Aged ; Coronary Angiography ; Endocardium ; pathology ; Heart Aneurysm ; diagnosis ; diagnostic imaging ; Humans ; Male ; Myocardial Infarction ; complications

OBJECTIVETo evaluate the prognostic significance of hyponatremia in patients with AMI.

METHODSThe study population consisted of 670 patients with AMI in coronary care unit in our hospital from January 2003 to December 2004. The patients were designed into three groups according to serum sodium concentration within twenty four to forty eight hours following the onset of AMI: Group A. Na(+) > or = 135 mmol/L; Group B. Na(+) 120-135 mmol/L; Group C. Na(+) < or = 120 mmol/L. The data of myocardial enzymes, myocardial infarction size, heart function and inhospital mortality were analyzed retrospectively.

RESULTS1. The inhospital mortality of each group: group A was 7.6% (17/225), group B was 8.1% (34/421), group C was 33.3% (8/24). The difference between group C and group B or group A was significant. The P value was little than 0.05. 2. Activities of serum creatine phosphatase kinase and serum creatine phosphatase kinase isoenzymes and myocardial infarction sizes in each group were different (P < 0.05). 3. 59 cases of all died and 611 cases of all recovered in duration of hospital stay. Serum sodium concentrations of the recovered group were (133.00 +/- 5.25) mmol/L, and that of the died group were (122.00 +/- 7.25) mmol/L (P < 0.01). 4. In a multivariate logistic regression analysis, hyponatremia was associated with 30-day mortality in patients with AMI. In analysis of the association between the degree of hyponatremia and outcome, we observed that the risk of 30-day mortality increased with the severity of hyponatremia.

CONCLUSIONHyponatremia may be one of the important markers that predict a worse prognosis in patients with AMI.

Adult ; Aged ; Aged, 80 and over ; Female ; Humans ; Hyponatremia ; complications ; diagnosis ; Male ; Middle Aged ; Myocardial Infarction ; blood ; complications ; diagnosis ; pathology ; Myocardium ; pathology ; Prognosis ; Retrospective Studies ; Sodium ; blood

The brain MR images of 23 patients with angiographically proved moyamoya disease were reviewed to evaluate the capability of MR to demonstrate vascular and parenchymal abnormalities. All the MR images were obtained on a 2.0 T superconducting system and included T1-weighted sagittal and T2-weighted axial images without implementation of flow compensation (FC). The vascular abnormalities demonstrated on MR images were narrowing of the cavernous internal carotid artery (ICA) (73%), narrowing or occlusion of the supraclinoid ICA (87%) and proximal middle cerebral artery (MCA) (91%), and multiple collateral vessels in the basal ganglia and/or thalamus (96%). The parenchymal abnormalities included ischemic infarctions (74%), predominantly located in watershed areas, hemorrhagic infarctions (26%), intracerebral hematomas (13%), and intraventricular hemorrhage (13%). In conclusion, MR imaging was a useful diagnostic modality for detecting both vascular and parenchymal abnormalities associated with moyamoya disease. This may obviate the need for invasive angiography as far as the diagnosis is wanted at the non-quantitative level.
Adolescent ; Adult ; Basal Ganglia/pathology/radiography ; Carotid Artery, Internal/pathology/radiography ; Cerebral Angiography ; Child ; Female ; Hematoma/complications/diagnosis/pathology ; Humans ; Magnetic Resonance Imaging ; Male ; Moyamoya Disease/complications/*diagnosis/pathology ; Myocardial Infarction/complications/diagnosis/pathology

ST segment elevation is one of the most important electrocardiographic features that need to be recognised. Although ST segment elevation myocardial infarction is one of the main causes of this abnormality, there are other non-ischaemic causes that are also important. We discuss reversible apical ballooning syndrome or Takotsubo cardiomyopathy, pericarditis and a case of ST segment elevation due to 'early repolarisation pattern'.
Cardiology ; methods ; Coronary Angiography ; methods ; Dyslipidemias ; complications ; Electrocardiography ; methods ; Female ; Humans ; Leukemia, Myeloid, Acute ; complications ; Male ; Middle Aged ; Myelodysplastic Syndromes ; complications ; Myocardial Infarction ; complications ; diagnosis ; Myocardial Ischemia ; pathology ; Prostatic Neoplasms ; complications ; Respiratory Tract Infections ; complications

We report the case of a female who died of suspected acute myocardial infarction. Post-mortem CT angiography (PMCTA) was performed with intravascular contrast infusion before the standard autopsy, and it successfully demonstrated the complete thrombotic occlusion of a coronary artery and also a corresponding perfusion defect on myocardium. We herein describe the PMCTA findings of a cardiac death with special emphasis on the potential benefits of this novel CT technique in forensic practice.
*Autopsy ; Coronary Occlusion/*diagnosis/etiology/radiography ; Coronary Vessels/pathology/radiography ; Female ; Humans ; Middle Aged ; Myocardial Infarction/etiology/pathology ; Myocardium ; Thrombosis/complications/*diagnosis ; Tomography, X-Ray Computed

Adult ; Aneurysm, Dissecting ; diagnosis ; physiopathology ; Aneurysm, False ; Coronary Aneurysm ; diagnosis ; physiopathology ; Coronary Vessels ; pathology ; physiopathology ; Humans ; Male ; Myocardial Infarction ; diagnosis ; physiopathology ; Thoracic Injuries ; complications ; physiopathology ; Young Adult

BACKGROUNDPrevious studies revealed that culprit vessels of ST-segment elevation myocardial infarction (STEMI) were often related to mild or moderate stenosis. However, recent studies suggested that severe stenosis was primarily found in culprit lesions. The objective of this study was to analyze the stenosis severity of culprit lesions in STEMI patients and to clarify the paradoxical results.

METHODSA total of 489 consecutive STEMI patients who underwent primary percutaneous coronary intervention were retrospectively studied from January 2012 to December 2014. The patients were divided into three groups based on stenosis severity using quantitative coronary analysis: Group A, 314 cases, stenosis ≥70%; Group B, 127 cases, stenosis 50-70%; and Group C, 48 cases, stenosis ≤50%. The clinical, demographic, and angiographic data of all groups were analyzed.

RESULTSPatients in Group A exhibited a significantly higher prevalence of history of angina pectoris (95.9% vs. 62.5%, P< 0.001), multivessel disease (73.2% vs. 54.2%, P = 0.007), and lower cardiac ejection fraction (53.3 ± 8.6 vs. 56.8 ± 8.4, P= 0.009) than those in Group C. Multivariable analysis revealed that history of angina pectoris (odds ratio [OR]: 13.89, 95% confidence interval [CI]: 6.21-31.11) and multivessel disease (OR: 2.32, 95% CI: 1.25-4.31) were correlated with severe stenosis of the culprit lesion in Group A.

CONCLUSIONSMost culprit lesions in STEMI patients were severe stenosis. These patients exhibited a higher prevalence of angina history and multivessel diseases.

Aged ; Coronary Angiography ; Coronary Thrombosis ; diagnosis ; pathology ; therapy ; Female ; Humans ; Male ; Middle Aged ; Multivariate Analysis ; Myocardial Infarction ; complications ; pathology ; therapy ; Percutaneous Coronary Intervention ; Retrospective Studies

Foramen Ovale, Patent ; pathology ; Humans ; Hypoxia ; complications ; etiology ; Male ; Middle Aged ; Myocardial Infarction ; diagnosis ; etiology ; physiopathology ; Singapore ; Ventricular Dysfunction, Right ; physiopathology

OBJECTIVES: To explore the value of mast cell tryptase and brain natriuretic peptide（BNP） in the differential diagnostic of sudden death due to hypersensitivity and coronary atherosclerotic heart disease. METHODS: Totally 30 myocardial samples were collected from the autopsy cases in the Department of Forensic Pathology, Shanxi Medical University during 2010-2015. All samples were divided into three groups： death of craniocerebral injury group, sudden death of hypersensitivity group and sudden death of coronary atherosclerotic heart disease group, 10 cases in each group. Mast cell tryptase and BNP in myocardium were detected by immunofluorescence staining and Western Blotting. RESULTS: Immunofluorescence staining showed that the positive staining mast cell tryptase appeared in myocardium of sudden death of hypersensitivity group and coronary atherosclerotic heart disease group. Among the three groups, the expression of mast cell tryptase showed significantly differences through pairwise comparison （P<0.05）; The expression level of BNP in sudden death of coronary atherosclerotic heart disease group were significantly higher than the sudden death of hypersensitivity group and death of craniocerebral injury group （P<0.05）. The difference of the expression level of BNP between the sudden death of hypersensitivity group and the death of craniocerebral injury group had no statistical significance （P>0.05）. CONCLUSIONS The combined detection of the mast cell tryptase and BNP in myocardium is expected to provide help for the forensic differential diagnosis of sudden death due to hypersensitivity and coronary atherosclerotic heart disease.
Anaphylaxis ; Autopsy ; Blotting, Western ; Case-Control Studies ; Coronary Artery Disease/complications* ; Death, Sudden, Cardiac/etiology* ; Diagnosis, Differential ; Fluorescent Antibody Technique ; Forensic Pathology ; Humans ; Male ; Myocardial Infarction ; Myocardium/metabolism* ; Natriuretic Peptide, Brain/metabolism* ; Tryptases/metabolism*

Adult ; Aneurysm, Dissecting ; diagnosis ; etiology ; Computed Tomography Angiography ; methods ; Conservative Treatment ; methods ; Coronary Angiography ; methods ; Coronary Vessels ; diagnostic imaging ; pathology ; Electrocardiography ; methods ; Heart Injuries ; complications ; Humans ; Magnetic Resonance Imaging, Cine ; methods ; Male ; Multimodal Imaging ; methods ; Myocardial Infarction ; diagnosis ; etiology ; therapy ; Treatment Outcome ; Wounds, Nonpenetrating ; complications