A new electrocardiographic criterion to differentiate between Takotsubo cardiomyopathy and anterior wall ST-segment elevation acute myocardial infarction.

Several studies have examined the ability of electrocardiography to differentiate between takotsubo cardiomyopathy (TC) and anterior wall acute ST-segment elevation myocardial infarction (AA-STEMI). In those studies, the magnitude of ST-segment elevation was not measured at the J point. The American Heart Association, American College of Cardiology Foundation, and Heart Rhythm Society guidelines recommend that the magnitude of ST-segment elevation should be measured at the J point.

Significance of a prominent Q wave in lead negative aVR (-aVR) in acute anterior myocardial infarction.

Purpose: The aim of this study was to clarify the significance of a Q wave in lead negative aVR (-aVR) in anterior wall acute myocardial infarction (AMI).

Methods: Eighty-seven patients with a first anterior wall AMI were classified into 2 groups according to the presence (n = 17, group A) or absence (n = 70, group B) of a prominent Q wave (duration > or =20 milliseconds) in lead -aVR at predischarge. Group A had a higher prevalence of a long left anterior descending coronary artery (LAD), a lower left ventricular ejection fraction, and more reduced regional wall motion in the apical and inferior regions than group B.

Electrocardiographic differentiation between occlusion of the first diagonal branch and occlusion of the left anterior descending coronary artery.

Purpose: We sought to electrocardiographically distinguish ST-segment elevation (STE)-acute myocardial infarction (AMI) caused by occlusion of the first diagonal branch (D1) from STE-AMI caused by occlusion of the left anterior descending coronary artery (LAD).

Methods: We examined 28 patients with STE-AMI caused by D1 occlusion (G-D) and 342 with STE-AMI caused by LAD occlusion (G-L).

Results: G-D had a higher prevalence of STE > or = 0.

Prolonged cardiogenic shock caused by a high-dose intravenous administration of dopamine in a patient with takotsubo cardiomyopathy.

We report a patient with takotsubo cardiomyopathy in whom cardiogenic shock continued with a high intraventricular pressure gradient (IVPG) under a high-dose intravenous administration of dopamine and in whom cessation of the administration improved the hemodynamics dramatically. The present case report suggests that the administration of dopamine may lead to further hemodynamic deterioration in patients with takotsubo cardiomyopathy who exhibits an IVPG.

Determinants of ST-segment level in lead aVR in anterior wall acute myocardial infarction with ST-segment elevation.

Background: This study aimed to clarify the determinants of ST-segment level in lead aVR in anterior wall acute myocardial infarction (AAMI).

Methods: We analyzed ST-segment levels in all 12 leads on admission and emergency coronary angiographic findings in 261 patients with a first AAMI with ST-segment elevation. The length of the left anterior descending coronary artery (LAD) was classified as follows: short = not reaching the apex; medium = perfusing less than 25% of the inferior wall; long = perfusing 25% or more of the inferior wall.

Prolonged sinus node dysfunction caused by obstruction of the sinus node artery occurring during coronary stenting.

We report a unique case with prolonged sinus node dysfunction caused by accidental occlusion of the sinus node artery occurring during coronary stenting for a proximal right coronary lesion.

A report of 2 cases of transient mid-ventricular ballooning.

Takotsubo cardiomyopathy is now well recognized not only in Japan but also in Western countries. In the present case report, we describe 2 cases of a variant type of Takotsubo cardiomyopathy showing transient ballooning of the mid-portion of the left ventricle.

Circadian variation in symptomatic subacute stent thrombosis after bare metal coronary stent implantation.

The present study examined whether onset of symptomatic subacute stent thrombosis (SAT) varies in a circadian manner after bare metal coronary stent implantation. Among 2,305 patients who underwent bare metal coronary stent implantation, 21 (0.9%) developed symptomatic SAT.

Relationship between heart rate variability and left ventricular remodeling after reperfused first anterior wall acute myocardial infarction.

The aim of the present study was to test the hypothesis that inadequate improvement in heart rate variability (HRV) in the healing stage of acute myocardial infarction (AMI) is associated with left ventricular (LV) remodeling. The study group comprised 20 patients (14 men, 6 women; mean age, 61+/-12 years) with a reperfused first anterior AMI ( View Article and Find Full Text PDF

Effect of preinfarction angina on heart rate variability in the early phase of the first anterior wall acute myocardial infarction.

The aim of this study was to clarify the effect of preinfarction angina on heart rate variability (HRV) in anterior wall acute myocardial infarction (AMI). A total of 36 patients experiencing their first anterior wall AMI were prospectively examined. The patients were divided into 2 groups according to the presence (group A, n=24) or absence (group B, n = 12) of preinfarction angina.