Evolutionary de Winter pattern: from STEMI to de Winter ECG —a case report

We report a case of a 34-year-old man with a history of smoking who presented to the local emergency department with a 49  min history of chest pain. The first ECG of the patient indicated that ST-segment elevation was noted in the lead V2–V4; 57 min later, a second ECG revealed a typical de Winter syndrome when the patient was transferred to the emergency chest pain centre of our hospital. A percutaneous coronary intervention (PCI) was performed approximately 8 h later because the patient initially refused the PCI. Acute coronary artery angiography showed that the proximal left anterior descending coronary artery was completely occluded. Our case suggests that ST-segment elevation myocardial infarction may evolve in the direction of de Winter, which reflects a coronary thrombus in formation, so the de Winter ECG pattern should not be considered static.
Source: ESC Heart Failure - Category: Cardiology Authors: Tags: Case Report Source Type: research

Related Links:

AbstractCardiovascular (CV) engagement in coronavirus disease 2019 (COVID-19) is a huge determinant of prognosis during the acute phase of the disease. However, little is known about the potential chronic implications of the late phase of COVID-19 and about the appropriate approach to these patients. Heart failure, type 1 and type 2 myocardial infarction, arrhythmias, myocarditis, pulmonary fibrosis, and thrombosis have been shown to be related to severe acute respiratory syndrome coronavirus 2 infection, and a ‘long COVID-19’ illness has been recognized with fatigue, chest pain, and dyspnoea among the most fre...
Source: ESC Heart Failure - Category: Cardiology Authors: Tags: ESC and HFA Paper Source Type: research
Int Heart J. 2021 Mar 17. doi: 10.1536/ihj.20-586. Online ahead of print.ABSTRACTA 61-year-old woman suffered chest pain and was admitted to a nearby hospital emergency department. She was diagnosed with acute myocardial infarction probably due to thromboembolism in the left anterior descending coronary artery and aspiration thrombectomy was performed. Afterwards, she developed refractory heart failure with severe global left ventricular dysfunction and was transferred to our hospital. An 18F-FDG-PET/CT scan revealed abnormal 18F-FDG uptake in non-infarcted regions of the left ventricle. Non-caseating granulomas were detec...
Source: International Heart Journal - Category: Cardiology Authors: Source Type: research
Rationale: Patent foramen ovale (PFO) is not considered to be the main cause of stroke and is classified as the infarction of undetermined cause. The relationship between PFO and cerebral embolism is still unclear and cerebral embolism accompanied with coronary artery embolization in PFO patient is rare. In this case, we reported a patient with PFO suffered acute cerebral and myocardial infarction simultaneously, and analyzed the source of emboli and potential pathogenesis. Patient concerns: A 53-year-old female presented with chief complaints of intermittent palpitations and chest tightness for 6 years, aggravated fo...
Source: Medicine - Category: Internal Medicine Tags: Research Article: Clinical Case Report Source Type: research
Abstract Prostanoids are a group of bioactive lipids that are synthesized de novo from membrane phospholipid-released arachidonic acid and have diverse functions in normal physiology and disease. NSAIDs, which are among the most commonly used medications, ameliorate pain, fever, and inflammation by inhibiting COX (cyclooxygenase), which is the rate-limiting enzyme in the biosynthetic cascade of prostanoids. The use of NSAIDs selective for COX-2 inhibition increases the risk of a thrombotic event (eg, myocardial infarction and stroke). All NSAIDs are associated with an increased risk of heart failure. Substantial v...
Source: Arteriosclerosis, Thrombosis and Vascular Biology - Category: Cardiology Authors: Tags: Arterioscler Thromb Vasc Biol Source Type: research
RARITAN, N.J., March 20, 2020 – The Janssen Pharmaceutical Companies of Johnson &Johnson announced today that it will unveil late-breaking data from its leading cardiovascular and metabolism portfolio during the virtual American College of Cardiology’s 69th Annual Scientific Session together with the World Congress of Cardiology (ACC.20/WCC) on March 28-30, 2020. Notably, four late-breaking abstracts for XARELTO® (rivaroxaban) will be presented, including data from the Phase 3 VOYAGER PAD study in patients with symptomatic peripheral artery disease (PAD) after lower-extremity revascularization.Click to ...
Source: Johnson and Johnson - Category: Pharmaceuticals Source Type: news
ConclusionsThis retrospective observational study found a similar efficacy between DOAC and VKA agents in patients with LV thrombi (70.6% vs. 71.5%); however, when the thrombus remains, VKAs are still the standard of care as it is possible to control INR levels (3 –4) with them.
Source: Clinical Drug Investigation - Category: Drugs & Pharmacology Source Type: research
A 75-year-old female patient presented to the emergency department with dyspnoea without chest pain. The personal history was significant for chronic obstructive pulmonary disease, smoking, and major depression. The electrocardiogram showed sinus tachycardia with ST elevations in V2 to V5 (Panel A). Clinical chemistry was significant for elevated N-terminal of prohormone brain natriuretic peptide (2892  ng/L), dynamic elevation of troponin T (baseline 21 ng/L, peak 78 ng/L), and normal creatine kinase. Echocardiography revealed left ventricular systolic dysfunction with reduced left ventricular ejectio...
Source: European Heart Journal - Category: Cardiology Source Type: research
This study sought to investigate what could be learned from how these men have fared. The men were born in 1925-1928 and similar health-related data from questionnaires, physical examination, and blood samples are available for all surveys. Survival curves over various variable strata were applied to evaluate the impact of individual risk factors and combinations of risk factors on all-cause deaths. At the end of 2018, 118 (16.0%) of the men had reached 90 years of age. Smoking in 1974 was the strongest single risk factor associated with survival, with observed percentages of men reaching 90 years being 26.3, 25.7, ...
Source: Fight Aging! - Category: Research Authors: Tags: Newsletters Source Type: blogs
CONCLUSION: Coronary artery disease should be systematically evoked in the presence of ventricular dysfunction in patients with systemic lupus, including when they are young and in the absence of chest pain. Nephrotic syndrome should be identified as a risk factor for arterial thrombosis. PMID: 30981562 [PubMed - as supplied by publisher]
Source: Revue de Medecine Interne - Category: Internal Medicine Tags: Rev Med Interne Source Type: research
This report describes a case of MINOCA patient suffered with multiple complications. Patient concerns: A 63-year-old female was admitted to the emergency department with acute onset of chest pain, electrocardiogram showed ST segment elevation in precordium leads. Diagnosis: Emergency coronary artery angiogram no significant coronary artery stenosis being observed. The diagnosis of MINOCA was established. She subsequently developed ventricular thrombus, heart failure, and ventricular arrhythmia. Interventions: The patient's ventricular tachycardia (VT) was refractory to different treatments. Due to the presence of ...
Source: Medicine - Category: Internal Medicine Tags: Research Article: Clinical Case Report Source Type: research
More News: Angiography | Angioplasty | Cardiology | Coronary Angioplasty | Electrocardiogram | Emergency Medicine | Heart | Heart Attack | Heart Failure | Hospitals | Pain | Percutaneous Coronary Intervention | Smokers | Thrombosis