Atypical symptoms of a fatal myocardial infarction in an elderly patient

2016 ◽  
Vol 16 (2) ◽  
pp. 279-281
Author(s):  
André Kueller ◽  
Hans-Joerg Hippe ◽  
Norbert Frey ◽  
Mark Luedde
Keyword(s):  
Myocardial Infarction ◽  
Elderly Patient ◽  
Atypical Symptoms ◽  
Fatal Myocardial Infarction

scholarly journals Recurrent Urosepsis and Cardiogenic Shock in an Elderly Patient with Pheochromocytoma

2011 ◽  
Vol 2011 ◽  
pp. 1-4 ◽  
Author(s):  
Joan Joo-Ching Khoo ◽  
Vanessa Shu-Chuan Au ◽  
Richard Yuan-Tud Chen
Keyword(s):  
Myocardial Infarction ◽  
Elderly Patient ◽  
Cardiogenic Shock ◽  
Older Patients ◽  
The Elderly ◽  
Hypertensive Patients ◽  
Catecholamine Excess ◽  
Effects Of Aging ◽  
Hypertensive Elderly Patient ◽  
Fatal Myocardial Infarction

Pheochromocytomas are thought to be uncommon in the elderly. However, the prevalence is likely to be higher than reported, as older patients are less likely to be diagnosed due to absence of classical symptoms of sympathetic overactivity and confounding effects of aging, comorbidities, and medications. We describe a hypertensive elderly patient with incidentally diagnosed pheochromocytoma complicated by recurrent urosepsis, cardiomyopathy, and fatal myocardial infarction. Our case demonstrates that, in older hypertensive patients without classical symptoms, orthostatic hypotension and urinary retention, which are common in the elderly, may indicate catecholamine excess and that the deleterious cardiovascular consequences of catecholamine excess in the elderly are not prevented by pharmacological α- and β-blockade.

Acute myocardial infarction in the neonatal period

2002 ◽  
Vol 12 (4) ◽  
pp. 411-413 ◽  
Author(s):  
S. Jothi Murugan ◽  
James Gnanapragasam ◽  
Joseph Vettukattil
Keyword(s):  
Myocardial Infarction ◽  
Left Coronary Artery ◽  
Neonatal Period ◽  
Acute Onset ◽  
Cardiac Centre ◽  
Electrocardiographic Changes ◽  
Echocardiographic Assessment ◽  
High Index Of Suspicion ◽  
Treatable Condition ◽  
Fatal Myocardial Infarction

AbstractWe describe two neonates presenting with myocardial infarction, due to two different aetiologies of this extremely rare but potentially treatable condition, and discuss the management. One neonate had myocardial infarction complicating enteroviral myocarditis and recovered completely. The second had fatal myocardial infarction due to thrombosis of the left coronary artery. Although rare, the attending paediatrician should have a high index of suspicion when evaluating a neonate with acute onset of collapse. Electrocardiographic changes are diagnostic, but further echocardiographic assessment and prompt management at a tertiary cardiac centre are advised.

Abstract 14029: New Findings in Women and Men Regarding Symptoms and Delay Times in Stemi

Circulation ◽  
2014 ◽  
Vol 130 (suppl_2) ◽  
Author(s):  
Eva Swahn
Keyword(s):  
Myocardial Infarction ◽  
Health Care ◽  
Chest Pain ◽  
Correct Diagnosis ◽  
Main Symptom ◽  
Atypical Symptoms ◽  
New Findings ◽  
Delay Times ◽  
Associated Symptoms ◽  
Prompt Diagnosis

Introduction: Myocardial infarction patients report higher prevalence of atypical symptoms in women, contributing to a less probability of a correct diagnosis. Studies exploring only the STEMI group where a prompt diagnosis is mandatory is lacking. We hypothesised that chest pain is equally common in women and men in a STEMI population. We further hypothesised that women have more associated symptoms than men in a STEMI population and thus a longer delay time. Methods: SymTime is a multicentre observational study where patients with a diagnosis of STEMI, admitted to CCUs where included. Within 24 h from admission they filled in a validated Swedish questionnaire, developed to measure how patients with MI describe their symptoms and actions in the pre-hospital phase. Results: 126 women and 406 men were included, mean age 70 and 64 (SD11) years respectively. After age adjustment, men had 5 times higher odds of having chest pain. Women had more symptoms in other typical locations. (Table) Only general feelings of illness (25 vs 13%, p = .001), fearfulness (31 vs 17 %, p.= 001) and nausea (49 vs 29 %, p < .001) were more common in women. Women had longer delay times from symptom onset to first medical contact, median time 1:30 hours: minutes vs 1:05 in men (p = 0.03). Conclusion: Women had significantly less chest pain, one reason for longer delay times in women. The prevalence of other typical MI symptoms such as pain in the chin/teeth, throat, shoulders, arms or back was higher in women. These findings should be communicated to the health care system as well as the community in order to get a prompt and correct diagnosis of STEMI in both genders. Table. Main symptom(s) in women and men with STEMI

Abstract 16233: Systemic Arterial Pulsatility Index is a Potential Metric for Microvascular Dysfunction

Circulation ◽  
2020 ◽  
Vol 142 (Suppl_3) ◽  
Author(s):  
Douglas Sawch ◽  
Benjamin Ruth ◽  
Sula Mazimba ◽  
Jamieson M Bourque ◽  
Kenneth C Bilchick ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Coronary Artery Disease ◽  
Pulsatility Index ◽  
Microvascular Dysfunction ◽  
Suspected Coronary Artery Disease ◽  
Continuous Variable ◽  
Coronary Microvascular Dysfunction ◽  
Chi Square ◽  
Artery Disease ◽  
Fatal Myocardial Infarction

Introduction: Coronary microvascular dysfunction is associated with both atherosclerosis and heart failure (HF). We aimed to evaluate the prognostic value of global coronary flow reserve (CFR) and systemic arterial pulsatility index, a metric of ventricular-arterial coupling, (SAPi = [systemic systolic pressure-systemic diastolic pressure]/pulmonary capillary wedge pressure) in patients with known or suspected coronary artery disease. Methods: This was a retrospective analysis at an academic tertiary care center for patients who underwent right heart catheterization (RHC) and positron emission tomography (PET) imaging within a 6 month period. Global CFR was evaluated with PET imaging and SAPi was calculated using cardiac hemodynamics from RHC. Patients were evaluated for endpoints of non-fatal myocardial infarction, revascularization, and death. Cox proportional hazards regression modeling was used to examine the associations between CFR & SAPi with death and other adverse cardiovascular events. Results: Among 74 patients with complete imaging and hemodynamic data (mean age 64.23 ± 11.18 years, 54.67% female) the mean SAPi was 4.87 ± 3.09 and CFR was 52.95 ± 16.17. Increased SAPi as a continuous variable trended towards decreased mortality [HR: 0.814 (95% CI 0.663-1.016, chi square 3.31, p=.07).] Increased CFR as a continuous variable was significantly associated with decreased mortality [HR: 0.964 (95% CI 0.936-0.993, chi square 6.03, p<0.05). Neither were associated with non-fatal myocardial infarction or early revascularization. There was a weak trend toward correlation between SAPi and CFR (r=0.19, p=0.11). Conclusions: SAPi a hemodynamic marker of ventricular arterial coupling was weakly associated with CFR. On the other hand, CFR was significantly associated with death in patients with known or suspected coronary artery disease. Future work is needed to assess the correlation between SAPi and coronary microvascular dysfunction.

CIGARETTE SMOKING AND NON-FATAL MYOCARDIAL INFARCTION IN WOMEN

1981 ◽  
Vol 113 (5) ◽  
pp. 575-582 ◽  
Author(s):  
WALTER C. WILLETT ◽  
CHARLES H. HENNEKENS ◽  
CHRISTOPHER BAIN ◽  
BERNARD ROSNER ◽  
FRANK E. SPEIZER
Keyword(s):  
Myocardial Infarction ◽  
Cigarette Smoking ◽  
Fatal Myocardial Infarction
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