1.Angioplasty on an infarct-related anomalous right coronary artery arising from posterior coronary sinus.
Man-Hong JIM ; Ryan L Y KO ; Carmen W S CHAN ; Stephen C W CHEUNG ; Wing-Hing CHOW
Annals of the Academy of Medicine, Singapore 2010;39(3):258-260
INTRODUCTIONThe objective of this case report was to illustrate the diagnostic and intervention approach of anomalous right coronary artery (RCA).
CLINICAL PICTUREA 60-year-old man presented with acute inferior myocardial infarction. Cardiac catheterisation revealed an anomalous RCA arising from the posterior coronary sinus as the infarct-related artery.
TREATMENTAd hoc percutaneous coronary intervention with stent implantation was performed using a few technical modifications.
OUTCOMEGood angiographic result was achieved within 90 minutes, with 260 mL of contrast used.
CONCLUSIONA high index of suspicion and logical diagnostic and intervention approach are required for the proper management of anomalous RCA.
Angioplasty, Balloon, Coronary ; Cardiac Catheterization ; methods ; Coronary Angiography ; Coronary Vessel Anomalies ; complications ; diagnostic imaging ; Humans ; Male ; Middle Aged ; Myocardial Infarction ; complications ; surgery
2.Jeopardised Inferior Myocardium (JIM) score: an arithmetic electrocardiographic score to predict the infarct-related artery in inferior myocardial infarction.
Man Hong JIM ; Kin Lam TSUI ; Kai Hang YIU ; Gary S H CHEUNG ; Chung Wah SIU ; Hee Hwa HO ; Wing Hing CHOW ; Shu Kin LI
Annals of the Academy of Medicine, Singapore 2012;41(7):300-304
INTRODUCTIONA few electrocardiographic criteria have been described to identify the infarct-related artery in inferior myocardial infarction. The aim of this study was to devise an arithmetic score to further improve the diagnostic accuracy.
MATERIALS AND METHODSFrom 2004 to 2006, 78 patients who underwent primary angioplasty for inferior myocardial infarction within 6 hours from symptom onset were recruited for electrocardiographic and angiographic analysis.
RESULTSThe mean age of patients was 65 ± 12 years with male predominance (74%). Less ST depression in lead I and aVL, and more prominent ST depression in lead V1-3 were observed in left circumflex artery (LCX) than right coronary artery (RCA) occlusions. In addition, more prominent ST depression in lead I and ST elevation in V1 were found in proximal RCA than distal RCA occlusions. Based on the findings, the Jeopardised Inferior Myocardium (JIM) score was constructed and defi ned as [II-V3/III+V1- I]. The sensitivity and specificity of JIM score ≤0.5 to predict proximal RCA occlusions; 0.5
CONCLUSIONBy taking into account more leads, the JIM score is capable of identifying the infarct-related artery with an improved diagnostic accuracy.
Aged ; Algorithms ; Coronary Angiography ; Coronary Occlusion ; diagnosis ; Coronary Vessels ; pathology ; Electrocardiography ; methods ; Female ; Humans ; Inferior Wall Myocardial Infarction ; diagnosis ; Male ; Middle Aged ; Predictive Value of Tests ; Sensitivity and Specificity