Electrocardiographic (ECG) abnormalities are often indicative of acute coronary artery occlusion. Early detection of these abnormalities is important for the identification of patients who may be ...candidates for emergent percutaneous coronary revascularization (PCR). In most cases, ST-segment elevation is the key factor in selecting patients for PCR. However, some cases with acute coronary artery occlusion do not have ST-segment elevation, resulting in delays in coronary reperfusion treatment. A 37-year-old male presented to the emergency department with typical chest pain. The patient indicated that he was a heavy marijuana user. Even though his admission ECG did not reveal ST-segment elevation, he was hemodynamically stable, and he did not develop life-threatening arrhythmias, he was immediately taken to the catheterization laboratory for urgent angiography with the diagnosis of acute myocardial infarction. The occluded left anterior descending artery seen in angiography was successfully revascularized with percutaneous coronary intervention. Herein, we present a case of a patient who was admitted to the emergency department with chest pain and ECG demonstrating the de Winter pattern. Based on this case, we present a detailed evaluation regarding the de Winter ECG pattern, which is equivalent to ST-segment elevation.
Marijuana (cannabis) is a frequently used recreational drug that potentially imposes serious health problems. We present a case of acute myocardial infarction with chronic total occlusion of left ...main coronary artery due to marijuana smoking in a 27-year-old man, which was not previously reported. This case illustrate that marijuana abuse can lead to serious cardiovascular events.
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GEOZS, IJS, IMTLJ, KILJ, KISLJ, NUK, OILJ, PNG, SAZU, SBCE, SBJE, UL, UM, UPCLJ, UPUK
The relationship between epicardial adipose tissue (EAT) and coronary artery disease has been predominantly demonstrated in the last two decades. The aim of this study was to investigate the ...predictive value of EAT thickness on ST-segment resolution that reflects myocardial reperfusion in patients undergoing primary percutaneous coronary intervention (pPCI) for acute ST-segment elevation myocardial infarction (STEMI). The present study prospectively included 114 consecutive patients (mean age 54 ± 10 years, range 35–83, 15 women) with first acute STEMI who underwent successful pPCI. ST-segment resolution (ΔSTR) <70 % was accepted as ECG sign of no-reflow phenomenon. The EAT thickness was measured by two-dimensional echocardiography. EAT thickness was increased in patients with no-reflow (3.9 ± 1.7 vs. 5.4 ± 2,
p
= 0.001). EAT thickness was also found to be inversely correlated with ΔSTR (
r
= −0.414,
p
= 0.001). Multivariate logistic regression analysis demonstrated that EAT thickness independently predicted no-reflow (OR 1.43, 95 % CI 1.13–1.82,
p
= 0.003). Receiver operating characteristic curve analysis demonstrated good diagnostic accuracy for EAT thickness in predicting no-reflow area under curve (AUC) = 0.72, 95 % CI 0.63–0.82,
p
< 0.001. In conclusion, increased EAT thickness may play an important role in the prediction of no-reflow in STEMI treated with pPCI.
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EMUNI, FIS, FZAB, GEOZS, GIS, IJS, IMTLJ, KILJ, KISLJ, MFDPS, NLZOH, NUK, OILJ, PNG, SAZU, SBCE, SBJE, SBMB, SBNM, UKNU, UL, UM, UPUK, VKSCE, ZAGLJ
Atrial fibrillation is the most common clinically significant arrhythmia. It is now established that atrial high-rate episodes are highly correlated with atrial fibrillation.
To investigate the ...relation between diastolic electrocardiographic parameters and subclinical atrial fibrillation detected by cardiac implantable electronic devices.
Ccross-sectional study.
A total of 203 patients who had a dual-chamber, rate-modulated pacing pacemaker implanted due to sinus node dysfunction were prospectively enrolled in this study. Atrial high-rate episodes were defined as any lasting more than 5 min with an atrial rate of ≥220 beats per minute during the previous year. Patient groups were categorized on the basis of pacemaker interrogation as the absence of atrial high-rate episodes atrial high-rate episodes (-) and the presence of atrial high-rate episodes atrial high-rate episodes (+). Episodes related to atrial over sensing were excluded. Twelve-lead surface electrocardiography was independently analyzed by two experienced readers for the measurement of diastolic electrocardiography parameters.
Among 203 patients (mean age: 67.5±9.1, 60.1% male), 51 (25.1%) with atrial high-rate episodes were defined as group 1 and 152 (74.9%) without atrial high-rate episodes were defined as group 2. Both groups were similar in terms of demographic characteristics and cardiovascular risk factors. Tend-Q and Tend-P were significantly longer in group 2. PQ interval was statistically longer in group 1. Corrected QT interval was significantly longer in group 1. Diastolic electrocardiography index, heart rate and PQ and QT intervals were the only independent predictors of atrial high-rate episodes in patients with dual pacemakers in multivariate analysis.
Abnormal diastolic electrocardiography parameters are powerful predisposing factors for the initiation of incident atrial fibrillation. Diastolic electrocardiography parameters and a novel diastolic index predict atrial high-rate episodes. Evaluating these parameters enables clinicians to identify patients who are at high risk and who may benefit from prophylactic treatment.
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IZUM, KILJ, NUK, PILJ, PNG, SAZU, UL, UM, UPUK
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