Acute Myocardial Infarction after Heart Irradiation in Young Patients with Hodgkin's Disease

CHEST Journal ◽  
1989 ◽  
Vol 95 (2) ◽  
pp. 388-390 ◽  
Author(s):  
Heikki Joensuu
Keyword(s):  
Myocardial Infarction ◽  
Acute Myocardial Infarction ◽  
Hodgkin's Disease ◽  
Hodgkin’S Disease ◽  
Young Patients

Screening for Coronary Artery Disease After Mediastinal Irradiation for Hodgkin's Disease

2007 ◽  
Vol 26 (1) ◽  
pp. 43-49 ◽  
Author(s):  
Paul A. Heidenreich ◽  
Ingela Schnittger ◽  
H. William Strauss ◽  
Randall H. Vagelos ◽  
Byron K. Lee ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Coronary Artery Disease ◽  
Acute Myocardial Infarction ◽  
Coronary Artery ◽  
Hodgkin's Disease ◽  
Cardiac Death ◽  
Stress Testing ◽  
Hodgkin’S Disease ◽  
Mediastinal Irradiation ◽  
Artery Disease

Purpose Incidental cardiac irradiation during treatment of thoracic neoplasms has increased risks for subsequent acute myocardial infarction or sudden cardiac death. Identifying patients who have a high risk for a coronary event may decrease morbidity and mortality. The objective of this study was to evaluate whether stress imaging can identify severe, unsuspected coronary stenoses in patients who had prior mediastinal irradiation for Hodgkin's disease. Patients and Methods We enrolled 294 outpatients observed at a tertiary care cancer treatment center after mediastinal irradiation doses ≥ 35 Gy for Hodgkin's disease who had no known ischemic cardiac disease. Patients underwent stress echocardiography and radionuclide perfusion imaging at one stress session. Coronary angiography was performed at the discretion of the physician. Results Among the 294 participants, 63 (21.4%) had abnormal ventricular images at rest, suggesting prior myocardial injury. During stress testing, 42 patients (14%) developed perfusion defects (n = 26), impaired wall motion (n = 8), or both abnormalities (n = 8). Coronary angiography showed stenosis ≥ 50% in 22 patients (55%), less than 50% in nine patients (22.5%), and no stenosis in nine patients (22.5%). Screening led to bypass graft surgery in seven patients. Twenty-three patients developed coronary events during a median of 6.5 years of follow-up, with 10 acute myocardial infarctions (two fatal). Conclusion Stress-induced signs of ischemia and significant coronary artery disease are highly prevalent after mediastinal irradiation in young patients. Stress testing identifies asymptomatic individuals at high risk for acute myocardial infarction or sudden cardiac death.

Myocardial infarction in young patients with Hodgkin's disease ? potential pothogenic role of radiotherapy, chemotherapy, and splenectomy

1993 ◽  
Vol 71 (1) ◽  
pp. 57-64 ◽  
Author(s):  
K.H. Scholz ◽  
C. Herrmann ◽  
U. Tebbe ◽  
J.M. Chemnitius ◽  
U. Helmchen ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Hodgkin's Disease ◽  
Hodgkin’S Disease ◽  
Young Patients

C0347 Thrombin binding to platelets of young patients with a history of acute myocardial infarction

2012 ◽  
Vol 130 ◽  
pp. S104
Author(s):  
Grazia Loredana Mendolicchio ◽  
Monica Bacci ◽  
Dennis Zavalloni ◽  
Lidia Rota ◽  
Zaverio Marcello Ruggeri
Keyword(s):  
Myocardial Infarction ◽  
Acute Myocardial Infarction ◽  
Young Patients ◽  
History Of

Acute myocardial infarction in young patients

2021 ◽  
Vol 79 (10) ◽  
pp. 1093-1098
Author(s):  
Wojciech Zasada ◽  
Beata Bobrowska ◽  
Krzysztof Plens ◽  
Artur Dziewierz ◽  
Zbigniew Siudak ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Acute Myocardial Infarction ◽  
Young Patients

scholarly journals Acute myocardial infarction in young adults: features of pathogenesis, disease course and justification of strategy for prevention of complications

2019 ◽  
Vol 26 (4) ◽  
pp. 32-43
Author(s):  
O. M. Parkhomenko ◽  
Ya. M. Lutay ◽  
O. I. Irkin ◽  
D. O. Bilyi ◽  
A. O. Stepura ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Acute Myocardial Infarction ◽  
Young Adults ◽  
Young Patients ◽  
Coronary Vessels ◽  
Left Ventricular ◽  
Left Ventricular Ejection ◽  
Premature Coronary Artery Disease ◽  
Ventricular Ejection Fraction ◽  
Arrhythmogenic Substrate

We retrospectively and prospectively studied 835 patients with acute myocardial infarction (AMI) under the age of 45 and older. Depending on age, patients were divided into two groups: < 45 years and ≥ 45 years. In 189 patients under 45 years of age, the main risk factors leading to the development of ST-elevation myocardial infarction were male sex (OR 6.58; 95 % CI (2.64–16.41), smoking (OR 2.02; 95 % CI (1.44–2.82) and family history of premature coronary artery disease (OR 1.75; 95 % CI (1.21–2.54). According to coronary angiography, AMI patients under 45 years of age in most cases showed no hemodynamically significant coronary vessels damage and had a different course of AMI caused by other reasons – aneurysms of the coronary arteries, muscle bridges, coronary spasm, spontaneous dissections. It was found that 10 % of young patients who did not have obstructive lesions of coronary vessels, according to magnetic resonance imaging (MRI) had focal myocarditis. However, it is noted that in patients under 45 years of age, the presence of familial hypercholesterolemia (FH) may affect the development of AMI. Thus, according to the DLCNS criteria, FH was more frequently reported in young patients than in patients older than 45 years (7.34 % vs 1.32 % (p<0.05)). Hospital course of AMI in young adults was more favorable, with fewer complications. Data from studies of flow-dependent vasodilation have shown that young patients have worse endothelial function on the 1st day of AMI (p=0.043), but better recovery of it in the dynamics of observation. However, in young patients, early (day 7, p=0.029) and late (day 90, p=0.041) left ventricular dilatation was more commonly reported compared with older patients. According to the MRI data on day 1 and in the dynamics (90 days), it was found that, despite the higher prevalence of AMI, young patients have better recovery of contractile myocardial function. The arrhythmogenic substrate (according to late ventricular potential) for life-threatening arrhythmias was more commonly recorded in the older age group at the beginning of the development of AMI, but it was detected with the same frequency in both groups during prolonged observation (6–12 months). Despite better survival and fewer complications during long-term follow-up (4.9 years on average), the greatest impact on the development of the combined endpoint (cardiovascular death / recurrent myocardial infarction / stroke) and death from any cause was made by the patients’ age up to 35 years (best prognosis), concomitant hypertension (worsens prognosis) and low left ventricular ejection fraction (increases complications). The study indicates the possibility of implementing a secondary prevention system in AMI patients of young age through careful (active) observation and control of adherence to treatment and the adequacy of its implementation.

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