4.Long-term Predictive Factors of Major Adverse Cardiac Events in Patients with Acute Myocardial Infarction Complicated by Cardiogenic Shock.
Eun Hui BAE ; Sang Yup LIM ; Myung Ho JEONG ; Hyung Wook PARK ; Ji Hyun LIM ; Young Joon HONG ; Weon KIM ; Ju Han KIM ; Jeong Gwan CHO ; Young Keun AHN ; Jong Chun PARK ; Soon Pal SUH ; Byoung Hee AHN ; Sang Hyung KIM ; Jung Chaee KANG
The Korean Journal of Internal Medicine 2005;20(1):8-14
BACKGROUND: Cardiogenic shock (CS) after acute myocardial infarction (AMI) develops in 5~10% of patients and it is associated with high mortality. The aim of this study is to assess the predictive factors of mortality for patients with AMI and CS. METHODS: Two hundred fifty five AMI patients with CS (the mean age was 66.0 +/- 11.0 years, M: F=156: 99) out of 1, 268 AMI patients who admitted at Chonnam National University Hospital between July 2000 and June 2002 were analyzed according to the clinical characteristics, coronary angiographic findings and MACE during admission and for the 1-year clinical follow-up. RESULTS: Among the enrolled patients, 129 patients survived without MACE (Group I, mean age 64.2 +/- 10.6 years, M: F=76: 53), and 126 patients had MACE (Group II, mean age 68.1 +/- 10.0 years, M: F=80: 46) during admission or during the 1-year follow-up period. There were significant differences in age between the Groups I and II (64.2 +/- 10.6 vs. 68.1 +/- 11.0 years, respectively, p=0.004) and the previous MI history (0 vs. 17.4%, respectively, p< 0.001). The left ventricular ejection fraction (EF) was lower in Group II (Group I vs. II: 49.1 +/- 13.0 vs. 39.1 +/- 12.9%, p< 0.001). The levels of troponin (Tn) I and C-reactive protein (CRP) were higher in Group II (Group I vs. II: 29.2 +/- 7.72 vs. 50.8 +/- 5.17 ng/dL, p=0.017, 3.8 +/- 0.48 vs. 9.9 +/- 1.21 mg/dL, p< 0.001 respectively). Left main stem lesion (LMSL) was more common in Group II than in Group I (0.7% vs. 22.0%, respectively, p=0.004). In-hospital death was associated with low Thrombolysis In Myocardial Infarction (TIMI) flow after coronary revascularization. CONCLUSION: Old age, a previous MI history, high Tn and CRP, low EF and LMSL are associated with higher MACE for patients with AMI and CS. Coronary revascularization with TIMI 3 flow lowers the in-hospital mortality.
Aged
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Female
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Hospital Mortality
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Humans
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Korea/epidemiology
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Male
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Middle Aged
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Myocardial Infarction/complications/*mortality
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Prognosis
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Shock, Cardiogenic/etiology/*mortality
6.Peripartum acute anterior ST segment elevation myocardial infarction: an uncommon presentation of acute aortic dissection.
Abdul Razakjr OMAR ; Wei-Ping GOH ; Yean-Teng LIM
Annals of the Academy of Medicine, Singapore 2007;36(10):854-856
INTRODUCTIONAtherosclerotic coronary artery thrombosis is the most common cause of acute myocardial infarction.
CLINICAL PICTUREA 30-year-old lady presented with acute peripartum massive anterior ST segment myocardial infarction and cardiogenic shock. This was due to acute Stanford type A aortic dissection with the intimal flap occluding the left coronary ostium. The initial diagnosis was not apparent. Echocardiography confirmed the diagnosis.
TREATMENT AND OUTCOMEShe underwent emergency surgical repair (Bentall procedure). Pathology confirmed underlying idiopathic cystic medial degeneration.
CONCLUSIONA high index of clinical suspicion is required in acute myocardial infarction presenting without traditional cardiovascular risk factors.
Acute Disease ; Adult ; Aneurysm, Dissecting ; complications ; diagnosis ; surgery ; Aortic Aneurysm ; complications ; diagnosis ; surgery ; Echocardiography ; Electrocardiography ; Female ; Humans ; Myocardial Infarction ; etiology ; physiopathology ; Pregnancy ; Pregnancy Complications, Cardiovascular ; Shock, Cardiogenic ; etiology
8.A Case of Acute Eosinophilic Myopericarditis Presenting with Cardiogenic Shock and Normal Peripheral Eosinophil Count.
Il Suk SOHN ; Jong Chun PARK ; Jae Hun CHUNG ; Kye Hun KIM ; Youngkeun AHN ; Myung Ho JEONG ; Jeong Gwan CHO
The Korean Journal of Internal Medicine 2006;21(2):136-140
Eosinophilic myocarditis usually results from myocardial damage as a result of drugs or parasites, and is generally associated with increased peripheral eosinophil count. This form of myocarditis is difficult to diagnose clinically. A 25 year-old previously healthy woman was transferred from a local clinic because of hypotension and dyspnea with sudden cardiogenic shock after a three day history of gastrointestinal illness. Echocardiography revealed concentric left ventricular wall thickening with moderate pericardial effusion. Biopsy of endomyocardial tissue from the right ventricle showed diffuse infiltration of inflammatory cells, mostly eosinophils, even though the patient had a peripheral eosinophil count that was normal at the time of biopsy. The patient was treated with corticosteroids for the symptoms of pericarditis, and she recovered without cardiac sequelae, clinically and echocardiographically. We here report a case of acute eosinophilic myopericarditis, with cardiogenic shock, diagnosed by endomyocardial biopsy with normal peripheral eosinophil count at the time of biopsy, and complete recovery without sequelae.
Shock, Cardiogenic/blood/*etiology
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Pericarditis/blood/*diagnosis
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Myocarditis/blood/*diagnosis
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Leukocyte Count
;
Humans
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Female
;
*Eosinophils
;
Eosinophilia/blood/*diagnosis
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Adult
;
Acute Disease
9.A Case of Mushroom Poisoning with Russula subnigricans: Development of Rhabdomyolysis, Acute Kidney Injury, Cardiogenic Shock, and Death.
Journal of Korean Medical Science 2016;31(7):1164-1167
Mushroom exposures are increasing worldwide. The incidence and fatality of mushroom poisoning are reported to be increasing. Several new syndromes in mushroom poisoning have been described. Rhabdomyolytic mushroom poisoning is one of new syndromes. Russula subnigricans mushroom can cause delayed-onset rhabdomyolysis with acute kidney injury in the severely poisoned patient. There are few reports on the toxicity of R. subnigricans. This report represents the first record of R. subnigricans poisoning with rhabdomyolysis in Korea, describing a 51-year-old man who suffered from rhabdomyolysis, acute kidney injury, severe hypocalcemia, respiratory failure, ventricular tachycardia, cardiogenic shock, and death. Mushroom poisoning should be considered in the evaluation of rhabdomyolysis of unknown cause. Furthermore, R. subnigricans should be considered in the mushroom poisoning with rhabdomyolysis.
Acute Kidney Injury/*etiology
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Basidiomycota/isolation & purification/*pathogenicity
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Electrocardiography
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Heart Ventricles/physiopathology
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Humans
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Male
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Middle Aged
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Mushroom Poisoning/*diagnosis/microbiology/mortality
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Rhabdomyolysis/*etiology
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Shock, Cardiogenic/*etiology
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Tachycardia, Ventricular/etiology
10.Right pace, wrong place.
Choon Pin LIM ; Khung Keong YEO ; Boon Yew TAN ; Reginald LIEW ; Jack W C TAN
Annals of the Academy of Medicine, Singapore 2012;41(9):417-419
Angioplasty, Balloon, Coronary
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Bradycardia
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etiology
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Cardiac Pacing, Artificial
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adverse effects
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Carotid Artery, Common
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abnormalities
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Heart Block
;
etiology
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Humans
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Jugular Veins
;
abnormalities
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Male
;
Middle Aged
;
Shock, Cardiogenic
;
etiology
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Thromboembolism
;
complications
;
Torsades de Pointes
;
etiology