scholarly journals Acute coronary syndrome without ST-elevation in hypertrophic cardiomyopathy and normal coronary angiogram: a case report

2013 ◽  
Vol 8 (9) ◽  
pp. 282-282
Author(s):  
Snezana Lazic ◽  
Slavica Pajovic ◽  
Radojica Stolic ◽  
Daniela Celic
Keyword(s):  
Acute Coronary Syndrome ◽  
Case Report ◽  
Hypertrophic Cardiomyopathy ◽  
Coronary Angiogram ◽  
Coronary Syndrome ◽  
Normal Coronary Angiogram ◽  
St Elevation

scholarly journals Complete Heart Block Complicating Takotsubo Syndrome: Case Report and Literature Review

2020 ◽  
Vol 2020 ◽  
pp. 1-5
Author(s):  
Michael J. McGee ◽  
William Yu ◽  
Joshua McCarthy ◽  
Malcolm Barlow ◽  
Rosemary Hackworthy
Keyword(s):  
Acute Coronary Syndrome ◽  
Case Report ◽  
Heart Block ◽  
Complete Heart Block ◽  
Final Diagnosis ◽  
Takotsubo Syndrome ◽  
Shortness Of Breath ◽  
Coronary Angiogram ◽  
Coronary Syndrome ◽  
Pacemaker Insertion

An 81-year-old woman presents with shortness of breath resulting in a diagnosis of picornavirus and complete heart block. Troponin was elevated and there was concern about acute coronary syndrome. The final diagnosis after echocardiogram and coronary angiogram was Takotsubo syndrome in addition to the heart block which required pacemaker insertion.

scholarly journals Usefulness of ECG to differentiate apical hypertrophic cardiomyopathy from non-ST elevation acute coronary syndrome

2020 ◽  
Author(s):  
Yirao Tao ◽  
Jing Xu ◽  
Samira Yerima Bako ◽  
Xiaobo Yao ◽  
Donghui Yang
Keyword(s):  
Acute Coronary Syndrome ◽  
Hypertrophic Cardiomyopathy ◽  
Maximal Amplitude ◽  
Apical Hypertrophic Cardiomyopathy ◽  
Coronary Syndrome ◽  
T Wave ◽  
St Segment ◽  
St Elevation ◽  
Elevation Acute Coronary Syndrome ◽  
T Waves

Abstract Objective: Apical hypertrophic cardiomyopathy (ApHCM) is a phenotypic variant of nonobstructive HCM. ApHCM is characterized by left ventricular hypertrophy involve the distal apex. The electrocardiographic character of ApHCM can mimic non-ST elevation acute coronary syndrome (NSTEACS) which triggers a series of studies and treatments that may be unnecessary. This study aimed to clarify the ECG differences between the two diseases.Methods: Initial electrocardiogram (ECG) recordings of 41 patients with ApHCM and 72 patients with NSTEACS were analyzed retrospectively. We analyzed the voltage of negative T (neg T) wave, R wave and the change of ST-segment in the 12-lead ECGs as well as the number of leads with neg T waves.Results: Across the 12-lead ECGs, the magnitude of R wave significantly differed between ApHCM and NSTEACS in 10 leads excluding leads aVR and V1. ApHCM was associated with a greater maximal amplitude of R wave in lead V5 (3.13±1.08 vs. 1.38±0.73, P=0.000). The magnitude of T wave significantly differed between ApHCM and NSTEACS in 10 leads excluding leads II and V1. ApHCM was associated with a greater maximal amplitude of neg T wave in lead V4 (0.85±0.69 vs. 0.35±0.23, P=0.000). The frequency of giant neg T (1mv or more) wave was higher in ApHCM (36.5% vs. 0%, P=0.000). The magnitude of ST-segment deviation significantly differed between ApHCM and NSTEACS in 10 leads excluding leads aVF and V2. ApHCM was associated with a greater maximal amplitude of ST-segment depression in lead V5 (0.19±0.07 vs. 0.03±0.06, P=0.000). The number of leads with neg T waves also differed between ApHCM and NSTEACS (6.75±1.42 vs. 6.08±1.51, P=0.046). The sum of R wave in lead V5, neg T wave in lead V6 and ST-segment depression in lead V4>2.585 mV identified ApHCM with 90.2% sensibility and 87.5% specificity, representing the highest diagnostic accuracy.Conclusions: Compared with NSTEACS patients, ApHCM patients presented higher R waves and neg T wave voltage as well as a greater ST-segment depression in the 12-lead ECGs.

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