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Simultaneous thrombosis of 2 vascular territories: is thrombolytic therapy a better option?
We have read with great interest the article by Akyuz and colleagues in the American Journal of Emergency Medicine and congratulate them for their observation. Their case exemplifies the concurrent occurrence of ST-segment elevation myocardial infarction (STEMI) and posterior circulation stroke that was eventually managed with thrombolytic therapy. Simultaneous thrombosis of 2 distant vascular territories is a rare and complicated clinical scenario. In these instances, there is usually an underlying cause linking both thrombotic events rather than being a mere coincidence. We have previously described the myocardial infarc...
Source: The American Journal of Emergency Medicine - July 1, 2013 Category: Emergency Medicine Authors: Hesham R. Omar, Devanand Mangar, Enrico M. Camporesi Tags: Correspondence Source Type: research

Troponin rise and poor outcome in patients with acute atrial fibrillation: rationale and criteria of selection of patients
The role of new onset atrial fibrillation (AF) as a marker of thromboembolic risk has been demonstrated in the setting of acute myocardial infarction . Thus, someone might inquire the role of acute AF in patients with abnormal troponin not fulfilling criteria of acute myocardial infarction and might question if the minor reported range of troponin I (cTn-I) values in the study population of Conti et al (from 0.15 to 7.0 ng/mL) may not be linked with a secondary ischemic mechanism, likely an imbalance between demand and supply . However, the independent predictive value of abnormal troponin for a composite of stroke, acute ...
Source: The American Journal of Emergency Medicine - May 22, 2013 Category: Emergency Medicine Authors: Alberto Conti, Yuri Mariannini, Erica Canuti Tags: Correspondence Source Type: research

Rescue thrombolysis in the treatment of cardiac shock and acute stroke
The patients with ST-elevation myocardial infarction are primarily managed with percutaneous coronary intervention (PCI) or thrombolysis. It is well accepted that rescue PCI should be implemented in case of unsuccessful thrombolysis. However, the reverse, rescue thrombolysis, that is, administering of thrombolytic therapy in a patient in whom primary PCI fails, is not well defined. There are no available data about rescue thrombolysis so far. We represent a 43-year-old male patient with Buerger disease (thromboangiitis obliterans) who was admitted to our emergency department for cardiac shock related to inferior and right ...
Source: The American Journal of Emergency Medicine - April 19, 2013 Category: Emergency Medicine Authors: Sukru Akyuz, Mustafa Azmi Sungur, Cevdet Donmez, Aylin Sungur, Nese Cam Tags: Case Reports Source Type: research

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