scholarly journals (Coronary vasospasm as the cause of acute coronary syndrome with ST elevation and the third-degree atrioventricular block - case report)

Cor et Vasa ◽  
2020 ◽  
Vol 62 (5) ◽  
pp. 462-465
Author(s):  
Jiří Fismol ◽  
Libor Škňouřil ◽  
Kamil Zeman
Keyword(s):  
Acute Coronary Syndrome ◽  
Case Report ◽  
Atrioventricular Block ◽  
Coronary Vasospasm ◽  
Coronary Syndrome ◽  
The Third ◽  
St Elevation ◽  
Third Degree Atrioventricular Block

scholarly journals Cystatin C for Enhancement of Risk Stratification in Non–ST Elevation Acute Coronary Syndrome Patients with an Increased Troponin T

2009 ◽  
Vol 55 (6) ◽  
pp. 1118-1125 ◽  
Author(s):  
Fons Windhausen ◽  
Alexander Hirsch ◽  
Johan Fischer ◽  
P Marc van der Zee ◽  
Gerard T Sanders ◽  
...  
Keyword(s):  
Acute Coronary Syndrome ◽  
Renal Function ◽  
Risk Stratification ◽  
Cystatin C ◽  
Treatment Strategy ◽  
Troponin T ◽  
Invasive Treatment ◽  
Coronary Syndrome ◽  
The Third ◽  
St Elevation

Abstract Background: We assessed the value of cystatin C for improvement of risk stratification in patients with non–ST elevation acute coronary syndrome (nSTE-ACS) and increased cardiac troponin T (cTnT), and we compared the long-term effects of an early invasive treatment strategy (EIS) with a selective invasive treatment strategy (SIS) with regard to renal function. Methods: Patients (n = 1128) randomized to an EIS or an SIS in the ICTUS trial were stratified according to the tertiles of the cystatin C concentration at baseline. The end points were death within 4 years and spontaneous myocardial infarction (MI) within 3 years. Results: Mortality was 3.4%, 6.2%, and 13.5% in the first, second, and third tertiles, respectively, of cystatin C concentration (log-rank P < 0.001), and the respective rates of spontaneous MI were 5.5%, 7.5%, and 9.8% (log-rank P = 0.03). In a multivariate Cox regression analysis, the cystatin C concentration in the third quartile remained independently predictive of mortality [hazard ratio (HR), 2.04; 95% CI, 1.02–4.10; P = 0.04] and spontaneous MI (HR, 1.95; 95% CI, 1.05–3.63; P = 0.04). The mortality rate in the second tertile was lower with the EIS than with the SIS (3.8% vs 8.7%). In the third tertile, the mortality rates with the EIS and the SIS were, respectively, 15.0% and 12.2% (P for interaction = 0.04). Rates of spontaneous MI were similar for the EIS and the SIS within cystatin C tertiles (P for interaction = 0.22). Conclusions: In patients with nSTE-ACS and an increased cTnT concentration, mild to moderate renal dysfunction is associated with a higher risk of death and spontaneous MI. Use of cystatin C as a serum marker of renal function may improve risk stratification.

scholarly journals Transient complete atrioventricular block and ST-segment elevation induced by coronary vasospasm due to iatrogenic hyperkalemia: a case report

2021 ◽  
Vol 15 (1) ◽  
Author(s):  
Miaomiao Cao ◽  
Li Chen ◽  
Chaofeng Sun ◽  
Guoliang Li
Keyword(s):  
Acute Coronary Syndrome ◽  
Atrioventricular Block ◽  
Periodic Paralysis ◽  
Coronary Vasospasm ◽  
Complete Atrioventricular Block ◽  
St Segment Elevation ◽  
Coronary Syndrome ◽  
St Segment ◽  
Normal Urine ◽  
Complete Atrioventricular

Abstract Background Hyperkalemia and acute coronary syndrome are not only all responsible for syncope related to complete atrioventricular block, but also share parts of electrocardiogram manifestations. Additionally, they influence each other. Case presentation A 32-year-old Chinese man presented with severe hypokalemia (1.63 mmol/l) at midnight in the emergency room. He developed unexpected rebound hyperkalemia (7.76 mmol/l) after 18 hours of oral and intravenous potassium chloride supplementation at a concentration of about 10 g/day and a rate of 10 mmol/hour. Subsequently, the patient complained of chest discomfort and dyspnea, followed by syncope for several minutes, approximately 2 hours after potassium reduction treatment had been started. The instant electrocardiogram showed complete atrioventricular block and elevated ST segment in the inferolateral leads, which resolved 15 minutes later, before hyperkalemia was corrected. Combined with mild coronary stenosis and negative myocardial injury markers, transient complete atrioventricular block induced by coronary vasospasm due to iatrogenic hyperkalemia was diagnosed. Normal urine potassium excretion, acid–base state, and other examinations made the diagnosis of hypokalemic periodic paralysis possible. Conclusions Hyperkalemia may provoke acute coronary syndrome, and early coronary angiography is an effective strategy for identifying the direct cause of acute complete atrioventricular block.

scholarly journals ACUTE CORONARY SYNDROME DUE TO CORONARY VASOSPASM – CASE REPORT

2017 ◽  
Vol 13 (5) ◽  
pp. 630-636
Author(s):  
S. D. Klimovskiy ◽  
G. G. Gazaryan ◽  
M. D. Krichman ◽  
P. B. Pisetskiy ◽  
A. G. Koledinskiy ◽  
...  
Keyword(s):  
Acute Coronary Syndrome ◽  
Case Report ◽  
Coronary Vasospasm ◽  
Coronary Syndrome
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