1/539. Recurring myocardial infarction in a 35 year old woman.A 35 year old woman presented with acute myocardial infarction without any of the usual risk factors: she had never smoked; she had normal blood pressure; she did not have diabetes; plasma concentrations of total cholesterol and high and low density lipoprotein cholesterol, fibrinogen, homocysteine, and Lp(a) lipoprotein were normal. She was not taking oral contraceptives or any other medication. coronary angiography showed occlusion of the left anterior descending coronary artery but no evidence of arteriosclerosis. Medical history disclosed a previous leg vein thrombosis with pulmonary embolism. Coagulation analysis revealed protein c deficiency. The recognition of protein c deficiency as a risk factor for myocardial infarction is important as anticoagulation prevents further thrombotic events, whereas inhibitors of platelet aggregation are ineffective.- - - - - - - - - - ranking = 1keywords = thrombosis, embolism (Clic here for more details about this article) |
2/539. Acute myocardial infarction induced by alternating exposure to heat in a sauna and rapid cooling in cold water.We describe a patient with acute myocardial infarction, which was thought to result from plaque rupture or thrombosis because of coronary artery spasm. The vasospasm was most likely induced by stimulation of the alpha-adrenergic receptors during alternating heat exposure during sauna bathing and rapid cooling during cold water bathing. This report emphasizes the dangers of rapid cooling after sauna bathing in patients with coronary risk factors.- - - - - - - - - - ranking = 0.7179712359192keywords = thrombosis (Clic here for more details about this article) |
3/539. Subacute stent thrombosis occurring more than one month after implantation for acute myocardial infarction. Description of two cases successfully treated with angioplasty and further stenting.Two patients are described with anterior acute myocardial infarction who had a successful recanalization of a totally occluded left anterior descending coronary artery by means of primary angioplasty and stenting. Reinfarction occurred more than 1 month after implantation. At angiography, a totally occluded left anterior descending coronary artery at the site of stenting was observed and was effectively reopened with angioplasty and stenting in both cases. This report aims to emphasize that acute myocardial infarction still represents a major risk factor for subacute stent thrombosis and that this potentially catastrophic event may occur late after implantation. Potential implications for revascularization strategies and medical treatment are discussed.- - - - - - - - - - ranking = 3.589856179596keywords = thrombosis (Clic here for more details about this article) |
4/539. Transient left ventricular dysfunction in childhood sickle cell disease.For unclear reasons, myocardial infarction is rare in childhood sickle cell disease, whereas lung, bone, and brain infarcts are more common. During vasoocclusive crisis and infection, acute myocardial ischemia and chronic volume overload from anemia may result in myocardial dysfunction. We report a child who had reversible cardiac dysfunction that mimicked myocardial infarction.- - - - - - - - - - ranking = 4.1358646849588E-5keywords = brain (Clic here for more details about this article) |
5/539. Coronary dissection and thrombosis associated with exercise testing three months after successful coronary stenting.exercise testing is commonly performed to assess the functional result of coronary revascularization procedures and is usually not associated with any complications. However, this report documents a rare case of coronary dissection and thrombosis, which resulted in an acute myocardial infarction, in a patient who underwent stress testing 3 months following successful coronary stent implantation.- - - - - - - - - - ranking = 3.589856179596keywords = thrombosis (Clic here for more details about this article) |
6/539. pulmonary embolism mimicking acute myocardial infarction.pulmonary embolism is a major cause of death in the united states. A high index of suspicion is required to achieve an accurate diagnosis. We report a case of a patient with syncope, ischemic electrocardiographic changes, and an elevated troponin i level, presenting just like acute myocardial infarction. The case highlights the value of an early use of 2-dimensional echocardiography in obtaining an accurate diagnosis, thus avoiding unnecessary and inappropriate treatment.- - - - - - - - - - ranking = 1.410143820404keywords = embolism (Clic here for more details about this article) |
7/539. rectum and sigmoid colon necrosis due to cholesterol embolization after implantation of an aortic stent-graft.Endovascular treatment of abdominal aortic aneurysms (AAAs) with stent-grafts is increasingly performed. Recent studies have shown that stent-graft placement for AAA is technically feasible and can effectively exclude aneurysms from the circulation. However, complications related to the procedure, such as graft thrombosis, migration of the prosthesis, peripheral embolization, and leaks with incomplete exclusion of the aneurysmal sac, have been reported. We report a case of rectum and sigmoid colon necrosis with fatal outcome due to cholesterol embolization after implantation of a stent-graft for an infrarenal AAA.- - - - - - - - - - ranking = 0.7179712359192keywords = thrombosis (Clic here for more details about this article) |
8/539. Atrial infarction is a unique and often unrecognized clinical entity.A patient with heart failure and acute atrial fibrillation received the final diagnosis of atrial infarction associated with ventricular infarction based on clinical findings of ischemia in association with atrial fibrillation and heart failure (mechanisms probably involved: contractile dysfunction and loss of atrial contribution). Although a transesophageal echocardiography, which could refine the diagnosis of anatomic abnormalities, was not performed, all evidence led to the diagnosis of atrial involvement. Electrocardiographic findings were consistent with Liu's major criterion 3. Therapy with digitalis, quinidine and angiotensin-converting enzyme inhibitors was chosen, as the patient had acute pulmonary edema. The use of beta-blockers and verapamil was res-tricted. No other complications, such as thrombo-embolism or atrial rupture, were noted.- - - - - - - - - - ranking = 0.2820287640808keywords = embolism (Clic here for more details about this article) |
9/539. Phenoprocoumon, head trauma and delayed intracerebral haemorrhage.Delayed traumatic intracerebral haemorrhage (DTICH) constitutes a serious complication of head injury, and several studies have set out to identify predisposing clinical variables and appropriate management strategies. Here we report a distinct and particularly malignant course of DTICH associated with oral anticoagulant therapy.- - - - - - - - - - ranking = 0.0052631191554699keywords = cerebral (Clic here for more details about this article) |
10/539. Results of saphenous vein graft stent implantation: single center results from use of oversized balloon catheters.The results and complications of a single-center experience of stent implantation in old saphenous vein grafts (SVGs) need to be defined. The authors studied their initial consecutive 92 patients (125 stents, 1.4 stents/per patient) with a mean age of 67 /-9 years. The patients' mean saphenous vein graft (SVG) age was 10 /-4 years, and the mean left ventricular ejection fraction was 46% /-15. Patient population included unstable angina (65%), stable angina (10%), myocardial infarction (21%), and silent ischemia (4%). The authors implanted 122 Palmaz-Schatz/biliary and three Gianturco-Roubin stents. They aimed at a balloon-artery ratio of 1.1/1.0. Procedural success, defined as stent deployment with <50% stenosis without death/Q-wave myocardial infarction/coronary artery bypass grafting (MI/CABG) was 95%. The mean luminal diameter (MLD) increased from 0.6 /-0.5 to 3.3 /-0.8 mm (p<0.001) and mean SVG stenosis diameter was decreased from 80% /-14 to -10% /-11 (p<0.001). Angiographic SVG lesions exhibited thrombus (17%), ulceration (38%), and plaque rupture (28%). Sixty-two patients were treated with warfarin and aspirin and 30 with ticlid and aspirin. Complications included death in three patients (3.3%) who sustained subacute stent thrombosis, and two of three had Q-wave MI. Distal embolization occurred in seven patients (8%); six of seven sustained a non Q-wave acute myocardial infarction (AMI); and one of seven a Q-wave MI. Eight (9%) patients had major groin hematoma, two had pseudoaneurysm (2.2%), one had arteriovenous (A-V) fistula (1.1%), two had vascular surgery (2.2%), nine had blood transfusion (9.8%), and three had stent migration (3.3%). Single-center experience with stents in SVGs indicates a highly successful procedural and angiographic immediate result. However, it was complicated by significant risk of non Q-wave MI due to distal coronary embolization which may affect prognosis.- - - - - - - - - - ranking = 0.7179712359192keywords = thrombosis (Clic here for more details about this article) |
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