1.High Killips Class as a Predictor of New-onset Atrial Fibrillation Following Acute Myocardial Infarction: Systematic Review and Meta-analysis.
En-Yuan ZHANG ; Li CUI ; Zhen-Yu LI ; Tong LIU ; Guang-Ping LI
Chinese Medical Journal 2015;128(14):1964-1968
BACKGROUNDRecent observational studies have shown that patients with higher Killips score (>I) have higher risk of new-onset atrial fibrillation (NOAF) following acute myocardial infarction (AMI), while others drew a neutral conclusion. The ultimate predictive value of high Killips class on NOAF remained obscure.
METHODSPubMed, Web of Science, China National Knowledge Infrastructure, and the Cochrane Controlled Trials Register Databases were searched until February 2015. Of the 3732 initially identified studies, 5 observational studies with 10,053 patients were analyzed.
RESULTSThe meta-analysis of these studies showed that higher Killips score on admission was associated with higher incidence of NOAF following AMI (odds ratio = 2.29, 95% confidence interval 1.96-2.67, P < 0.00001), while no significant differences exist among individual trials (P = 0.14 and I2 = 43%).
CONCLUSIONSKillips class >I was associated with the higher opportunity of developing NOAF following AMI.
Atrial Fibrillation ; diagnosis ; etiology ; Humans ; Myocardial Infarction ; complications ; Risk Factors
4.Acute myocardial infarction and sub-acute stent thrombosis associated with occult essential thrombocythemia.
Zafer ISILAK ; Mehmet TEZCAN ; Murat ATALAY ; Ejder KARDESOGLU
Chinese Medical Journal 2014;127(19):3512-3513
Aged
;
Female
;
Humans
;
Myocardial Infarction
;
diagnosis
;
etiology
;
Stents
;
adverse effects
;
Thrombocythemia, Essential
;
complications
;
diagnosis
;
Thrombosis
;
diagnosis
;
etiology
5.Clinical analysis and risk stratification of ventricular septal rupture following acute myocardial infarction.
Xiao-Ying HU ; Hong QIU ; Shu-Bin QIAO ; Lian-Ming KANG ; Lei SONG ; Jun ZHANG ; Xiao-Yan TAN ; Yuan WU ; Yue-Jin YANG ; Run-Lin GAO ; Zai-Jia CHEN
Chinese Medical Journal 2013;126(21):4105-4108
BACKGROUNDVentricular septal rupture (VSR) remains an infrequent but devastating complication of acute myocardial infarction (AMI). The best time to undergo surgical repair is controversial and there is currently no risk stratification for patients with VSR to guide treatment. The purpose of this study was to review the clinical outcomes of 70 patients with VSR, to analyze the short-term prognosis factors of VSR following AMI, and to make a risk stratification for patients with VSR.
METHODSA total of 70 consecutive VSR patients following AMI treated in our hospital from January 2002 to October 2010 were enrolled in this study retrospectively. The difference of clinical characteristics were observed between patients with VSR who survived ≤30 days and survived >30 days. We analyzed the short-term prognosis factors of VSR and established the short-term prognosis index of VSR (SPIV) based on the Logistic regression analysis to stratify patients with VSR.
RESULTSAmong 12 354 patients with acute ST-segment elevation myocardial infarction, 70 (0.57%) patients (33 males and 37 females) were found to have VSR. The average age was (68.1±8.5) years. Fifty-four (77.1%) patients were diagnosed with an acute anterior infarction. Patients with VSR selected for surgical repair had better outcomes than patients treated conservatively; 1-year mortality 9.5% versus 87.8%, P < 0.005. Logistic regression analysis revealed that female (P = 0.013), anterior AMI (P = 0.023), non-ventricular aneurysm (P = 0.023), non-diabetes (P = 0.009), Killip class 3 or 4 (P = 0.022) and time from AMI to VSR less than 4 days (P = 0.027) were independent risk determinants for shortterm mortality. SPIV ≥9 indicates a high risk as the 30-day mortality is 77.4%; SPIV <8 indicates a low risk as the 30-day mortality is 28.6%; SPIV between 8 and 9 indicates a moderate risk.
CONCLUSIONSVSR remains a rare but devastating complication of AMI. The independent risk determinants for short-term mortality of VSR were female gender, anterior AMI, non-ventricular aneurysm, non-diabetes, Killip class 3 or 4, and the time from AMI to VSR less than 4 days. It is reasonable to take more active treatments for the patients at high risk to save more lives.
Aged ; Female ; Humans ; Male ; Middle Aged ; Myocardial Infarction ; complications ; physiopathology ; Ventricular Septal Rupture ; diagnosis ; etiology
6.31 cases of pneumoconiosis complicated with acute myocardial infarction in coal miners.
Yong WON ; Hui CHIN ; Yu-tzai CHEN ; Shi-hi LIU ; Shi-she WANG ; Wen-sho HSU
Chinese Journal of Industrial Hygiene and Occupational Diseases 2003;21(3):171-171
Aged
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Coal Mining
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Female
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Humans
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Male
;
Middle Aged
;
Myocardial Infarction
;
diagnosis
;
etiology
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Pneumoconiosis
;
complications
7.Imaging in noncardiovascular thoracic emergencies: a pictorial review.
Singapore medical journal 2015;56(11):604-quiz 611
Cardiovascular and noncardiovascular conditions are commonly encountered in the emergency department. While the majority of patients have underlying cardiovascular aetiologies, such as acute myocardial infarction, congestive heart failure, aortic dissection and pulmonary embolism, a small subset of patients have underlying noncardiovascular conditions, although they present with similar symptoms of chest pain, dyspnoea, cough, haemoptysis and haematemesis. This article aims to describe the imaging findings in common noncardiovascular conditions of the chest that are frequently encountered in the emergency department, with a review of the existing literature.
Chest Pain
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diagnosis
;
etiology
;
Diagnosis, Differential
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Diagnostic Imaging
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Emergencies
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Humans
;
Myocardial Infarction
;
complications
;
diagnosis
;
Pulmonary Embolism
;
complications
;
diagnosis
8.Acute Myocardial Infarction Caused by Coronary Artery Dissection Following Blunt Chest Trauma.
Se Jung YOON ; Hyuck Moon KWON ; Dong Soo KIM ; Bum Kee HONG ; Dong Yeon KIM ; Yun Hyeong CHO ; Byung Seung KANG ; Hyun Seung KIM
Yonsei Medical Journal 2003;44(4):736-739
Chest trauma can lead to various cardiac complications ranging from simple arrhythmias to myocardial rupture. An acute myocardial infarction (AMI) is a rare complication that can occur after chest trauma. We report a case of 66-year-old male who suffered a blunt chest trauma from a traffic accident resulting in an AMI. The coronary angiography revealed an eccentric 50% narrowing of the ostium of left anterior descending artery (LAD) by a dissection flap with calcification. Intravascular ultrasonography (IVUS) revealed eccentric calcified plaque (minimal luminal diameter [MLD]=3.5 mm) with a dissection flap. Intervention was not performed considering the MLD and calcified flap, and he has been conservatively managed with aspirin and losartan for 2 years. The follow-up coronary angiography showed an insignificant luminal narrowing of the proximal LAD from the ostium without evidence of a dissection. An early coronary evaluation including an IVUS study should be considered for managing patients who complain of ongoing, deep-seated chest pain with elevated cardiac enzyme levels and an abnormal electrocardiogram (ECG) after a blunt chest trauma. Based on this case, some limited cases of traumatic coronary artery dissections can be healed with conservative management and result in a good prognosis.
Aged
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Aneurysm, Dissecting/diagnosis/*etiology
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Coronary Aneurysm/diagnosis/*etiology
;
Coronary Angiography
;
Human
;
Male
;
Myocardial Infarction/diagnosis/*etiology
;
Radiography, Thoracic
;
Thoracic Injuries/*complications
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Ultrasonography, Interventional
;
Wounds, Nonpenetrating/*complications
9.Bupivacaine Induced Cardiac Toxicity Mimicking an Acute Non-ST Segment Elevation Myocardial Infarction.
Ho Yoel RYU ; Jang Young KIM ; Hyun Kyo LIM ; Junghan YOON ; Byung Su YOO ; Kyung Hoon CHOE ; Seung Hwan LEE
Yonsei Medical Journal 2007;48(2):331-336
Bupivacaine is widely used as a local anesthetic. Central nervous system (CNS) and cardiovascular toxicity are well known side effects. However, there has been no report of bupivacaine-induced myocardial injury. We present a case of bupivacaine cardiac toxicity mimicking an acute non-ST segment elevation myocardial infarction, which was eventually diagnosed as bupivacaine-induced cardiac toxicity without CNS toxicity. As soon as a healthy young woman at a private clinic was given a spinal anesthesia of 6mg bupivacaine for hemorrhoidectomy, she developed arrhythmia and hypotension. She was transferred to our emergency room. There was an accelerated idioventricular rhythm with ST segment depression on electrocardiogram, coarse breathing sounds with rales on whole lung field and a butterfly sign on the chest radiograph. 2D transthoracic echocardiography (TTE) revealed reduced left ventricle systolic ejection fraction (approximately 27%). There was regional wall motion abnormality of the left ventricle on 2D TTE and the cardiac marker was increased. We diagnosed the patient as having acute non-ST segment elevation myocardial infarction but her impaired cardiac function improved gradually. On the seventh day from admission, there was a complete spontaneous recovery of cardiac function, and coronary angiography revealed a normal coronary artery. Therefore, we firmly believe that bupivacaine directly injures the cardiac cell.
Myocardium/*pathology
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Myocardial Infarction/chemically induced/*diagnosis/etiology
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Humans
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Heart/*drug effects
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Female
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Electrocardiography
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Diagnosis, Differential
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Bupivacaine/*adverse effects
;
Adult
10.Myocardial infarction following recombinant tissue plasminogen activator treatment for acute ischemic stroke: a dangerous complication.
Zhi-Gang ZHOU ; Rui-Lan WANG ; Kang-Long YU
Chinese Medical Journal 2012;125(15):2775-2776
Thrombolysis with intravenous tissue plasminogen activator (t-PA) is currently an approved therapy for patients with acute ischemic stroke. Acute myocardial infarction (AMI) immediately following t-PA treatment for stroke is a rare but serious complication. A case of acute myocardial infarction (MI) following IV t-PA infusion for acute stroke was observed. This is a 52-year-old male with a known history of hypertension and chest pain, who subsequently developed MI four hours after IV t-PA was administered for acute ischemic stroke. The disruption of intra-cardiac thrombus and subsequent embolization to the coronary arteries may be an important mechanism. In addition, spontaneous recanalization of infarct-related arteries may be associated with greater myocardial salvage and better prognosis.
Humans
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Male
;
Middle Aged
;
Myocardial Infarction
;
diagnosis
;
etiology
;
Stroke
;
complications
;
drug therapy
;
Tissue Plasminogen Activator
;
therapeutic use