Cases reported "Myocardial Infarction"

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1/375. 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.
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ranking = 1
keywords = thrombosis, vein, vein thrombosis
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2/375. 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.
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ranking = 0.99737991454999
keywords = thrombosis
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3/375. 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.
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ranking = 4.98689957275
keywords = thrombosis
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4/375. 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.
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ranking = 4.98689957275
keywords = thrombosis
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5/375. 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.
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ranking = 0.99737991454999
keywords = thrombosis
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6/375. Impending acute myocardial infarction during severe exercise associated with a myocardial bridge.

    A young man had an impending acute myocardial infarction while playing soccer. chest pain and anterior ST-segment elevation lasted 3 hours despite anti-ischemic medication, including streptokinase thrombolysis. An electrocardiogram recorded after the symptoms had passed was normal. There was a minimal increase in cardiac enzyme levels, and a pyrophosphate scan and echocardiogram were normal. Coronary cineangiography showed normal coronary arteries except for systolic compression of the left anterior descending coronary artery. An exercise stress test, while the patient was on atenolol, showed absence of myocardial ischemia. This impending acute myocardial infarction could have been caused by an acute thrombus with lysis prior to catheterization or by a deep muscle bridge that kinked or twisted the coronary artery due to myocardial forceful muscular contraction during the sympathetic stimulation of exercise. In conclusion, an impending acute myocardial infarction may occur in young patients having myocardial bridges, and a beta-blocker must be administered, especially when this condition appears during severe exercise.
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ranking = 9.5616862187889E-5
keywords = deep
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7/375. Surgical management of arteriosclerotic coronary artery aneurysm.

    A 60-year-old man suffered antero-septal myocardial infarction at the age of 56. coronary angiography demonstrated total occlusion of the left anterior descending artery and a large saccular aneurysm of the right coronary artery. Diffuse coronary ectasia was also shown in the right coronary artery adjacent to the aneurysm. Despite anticoagulant therapy, the aneurysm formed a thrombus and developed coronary artery stenosis distal to the aneurysm. ligation of the aneurysm and in situ gastroepiploic artery grafting were performed. Sudden heart failure was developed during skin closure. As this condition was considered to be graft hypoperfusion, supplemental saphenous vein grafting was placed. ligation is a simple, reliable technique to prevent future complications for a large saccular right coronary artery aneurysm, however, gastroepiploic artery might be an inappropriate bypass conduit for the ligated coronary artery with diffuse ectasia.
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ranking = 0.0018793700926966
keywords = vein
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8/375. Diffuse myocardial infarction caused by isolated bilateral coronary ostial stenoses in a young woman: report of a case.

    A young Japanese woman who appeared to be free from any coronary risk factors was admitted to a local hospital with chest pain. Serological tests showed no evidence of inflammation; however, an electrocardiogram revealed diffuse myocardial ischemia and a coronary angiogram demonstrated isolated bilateral coronary ostial stenoses. Moreover, her serum creatine phosphokinase level was high. On the day following admission, the patient developed severe cardiogenic shock, and she was transferred to our hospital where emergency coronary artery bypass grafting with the saphenous veins was performed using retrograde tepid blood cardioplegia. Recovery of cardiac function was immediate and her postoperative course was uneventful. We suspect that fibromuscular dysplasia was the most likely cause of the ostial stenoses in this patient.
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ranking = 0.0018793700926966
keywords = vein
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9/375. 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.
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ranking = 1.0086561351062
keywords = thrombosis, vein
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10/375. role of the vascular endothelium in patients with angina pectoris or acute myocardial infarction with normal coronary arteries.

    chest pain with normal coronary angiograms is a relatively common syndrome. The mode of presentation of this syndrome includes patients with syndrome X and patients with an acute myocardial infarction and angiographically normal coronary arteries. Different mechanisms have been proposed to elucidate the exact cause and to explain the various clinical presentations in these patients. Abnormalities of pain perception and the presence of oesophageal dysmotility have all been reported in patients with syndrome X. In situ thrombosis or embolization with subsequent clot lysis and recanalization, coronary artery spasm, cocaine abuse, and viral myocarditis have been described as potential mechanisms responsible for an acute myocardial infarction in patients with angiographically normal coronary arteries. Recent data suggest that both microvascular and epicardial endothelial dysfunction may play an important role in the pathophysiological mechanism of the syndrome of stable angina or acute myocardial infarction with normal coronary arteries.
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ranking = 0.99737991454999
keywords = thrombosis
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