scholarly journals The Myth of Myocardial Infarction With Normal Coronary Angiography

Cureus ◽  
2021 ◽  
Author(s):  
Ziad A Taher ◽  
Abdulhalim J Kinsara
Keyword(s):  
Myocardial Infarction ◽  
Coronary Angiography ◽  
Normal Coronary Angiography

Prevalence of Factor V Leiden in Patients with Myocardial Infarction and Normal Coronary Angiography

2000 ◽  
Vol 83 (06) ◽  
pp. 822-825 ◽  
Author(s):  
Antoine Da Costa ◽  
Stéphane Munier ◽  
Bernard Mercier ◽  
Brigitte Tardy ◽  
Claude Ferec ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Coronary Artery ◽  
Coronary Angiography ◽  
Coronary Artery Stenosis ◽  
Factor V Leiden ◽  
Artery Stenosis ◽  
Factor V ◽  
Significant Coronary Artery Stenosis ◽  
Increased Risk ◽  
Normal Coronary Angiography

SummaryFactor V Leiden is associated with an increased risk of venous thrombosis and myocardial infarction in young women, but not in men in this latter case. The aim of this study was to evaluate the prevalence of this mutation in patients with myocardial infarction but normal coronary angiography.We compared 3 groups of patients: one group consisted of 107 patients with premature myocardial infarction but no significant coronary artery stenosis; another group of 244 patients with myocardial infarction and significant coronary artery stenosis; a third group of 400 healthy controls.Factor V Leiden was found in 13 patients (12.1%) who had a myocardial infarction without significant coronary artery stenosis, 11 patients (4.5%) who had a myocardial infarction with significant coronary artery stenosis (p = 0.01) and in 20 controls (5%) (p = 0.01). Odds ratio associated with factor V Leiden were respectively 2.93 (CI95 : 1.18-7.31) and 2.63 (CI95 : 1.19-5.78) when we compared myocardial infarction patients without significant coronary artery stenosis to controls or to patients with significant coronary artery stenosis.In myocardial infarction patients without significant coronary artery stenosis, prevalence of factor V Leiden is significantly higher than in controls. This new finding supports the hypothesis that thrombosis plays a key role in this selected situation.

scholarly journals ST Segment Elevation Is Not Always Myocardial Infarction: A Case of Focal Myopericarditis

2017 ◽  
Vol 2017 ◽  
pp. 1-4
Author(s):  
Cyrus M. Munguti ◽  
Samuel Akidiva ◽  
Jacob Wallace ◽  
Hussam Farhoud
Keyword(s):  
Myocardial Infarction ◽  
Coronary Artery Disease ◽  
Chest Pain ◽  
Coronary Artery ◽  
Coronary Angiography ◽  
Cardiac Mri ◽  
St Segment Elevation ◽  
St Segment ◽  
Normal Coronary Angiography ◽  
Artery Disease

Protocols exist on how to manage STEMI patients, with well-established timelines. There are times when patients present with chest pain, ST segment elevation, and biomarker elevation that are not due to coronary artery disease. These conditions usually present with normal coronary angiography. We present a case that was clinically indistinguishable from STEMI and that was diagnosed with focal myopericarditis on cardiac MRI.

2388Differential diagnosis of MINOCA patients: the contribution of early cardiac magnetic resonance imaging to the final diagnosis in patients with normal coronary angiography

2019 ◽  
Vol 40 (Supplement_1) ◽  
Author(s):  
H Vago ◽  
L Szabo ◽  
V Horvath ◽  
Z Dohy ◽  
C Czimbalmos ◽  
...  
Keyword(s):  
Risk Factors ◽  
Myocardial Infarction ◽  
Cardiac Magnetic Resonance ◽  
Magnetic Resonance ◽  
Coronary Angiography ◽  
Definitive Diagnosis ◽  
Lower Percentage ◽  
Provisional Diagnosis ◽  
Laboratory Values ◽  
Normal Coronary Angiography

Abstract Introduction The diagnostic value of cardiac magnetic resonance (CMR) imaging has been suggested in determination of the cause behind Myocardial Infarction with Non-obstructive Coronary Arteries (MINOCA). According to the current STEMI Guideline CMR is considered to have the best diagnostic performance, when CMR timing is within its optimal ≤2 weeks. Purpose The aim of our study was to establish the prevalence of the underlying pathologies using early (1–7 days) CMR examination in patients with signs of troponin positive acute coronary syndrome (ACS) but normal coronary angiography (NCA). We also aimed to investigate how early CMR changes the provisional diagnosis, and to provide detailed information of CMR characteristics of our pts and to compare laboratory parameters and risk factors of each group. Methods Between 2010–2018 (n=234) consecutive pts (40.2±12.1y, 159 male) with troponin positive ACS underwent CMR examination following NCA (≤20% stenosis), in a mean length of time of 2.5 days. Cine movie, T2-weighted and late gadolinium enhanced images (LGE) were performed. Left ventricular end-diastolic and end-systolic volumes (LVESVi), ejection fraction (LVEF), mass (LVM) and myocardial necrosis were evaluated. We analysed the risk factors and laboratory values of our patients. Results CMR proved acute myocardial infarction (MI) in 42 pts (52% male), acute myocarditis in 138 pts (89% male), Tako-Tsubo cardiomyopathy (TTC) in 25 woman, myocardial contusion in one case, in three cases CMR raised the suspicion of sarcoidosis and in 25 pts (56% male) there was no CMR abnormality. LVEF was lower, LVESVi was elevated in TTC patients compared to MI and myocarditis (LVEF: 44±9.1 vs 56.5±7 vs 55±6.6%; LVESVi: 52.5±12.9 vs 41±16.8 vs 42.1±8.9 ml/m2 p<0.001). The most frequently affected areas of the myocardium by LGE were the basal and mid inferolateral segments in case of myocarditis (69% of pts). In MI pts the anterior wall was affected only in 16%, while the involvement of inferior wall was visible in 57% of the pts. Early CMR examination established a definitive diagnosis in 88% of the cases, in 11% there was no CMR abnormality and it remained inconclusive in only 1% of the cases. CMR changed the provisional diagnosis in 47% of the pts. Myocarditis pts were younger (myocarditis: 32.5±10.8 vs MI 47.6±15.5 vs TTC 65.5±9.6 y; p<0.001) and lower percentage had hypercholesterinaemia (myocarditis: 18.8 vs MI: 40 vs TTC: 54.5%, p<0.01) or hypertension (myocarditis: 14.3 vs MI: 38.7 vs TTC: 55.6%, p<0.001). Laboratory values showed significant elevation of hsTroponin and CKMB of MI and myocarditis pts compared to other groups (p<0.05), but there was no difference between these two groups. Underlying pathologies in MINOCA Conclusion In patients with the working diagnosis of MINOCA and normal coronary angiography early CMR established a definitive diagnosis in 88% of our patients and changed the provisional diagnosis in 47% of the pts. Acknowledgement/Funding Project no. NVKP_16-1-2016-0017 has been implemented with the support provided from the National Research, Development and Innovation Fund of Hungary

scholarly journals The Role of Coronary Computed Tomography Angiography and Cardiac Magnetic Resonance in STEMI Patients with Normal Coronary Angiography

2017 ◽  
Vol 2 (3) ◽  
pp. 254-257
Author(s):  
Elena Beganu ◽  
Ioana Rodean ◽  
Lehel Bordi ◽  
Daniel Cernica ◽  
Imre Benedek
Keyword(s):  
Myocardial Infarction ◽  
Computed Tomography ◽  
Magnetic Resonance ◽  
Coronary Angiography ◽  
Coronary Angiogram ◽  
St Segment Elevation ◽  
St Segment ◽  
Normal Coronary Angiography ◽  
Angiographic Examination

Abstract Usually, the diagnosis of myocardial infarction based on patient symptoms, electrocardiogram (ECG) changes, and cardiac enzymes, is not a challenge for cardiologists. The correlation between coronary anatomy and the ECG territories that present ischemic changes can help the clinician to estimate which coronary artery presents lesions upon performing a coronary angiogram. In certain situations, the diagnosis of myocardial infarction can be difficult due to the lack of correlations between the clinical and paraclinical examinations and the coronary angiogram. In some cases, patients with chest pain and ST-segment elevation on the ECG tracing present with a normal coronary angiography. In other cases, patients without important changes on the ECG can present critical lesions or even occlusions upon angiographic examination. The aim of this article is to highlight the role of noninvasive coronary magnetic resonance and multi-slice computed tomography in patients with ST-segment elevation myocardial infarction and normal coronary angiography.

scholarly journals Comparison of Mean Platelet Volume in Acute Myocardial Infarction vs. Normal Coronary Angiography

2016 ◽  
Vol 8 (11) ◽  
pp. 320 ◽  
Author(s):  
Alireza Rai ◽  
Mohammadreza Saidi ◽  
Nahid Salehi ◽  
Farzad Sahebjamei ◽  
Masoud Jalilian ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Acute Myocardial Infarction ◽  
Platelet Count ◽  
Coronary Angiography ◽  
University Hospital ◽  
Control Group ◽  
Platelet Volume ◽  
St Segment Elevation ◽  
Significant Difference ◽  
Normal Coronary Angiography

<p>Considering the importance of cardiovascular disease and the role that platelets have in thrombosis formation in the coronary arteries, this study was done in order to assess platelet-related indices in patients who suffered acute myocardial infarction (MI) and compare them with those who had normal coronary angiography results.In this descriptive-analytical study, 200 patients who were admitted to our university hospital due to chest pain were included. The patients were divided into five groups including ST-segment elevation MI (STEMI), non-STEMI, unstable angina (UA), stable angina (SA), and healthy subjects (as control group). Platelet-related indices including platelet count as well asmean platelet volume (MPV) was determined. For this purpose, blood samples were taken from the patients upon admission and platelet count and volume were measured within three hours of admission.There was no statistically significant difference regarding MPV between the study groups (P&gt; 0.05).</p><p>MPV did not have any role in diagnosing various types of coronary artery disease (CAD).</p>

scholarly journals Clinical and prognostic correlates of St-elevation myocardial infarction patients with normal coronary angiography

2015 ◽  
Vol 35 (4) ◽  
pp. 135
Author(s):  
Chun-Hsien Wu ◽  
Cheng-Chung Cheng ◽  
Shu-Meng Cheng ◽  
Chin-Sheng Lin ◽  
Wen-Yu Lin ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Coronary Angiography ◽  
St Elevation Myocardial Infarction ◽  
Normal Coronary Angiography ◽  
St Elevation
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