Pulmonary embolism (PE) is a great simulator; It mimics step by step its main differential diagnosis which is myocardial infarction. Its clinical and electrical manifestations are unspecific. Rarely, an ST-segment elevation can occur making the diagnosis more difficult. Recognizing such an uncommon electrocardiographic (ECG) pattern is of an important relevance to lead to a prompt and suitable therapeutic management. In our paper, we discuss a 68 years-old man case who presents with dyspnea and chest pain with ST-segment elevation in V1, aVR, DIII, and right-sided leads suggestive of isolated right ventricular infarction, admitted in a stable hemodynamical status which rapidly deteriorated. Echocardiographic assessment has shown signs of acute pulmonary heart disease with the presence of the specific McConnell's sign. A computed tomography pulmonary angiogram was performed revealing massive bilateral PE that benefited from thrombolytic therapy with alteplase with a remarkable following and regression of the ST-segment elevation. To our knowledge, this is the first case report of massive PE presenting with these ECG findings in the context of COVID 19 pneumonia, of which practitioners should be aware to better orient diagnosis and therapeutic management.
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http://dx.doi.org/10.1016/j.amsu.2022.104943 | DOI Listing |
Front Cardiovasc Med
December 2024
Department of Cardiology, The First Affiliated Hospital of Guangxi Medical University, Nanning, Guangxi, China.
Background: Acute myocardial infarction (AMI), particularly ST-segment elevation myocardial infarction (STEMI), significantly impacts global health, exacerbated by risk factors such as diabetes mellitus (DM). While the Gensini score effectively quantifies coronary artery lesions, its correlation with fasting blood glucose (FBG) levels, particularly in a non-linear fashion, has not been thoroughly explored in STEMI patients.
Methods: This study analyzed data from 464 STEMI patients treated with percutaneous coronary intervention at the First People's Hospital of Taizhou City, Zhejiang Province, China, from January 2010 to October 2014.
Cardiovasc Ther
January 2025
Department of Cardiology, Tangshan Gongren Hospital, Tangshan, Hebei Province, China.
Acute coronary syndrome (ACS) is one of the most common leading global causes of mortality, encompassing ST-segment elevation myocardial infarction (STEMI), non-ST-segment elevation myocardial infarction (NSTEMI), and unstable angina (UA). Percutaneous coronary intervention (PCI) has become a pivotal therapeutic approach for ACS, underscoring the importance of anticoagulation strategies. Among the commonly employed anticoagulants in PCI, heparin and bivalirudin take precedence, with heparin serving as the archetypal choice.
View Article and Find Full Text PDFEur Heart J Case Rep
January 2025
Cardiology Department, Meir Medical Center, Tchernichovsky St 59, Kfar Saba 4418001, Israel.
Background: Anomalous origin of the left coronary artery (LCA) from the pulmonary artery (PA) (ALCAPA) is a rare congenital abnormality. We present a case of an ALCAPA in a 25-year-old man.
Case Summary: A 25-year-old male with no past medical history was admitted to our intensive cardiac care unit after sudden cardiac arrest due to ventricular fibrillation and suspected acute coronary syndrome.
Sci Rep
January 2025
Department of Cardiology, General Hospital of Southern Theater Command, No.111, Liuhua Road, Liuhuaqiao Community, Liuhua Street, Yuexiu District, Guangzhou, 510000, Guangdong, China.
Coronary artery spasm (CAS) is a key contributor to the pathogenesis of acute ST-segment elevation myocardial infarction (STEMI). While smoking is recognized as a major risk factor for CAS, the relationship between cumulative cigarette consumption and infarction-related CAS across different age groups in STEMI patients remains unclear. This study aimed to investigate the correlation between cumulative cigarette consumption and infarction-related CAS across different age groups through a retrospective analysis.
View Article and Find Full Text PDFInt J Cardiol
December 2024
Department of Cardiology, Renmin Hospital of Wuhan University, Wuhan, China; Cardiovascular Research Institute of Wuhan University, Wuhan, China; Hubei Key Laboratory of Cardiology, Wuhan, China. Electronic address:
Aims: Timely assessment of abnormal microvascular perfusion (MVP) may improve prognosis in patients with ST-segment elevation myocardial infarction (STEMI). This study aimed to determine the clinical implications of contrast-flow quantitative flow ratio (cQFR) in evaluating abnormal MVP and subsequent outcomes among STEMI patients after successful primary percutaneous coronary intervention (PPCI).
Methods: The study population consisted of 2 independent cohorts.
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