National Heart ◽  
St Segment ◽  
St Elevation

Background and aims: Acute coronary syndrome (ACS), which comprises acute ST-segment elevation myocardial infarction, non-ST segment elevation myocardial infarction and unstable angina is a major health problem and represents a large number of hospitalizations annually worldwide. We aim to describe pattern of the ACS admission and in-hospital mortality at tertiary national heart centre of the country. Methods: A hospital database was used to analyze all 7424 patients admitted in coronary care unit of the centre for ACS from September 2001 till December 2012. We evaluated trend of ACS admission and in-hospital mortality. Results: Five thousand three hundred ninety one (72.6%) were male and two thousand thirty three (27.4%) were female. Patient of 21years to 98 years were admitted for ACS .Four thousand five hundred and ninety nine(61.9%) patient were admitted due to ST elevation myocardial infarction, whereas one thousand nine hundred and thirteen (25.8%) were admitted for Unstable angina and nine hundred twelve (12.3%) were admitted for Non ST elevation myocardial infarction. In-hospital mortality was 5.74% for acute coronary syndrome. There was significant difference in in-hospital mortality between ST elevation myocardial infarction (7.76%), Non ST segment elevation acute coronary syndrome (3.61%) and Unstable Angina (1.88%).There is a gradual increase in Primary Percutaneous Coronary intervention as a mode of reperfusion therapy whereas there is a decrease in the rate of thrombolysis. Conclusion: Our study provides us some important information about the trend and in-hospital mortality rate in national heart centre. Though it is a single centre study can provide us the insight of the ACS outcome. DOI: http://dx.doi.org/10.3126/jaim.v3i1.10698 Journal of Advances in Internal Medicine 2014;03(01):23-26

The Value of Electrocardiographic Changes in Evaluating the Prognosis of Acute ST-Elevation Myocardial Infarction (STEMI) After PCI

2021 ◽  
Vol 7 (5) ◽  
pp. 1435-1442
Author(s):  
Yang Yang ◽  
Xiuyu Liang ◽  
Yuzhe Fan ◽  
Gendong Zhou ◽  
Xiaohong Zhang
Keyword(s):  
Myocardial Infarction ◽  
Evaluation Method ◽  
St Elevation Myocardial Infarction ◽  
Control Group ◽  
Observation Group ◽  
St Segment Elevation ◽  
St Segment ◽  
Thrombolytic Effect ◽  
St Elevation ◽  
The Difference

To explore the relationship between the changes of ECG indexes and the prognosis after PCI in patients with acute ST-elevation myocardial infarction (STEMI), and to develop the evaluation method and analyze the advantages and characteristics. 420 patients with acute myocardial infarction (AMI) were admitted to our hospital from March 2017 to April 2020. They were divided into the observation group (ST segment elevation type) with 220 patients and control group (non-ST segment elevation type) with 200 patients according to whether ST segment elevation was or not. ECG was detected before and 1 hour after operation, evaluation of thrombolytic effect, 6-minute walking test and echocardiography were performed 3 months after operation. Compared with the control group, the ECG of the observation group showed St Compared with the control group, the thrombolytic effect of the observation group was significantly improved, and the difference was statistically significant (P < 0.05); compared with the control group, the thrombolysis effect of the observation group was significantly improved, the difference was statistically significant (P < 0.05); ECG index can effectively reflect the recovery of cardiac function after PCI in patients with acute STEMI, and can effectively indicate the improvement of symptoms in patients with AMI, which is worthy of clinical application.

Telephonic transmission of 12-lead electrocardiograms during acute myocardial infarction

2005 ◽  
Vol 11 (4) ◽  
pp. 185-190 ◽  
Author(s):  
K Mischke ◽  
M Zarse ◽  
M Perkuhn ◽  
C Knackstedt ◽  
K Markus ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Acute Myocardial Infarction ◽  
Final Diagnosis ◽  
St Elevation Myocardial Infarction ◽  
Control Group ◽  
Call Centre ◽  
Coronary Syndrome ◽  
False Positive Diagnosis ◽  
St Segment ◽  
St Elevation

To test the feasibility of a small and simple system for telephonic transmission of 12-lead electrocardiograms (ECGs), 70 patients with acute coronary syndrome admitted to the cardiac care unit (CCU) were included in a feasibility study. The transmission system consisted of a belt with multiple electrodes, which was positioned around the chest. The ECG signal was sent to a call centre via a standard telephone line. In parallel, a standard 12-lead ECG was recorded on site. In a retrospective analysis, each lead of the transmitted ECG was compared with the on-site 12-lead ECG with regard to ST-segment changes and final diagnosis. In all 37 patients with acute ST-elevation myocardial infarction, the diagnosis was correctly established on the basis of telephone-transmitted ECGs. In 96% of limb and 88% of chest leads, ST elevations which were visible in standard ECGs were correctly displayed on telephonically transmitted ECGs. In the remaining 33 patients no false-positive diagnosis was made using transtelephonic ECG analysis. A control group of 31 patients without apparent heart disease showed high concordance between standard ECGs and telephonically transmitted ECGs. Telephonically transmitted 12-lead ECGs interpreted by a hospital-based internist/cardiologist might allow a rapid and accurate diagnosis of ST-elevation myocardial infarction and may increase diagnostic safety for the emergency staff during prehospital decision making and treatment of acute myocardial infarction.

scholarly journals Microfistulas Causing Diverse Regional Ischemia: Consecutive Inferior and Lateral ST-Elevation Myocardial Infarction

2020 ◽  
Vol 23 (10) ◽  
pp. 704-706
Author(s):  
Tufan Çınar ◽  
Yavuz Karabağ ◽  
İbrahim Rencuzogullari ◽  
Metin Cağdaş
Keyword(s):  
Myocardial Infarction ◽  
Coronary Artery ◽  
St Elevation Myocardial Infarction ◽  
Type I ◽  
St Segment Elevation ◽  
St Segment ◽  
Coronary Artery Fistulas ◽  
Clinical Consequences ◽  
Electrocardiographic Changes ◽  
St Elevation

Coronary artery fistulas (CAFs) are described as abnormal communications between a coronary artery and cardiac chambers, or other vascular structures. The two types of CAFs are defined as type I (singular fistula) and type II (microfistulas). Even though various electrocardiographic changes have been previously described in CAF patients, coronary-artery microfistulas causing ST-segment elevation in diverse locations have not been reported. We describe a case report of an adult patient who presented with acute inferior myocardial infarction due to coronary-artery microfistulas. During the hospital stay, the patient re-experienced chest pain, and control electrocardiography revealed ST-segment elevation in the I and AVL leads along with reciprocal ST-segment depression in the inferior precordial leads. Although CAFs are clinically rare, they can have important clinical consequences. Microfistulas should be kept in mind as a cause of ST elevation myocardial infarction in some patients.

scholarly journals A Comparative Study of St Segment Resolution between Diabetic and Non-Diabetic ST Segment Elevation Myocardial Infarction Patients following Streptokinase Thrombolysis

2019 ◽  
Vol 11 (2) ◽  
pp. 118-122
Author(s):  
Shahriar Iqbal ◽  
M Saiful Bari ◽  
MA Bari ◽  
Mirza Md Nazrul Islam ◽  
M Abdullah Al Shafi Majumder ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Myocardial Infarction ◽  
Thrombolytic Therapy ◽  
St Elevation Myocardial Infarction ◽  
Diabetic Patients ◽  
St Segment Elevation ◽  
Segment Elevation Myocardial Infarction ◽  
St Segment ◽  
St Elevation ◽  
Prolong Hospital Stay

Background: One of the most effective and used (in our settings) methods of reperfusion of ST elevation myocardial infarction (STEMI) is administration of streptokinase (SK) infusion. This study was conducted with the aim to compare ST segment resolution between diabetic and non-diabetic patients with ST segment elevation myocardial infarction after thrombolysis by streptokinase. Methods: A total of 100 patients with ST elevation myocardial infarction with or without diabetes mellitus were studied from December 2016 to November 2017. Among these half of patients were diabetic while rests were non-diabetic. Streptokinase was administered to all patients. Resolution (reduction) of elevated ST segment was evaluated after 90 min of streptokinase administration. Results: Failed reperfusion (<30% ST resolution) was significantly higher in diabetic as compared to nondiabetic patients (42% vs. 12%, p <0.001). In hospital complications were more in diabetic patients who has failed reperfusion following streptokinase thrombolysis. Cardiogenic shock occurred in 44% and acute LVF in 30% patients and EF (46.54%) was significantly lower in diabetic patients and higher number of diabetic patients had prolong hospital stay than non-diabetic patients with STEMI. Conclusion: The outcome of thrombolytic therapy is adversely affected by diabetes mellitus in patients with ST-elevation myocardial infarction. Cardiovasc. j. 2019; 11(2): 118-122

scholarly journals Apparent ST elevation in right bundle branch block pseudo-mimicking myocardial infarction

2019 ◽  
Vol 7 ◽  
pp. 2050313X1982774 ◽  
Author(s):  
Itsuro Kazama ◽  
Toshiyuki Nakajima
Keyword(s):  
Myocardial Infarction ◽  
Acute Coronary Syndrome ◽  
Right Bundle Branch Block ◽  
Cardiac Death ◽  
Close Monitoring ◽  
Bundle Branch Block ◽  
St Segment Elevation ◽  
Coronary Syndrome ◽  
St Segment ◽  
St Elevation

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. In such cases, close monitoring of the electrocardiogram findings and careful observation of the patient’s symptoms would be necessary.

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