RESUMEN
Right ventricular infarction usually occurs in association with inferior infarction, with no remarkable electrocardiographic signs in conventional leads. This report describes a patient with a previous inferior acute myocardial infarction who developed right ventricular infarction with significant anterior lead ST segment elevation (V1-V4) caused by the loss of two large right ventricular branches during a coronary angioplasty of the right coronary artery. The case is discussed and the literature is reviewed.
Asunto(s)
Electrocardiografía , Ventrículos Cardíacos/fisiopatología , Infarto del Miocardio/diagnóstico , Adulto , Disección Aórtica/diagnóstico , Disección Aórtica/fisiopatología , Disección Aórtica/terapia , Angioplastia Coronaria con Balón , Aneurisma Coronario/diagnóstico , Aneurisma Coronario/fisiopatología , Aneurisma Coronario/terapia , Angiografía Coronaria , Diagnóstico Diferencial , Humanos , Masculino , Infarto del Miocardio/fisiopatología , Infarto del Miocardio/terapia , RecurrenciaRESUMEN
Myocardial bridges consist of muscle fiber bundles lining an epicardial coronary artery for a variable distance. They are a relatively common finding, with incidence changing on the basis of the study method used (angiographic/necropsy). Although myocardial bridges are usually associated with a benign prognosis, being in many cases asymptomatic and only found by chance, their presence has also been considered a cause of angina, malignant arrhythmia, myocardial infarction and sudden death. They are diagnosed in vivo by angiography when a systolic compression of a coronary artery which disappears during diastole is evidenced. We report the case of a patient with electrocardiographic signs of severe ischemia in the territory of the anterior descending artery, which was initially assessed as myocardial infarction and treated as such. Eventually, the ECG returned to normal, and no new Q waves of necrosis occurred. An angiohemodynamic study confirmed the existence of an isolated muscular bridge over the middle third of the anterior descending artery, with no other associated coronary lesions.
Asunto(s)
Anomalías de los Vasos Coronarios/complicaciones , Isquemia Miocárdica/etiología , Enfermedad Aguda , Anomalías de los Vasos Coronarios/diagnóstico , Anomalías de los Vasos Coronarios/diagnóstico por imagen , Diagnóstico Diferencial , Electrocardiografía , Humanos , Masculino , Persona de Mediana Edad , Infarto del Miocardio/diagnóstico , Isquemia Miocárdica/diagnóstico por imagen , Tomografía Computarizada de Emisión de Fotón ÚnicoRESUMEN
An electrocardiogram tracing of a patient in conducted sinus rhythm with left bundle branch block is shown, in which occasional pseudonormalization of intraventricular conduction is seen. This event is attributed to ventricular fusions with end-diastolic extrasystoles of the left His-Purkinje system distal to the block site. This type of extrasystole is discussed. In this case, normalization of ventricular activation allowed for diagnosis of inferior subepicardial ischemia.
Asunto(s)
Bloqueo de Rama/complicaciones , Isquemia Miocárdica/complicaciones , Complejos Prematuros Ventriculares/complicaciones , Bloqueo de Rama/diagnóstico , Bloqueo de Rama/fisiopatología , Diagnóstico Diferencial , Diástole , Electrocardiografía , Humanos , Masculino , Persona de Mediana Edad , Isquemia Miocárdica/diagnóstico , Isquemia Miocárdica/fisiopatología , Complejos Prematuros Ventriculares/diagnóstico , Complejos Prematuros Ventriculares/fisiopatologíaRESUMEN
Nowadays, the implantation of coronary endoprosthesis within the left main coronary artery is not considered as an absolute contraindication. Here, we show a case of acute occlusion within the left main coronary artery. This was resolved by implanting a stent during a programmed cardiac catheterization. It should be stressed that this problem was occurred without manipulating the left coronary tree. In addition, the patient was in cardiac arrest when the stent was implanted. Cardiopulmonary resuscitation was applied because of this condition.