4.Management of acute ST-elevation myocardial infarction: Reperfusion options.
Dmitriy KIREYEV ; Huay Cheem TAN ; Kian Keong POH
Annals of the Academy of Medicine, Singapore 2010;39(12):927-927
Primary percutaneous coronary intervention and thrombolysis remain therapies of choice for patients presenting with ST-segment elevation myocardial infarction (STEMI). Clinical outcome in the management of acute STEMI is dependent on myocardial reperfusion time and reperfusion strategies. Optimisation of these strategies should take into consideration logistical limitations of the local medical systems and the various patient profiles. We review the reperfusion strategies and its history in Singapore, comparing its clinical application with that in some developed Western countries.
Humans
;
Myocardial Infarction
;
blood
;
physiopathology
;
therapy
;
Myocardial Reperfusion
;
methods
;
Singapore
5.J wave syndromes: a decade of progress.
Guo-Liang LI ; Lin YANG ; Chang-Cong CUI ; Chao-Feng SUN ; Gan-Xin YAN ;
Chinese Medical Journal 2015;128(7):969-975
OBJECTIVEThe objective was to provide a brief history of J wave syndromes and to summarize our current understanding of their molecular, ionic, cellular mechanisms, and clinical features. We will also discuss the existing debates and further direction in basic and clinical research for J wave syndromes.
DATA SOURCESThe publications on key words of "J wave syndromes", "early repolarization syndrome (ERS)", "Brugada syndrome (BrS)" and "ST-segment elevation myocardial infarction (STEMI)" were comprehensively reviewed through search of the PubMed literatures without restriction on the publication date.
STUDY SELECTIONOriginal articles, reviews and other literatures concerning J wave syndromes, ERS, BrS and STEMI were selected.
RESULTSJ wave syndromes were firstly defined by Yan et al. in a Chinese journal a decade ago, which represent a spectrum of variable phenotypes characterized by appearance of prominent electrocardiographic J wave including ERS, BrS and ventricular fibrillation (VF) associated with hypothermia and acute STEMI. J wave syndromes can be inherited or acquired and are mechanistically linked to amplification of the transient outward current (I to )-mediated J waves that can lead to phase 2 reentry capable of initiating VF.
CONCLUSIONSJ wave syndromes are a group of newly highlighted clinical entities that share similar molecular, ionic and cellular mechanism and marked by amplified J wave on the electrocardiogram and a risk of VF. The clinical challenge ahead is to identify the patients with J wave syndromes who are at risk for sudden cardiac death and determine the alternative therapeutic strategies to reduce mortality.
Brugada Syndrome ; diagnosis ; physiopathology ; Electrocardiography ; Humans ; Myocardial Infarction ; diagnosis ; physiopathology
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