PMID- 25246457
OWN - NLM
STAT- MEDLINE
DCOM- 20150622
LR  - 20211021
IS  - 1757-790X (Electronic)
IS  - 1757-790X (Linking)
VI  - 2014
DP  - 2014 Sep 22
TI  - An unusual cause of ST elevation myocardial infarction (STEMI).
LID - 10.1136/bcr-2014-203981 [doi]
LID - bcr2014203981
AB  - A 67-year-old Caucasian woman presented to clinic with a 2-month history of 
      worsening shortness of breath on exertion and a single episode of chest pain 1 
      week before. Her ECG in clinic showed ST elevation inferiorly and she was 
      admitted from clinic for further investigations as inpatient. She was initiated 
      on the acute coronary syndrome protocol and underwent emergency left heart 
      catheterisation on the day of admission. The coronary angiogram revealed large 
      aneurysmal dilations in the right coronary artery and left main stem. A 
      ventriculogram showed poor left ventricular (LV) systolic function in line with 
      subsequent transthoracic echocardiogram, which revealed her to have an left 
      ventricular ejection-fraction (LVEF) of approximately 20%. It was agreed with the 
      cardiothoracic surgeons to treat the aneurysms non-operatively and start 
      low-molecular weight heparin. Furthermore the underlying biventricular impairment 
      was treated with ACE-inhibitors, beta-blockers and diuretic therapy (loop and 
      potassium-sparing). The strategy was to prevent further thrombus formation with 
      the aneurysmal vessels and to achieve this the patient was initiated on lifelong 
      warfarin. Other medical risk factors were optimised and patient started on statin 
      medication. The aneurysm was monitored with serial CTs with a view to reconsider 
      surgical intervention if any evidence of dilation. This case highlights an 
      unusual cause of ST elevation myocardial infarction.
CI  - 2014 BMJ Publishing Group Ltd.
FAU - Monem, Mohammed
AU  - Monem M
AD  - St Peter's Hospital, Surrey, UK.
FAU - Rampat, Rajiv
AU  - Rampat R
AD  - St Peter's Hospital, Surrey, UK.
LA  - eng
PT  - Case Reports
PT  - Journal Article
DEP - 20140922
PL  - England
TA  - BMJ Case Rep
JT  - BMJ case reports
JID - 101526291
SB  - IM
MH  - Aged
MH  - Coronary Aneurysm/*complications/diagnosis/diagnostic imaging/physiopathology
MH  - Coronary Angiography
MH  - Diagnosis, Differential
MH  - Electrocardiography
MH  - Female
MH  - Humans
MH  - Myocardial Infarction/*etiology/physiopathology
PMC - PMC4173268
EDAT- 2014/09/24 06:00
MHDA- 2015/06/24 06:00
PMCR- 2016/09/22
CRDT- 2014/09/24 06:00
PHST- 2014/09/24 06:00 [entrez]
PHST- 2014/09/24 06:00 [pubmed]
PHST- 2015/06/24 06:00 [medline]
PHST- 2016/09/22 00:00 [pmc-release]
AID - bcr-2014-203981 [pii]
AID - 10.1136/bcr-2014-203981 [doi]
PST - epublish
SO  - BMJ Case Rep. 2014 Sep 22;2014:bcr2014203981. doi: 10.1136/bcr-2014-203981.