scholarly journals Inferior Wall ST-elevation Myocardial Infarction Complicated by Ventricular Septal Defect and Free Wall Pseudoaneurysm with Rupture

Cureus ◽  
2018 ◽  
Author(s):  
Salma Khatoon ◽  
Michael Goyfman ◽  
Sepideh Nabatian ◽  
Sonia Henry ◽  
Steinberg Bart
Keyword(s):  
Myocardial Infarction ◽  
Ventricular Septal Defect ◽  
Septal Defect ◽  
St Elevation Myocardial Infarction ◽  
Inferior Wall ◽  
Free Wall ◽  
St Elevation

scholarly journals Non-ST elevation myocardial infarction and post-stenting ventricular septal defect in the setting of viral myocarditis

2017 ◽  
Vol 7 (2) ◽  
pp. 230-234
Author(s):  
Lilia M. Sierra-Galan ◽  
Angel L. Alberto-Delgado ◽  
Ana-Camila Flores-Ventura ◽  
Eugenio A. Ruesga-Zamora ◽  
Raquel Mendoza-Aguilar ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Ventricular Septal Defect ◽  
Septal Defect ◽  
Viral Myocarditis ◽  
St Elevation Myocardial Infarction ◽  
St Elevation

scholarly journals Shahid Gangalal National Heart Centre-ST-elevation Myocardial infarction Registry (SGNHC-STEMI-Registry), Nepal

2020 ◽  
Vol 17 (1) ◽  
pp. 7-16
Author(s):  
Chandra Mani Adhikari ◽  
Kiran Prasad Acharya ◽  
Reeju Manandhar ◽  
Kunjang Sherpa ◽  
Rikesh Tamrakar ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Cardiogenic Shock ◽  
Reperfusion Therapy ◽  
St Elevation Myocardial Infarction ◽  
Inferior Wall ◽  
Cross Sectional ◽  
Killip Class ◽  
National Heart ◽  
St Elevation ◽  
Time Of Presentation

Background and Aims: Incidence of ST-elevation myocardial infarction (STEMI) is increasing in Nepal. We aim to describe the presentation, management, complications, and outcomes of patients admitted with a diagnosis of STEMI in Shahid Gangalal National Heart Centre (SGNHC), Nepal. Methods: Shahid Gangalal National Heart Centre-ST-elevation registry (SGNHC-STEMI) registry was a cross sectional, observational, registry. All the patients who were admitted with the diagnosis of STEMI from January 2018 to December 2018 were included. Results: In this registry, 1460 patients out of 1486 patients who attended emergency were included. The mean age of patients was 60.8±13.4 years (range: 20 years to 98 years) with 70.3% male patients. Most of the patients (83.2%) were referred from other hospitals and 16.8% of patients directly attended the SGNHC emergency. During the presentation, smoking (54%) was the most common risk factor, followed by hypertension (36.6%), diabetes mellitus (25.3%), and dyslipidemia (7.8%). After admission, new cases of dyslipidemia, HTN, Impaired Fasting Glucose (IFG), and Type 2 DM were diagnosed in 682 (51.3%), 182 (20.1%), 148 (10.3%) and 95 (8.9%) respectively. At the time of presentation, 73.3% were in Killip class I and 26.3% were above Killip class II with 5.1% in cardiogenic shock. Thirty-one percent of the cases received reperfusion therapy (Primary percutaneous intervention in 25.2% and fibrinolysis in 5.8%). Inferior wall MI was the most common type of STEMI. Among the patients who underwent invasive therapy, the multi-vessel disease was noted in 46.2% cases and left main coronary artery involvement in 0.7% cases. In-hospital mortality was 6.2% with cardiogenic shock being the most common cause. Aspirin (97.8%), clopidogrel (96.2%), statin (96.4%), ACEI/ARB (76.8%) and beta-blocker (76.8%) were prescribed during discharge. Conclusion: The SGNHC-STEMI registry provides valuable information on the overall aspect of STEMI in Nepal. In general, the SGNHC-STEMI registry findings are consistent with other international data.

Repair of Acute Inferior Wall Myocardial Infarction-Related Basal Ventricular Septal Defect: Transatrial versus Transventricular Approach

2013 ◽  
Vol 28 (5) ◽  
pp. 475-480 ◽  
Author(s):  
Vikas Sharma ◽  
Kevin L. Greason ◽  
Vuyisile T. Nkomo ◽  
Hartzell V. Schaff ◽  
Harold M. Burkhart ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Ventricular Septal Defect ◽  
Septal Defect ◽  
Inferior Wall

P264 Comparison of in-hospital mortality between acute inferior wall STEMI patients with right ventricular infarction and without right ventricular infarction undergoing a primary PCI in KCMH

2020 ◽  
Vol 41 (Supplement_1) ◽  
Author(s):  
S Preechawuttidej ◽  
S Srimahachota
Keyword(s):  
Myocardial Infarction ◽  
Hospital Mortality ◽  
Cardiogenic Shock ◽  
Right Ventricular ◽  
St Elevation Myocardial Infarction ◽  
Hospital Death ◽  
Inferior Wall ◽  
Right Ventricular Infarction ◽  
St Elevation ◽  
Ventricular Infarction

Abstract Background Patients with acute inferior wall ST elevation myocardial infarction, if there is a right ventricular myocardial infarction involvement, they have pretended a worse prognosis with hemodynamic and electrophysiologic complications causing higher in-hospital morbidity and mortality. However most patients in previous studies were mainly treated with intravenous fibrinolysis and also studied in the Caucasian populations. Objectives To compare the in-hospital mortality rate of patients with acute inferior wall ST elevation myocardial infarction with and without right ventricular infarction involvement, whom were treated with primary percutaneous coronary intervention (PPCI). Methods The study was a retrospective descriptive study which enrolled patients with acute inferior wall ST elevation myocardial infarction who were treated with PPCI in our hospital from 1 January 2007 - 31 December 2016. Results Among 452 acute inferior wall ST elevation myocardial infarction patients who were treated with PPCI, there were 99 patients who had right ventricular infarction involvement, the in-hospital mortality rate was 23.2%, mainly due to cardiogenic shock, compared with 5.1 % in patients who had no right ventricular infarction (p < 0.001). Patients with right ventricular infarction had a significantly higher incidence of cardiogenic shock (48.5% versus 15.6%, P < 0.001), the lower number of left ventricle ejection fraction (51.15 ± 17.27% versus 55.79 ± 12.46%, p = 0.037), the higher incidence of complete heart block (33.3% versus 11.9%, p < 0.001) and ventricular tachycardia (15.2% versus 5.9%, p = 0.003). After adjustment for age, female sex, diabetes, hypertension, previous myocardial infarction, cardiogenic shock on admission, left ventricular ejection fraction, ventricular tachycardia and complete heart block, the right ventricular infarction remained the independent predictor of in-hospital death (adjusted hazard ratio, 1.69; 95% confidence interval, 0.38 to 7.48; P = 0.489) and significant independent predictor for 1-year mortality (adjusted hazard ratio, 2.76; 95% confidence interval, 1.08 to 7.03; P = 0.034). Conclusion Patients with acute inferior wall STEMI whom were treated with PPCI, if there was right ventricular infarction involvement, the in-hospital death and 1-year mortality were significantly higher than who were without right ventricular infarction.

scholarly journals P1482 Surviving free wall rupture

2020 ◽  
Vol 21 (Supplement_1) ◽  
Author(s):  
E Pomiato ◽  
P Milewski ◽  
A Comunello ◽  
E Schoepf ◽  
R Oberhollenzer ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Cardiac Surgery ◽  
Coronary Angiography ◽  
Multimodality Imaging ◽  
Interventricular Septum ◽  
St Elevation Myocardial Infarction ◽  
Free Wall ◽  
Free Wall Rupture ◽  
St Elevation ◽  
Anterior Septum

Abstract Introduction Free wall cardiac rupture (CR) is a rare event accounting for 0.1–0.3% of the patients suffering acute myocardial infarction. Its outcome is very poor and it is the third most common cause of early mortality after hospitalization for ST Elevation Myocardial Infarction (STEMI). Purpose We report a case of a 63 years-old woman surviving a free wall rupture after ST Elevation Myocardial Infarction. Methods The patient was referred to our cath-lab to undergo primary PCI in ST elevation myocardial infarction. Results Coronary angiography showed long thrombotic occlusion of left anterior descendent (LAD) artery and critical stenosis of posterior descending artery. The CULPRIT lesion on the anterior descending artery was treated with angioplasty and implantation of three drug eluting stents (3.0x31 mm; 2.75x15 mm; 2.5x30 mm). Twenty four hours later the patient developed a double cardiac arrest with pulseless electrical activity, which were immediately managed with ALS protocol. The patient recovered both time within a couple of minutes and point-of-care transthoracic echocardiogram (TTE) showed a newly developed circumferential pericardial effusion (maximum diastolic diameter 9 mm), associated to a significant thinning of the anterior interventricular septum. A fibrin clot was tamponating a suspected free wall rupture. Emergent coronary angiography showed an in-stent thrombosis but failed to restore adequate blood flow in the LAD artery. In the following days, the patients developed cardiogenic shock handled with i.v. dobutamine and intra-aortic balloon pump (IABP). Only after day 10 hemodynamic parameters started to improve gradually, allowing IABP removal and finally discharge on day 30. A second TTE, performed on day 7, confirmed massive necrosis of the anterior wall with severely reduced ejection fraction (EF 22%), pericardial thrombus and aneurismatic evolution of the apex and the mid-anterior septum. To support our finding we performed a cardiac magnetic resonance which confirmed missing ventricular wall at the anterior apex. It also showed transmural late gadolinium enhancement (LGE) of the anterior mid-apical septum and of the apex and a huge pericardial thrombus encompassing the whole mid-anterior septum (Figure 1, a-f). Before discharge the patient underwent two cardiac surgery visits which contraindicated surgical treatment in the acute phase. Therefore she was sent to cardiac rehabilitation program. Six months later, the patient finally underwent cardiac surgery and the covered free wall rupture was confirmed in the operating theatre. Conclusion This is a very rare case of covered free wall rupture, treated 6 months after the acute event. Multimodality imaging was essential to confirm the diagnosis and to guide the following management. Abstract P1482 Figure 1

scholarly journals Persistent Hiccups as the Only Presenting Symptom of ST Elevation Myocardial Infarction

2018 ◽  
Vol 2018 ◽  
pp. 1-4
Author(s):  
Nasreen Shaikh ◽  
Rishi Raj ◽  
Srinivas Movva ◽  
Charles Mattina
Keyword(s):  
Myocardial Infarction ◽  
Clinical Manifestations ◽  
Foot Ulcer ◽  
Kidney Injury ◽  
Diabetic Foot Ulcer ◽  
Coronary Artery Occlusion ◽  
Coronary Intervention ◽  
St Elevation Myocardial Infarction ◽  
Inferior Wall ◽  
St Elevation

Clinical manifestations of acute myocardial infarction can be more than just chest pain. Patients can present with dyspnea, fatigue, heart burn, diaphoresis, syncope, and abdominal pain to name a few. Our patient was a 74-year-old male with a past medical history of type 2 diabetes mellitus, hypertension, hyperlipidemia, and COPD due to chronic tobacco use, who presented with persistent hiccups for 4 days and no other complaints. Coincidently, he was found to have a diabetic foot ulcer with sepsis and acute kidney injury and hence was admitted to the hospital. A routine 12-lead EKG was done, and he was found to have an inferior wall ST elevation myocardial infarction. He underwent diagnostic catheterization which demonstrated 100% right coronary artery occlusion and a thallium viability study which confirmed nonviable myocardium; hence, he did not undergo percutaneous coronary intervention. Elderly patients who present with persistent hiccups should be investigated for an underlying cardiac etiology.

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