Tag Archives: ST-elevation myocardial infarction

Introduction Multiple risk factors have been identified for myocardial infarction (MI). Hypercholesterolaemia is one of the major risk factors for cardiovascular diseases, and has an important pathophysiological role in the development of acute ST-elevation myocardial infarction (STEMI).1 Endothelial dysfunction, inflammation, increased thrombogenicity, and plaque vulnerability are the main underlying mechanisms explaining the complex interaction between hypercholesterolaemia and STEMI.2–4 Low-density lipoprotein-cholesterol (LDL-C) has been shown to be a major risk factor in patients with MI, and aggressive LDL-C lowering remains a main ta

Figure 1. ST-elevation in aVR Introduction The variety of electrocardiogram (ECG) changes that occur following acute myocardial infarction (AMI), occur in concordance with coronary circulation anatomy. ST-segment elevation in lead aVR can indicate an anterior wall AMI.1,2 However, lead aVR is commonly neglected by clinicians,3 and as such, this may be a potential source of adverse patient outcomes. The aim of this single-centre study is to investigate how proficiently AMIs presenting with aVR ST-elevation are recognised, using ‘door-to-balloon times’ as an outcome measure in patients having primary percutaneous coronary intervention (PCI)

Introduction An acute myocardial infarction causes a number of electrocardiogram (ECG) changes corresponding to coronary anatomy.1,2 The posterior myocardial infarction (PMI) refers to an infarction of the posterior wall of the left ventricle (LV).3 On the 12-lead ECG, the key to detecting a PMI is through indirect evidence via ST-depression in the antero-septal (V1–V4) leads and evolving R-waves in V1 or V2 with R/S ratios >1.1 A common theory is that these evolving R-waves represent inverted Q-waves. While ST-depression typically occurs in V1–V4, it may also extend into V5 and perhaps other leads.4 In these cases, posterior occlusion

Introduction Primary percutaneous coronary intervention (PPCI) is the preferred management for ST-elevation myocardial infarction (STEMI),1 and guidance committees have universally adopted this strategy as the ‘gold standard’ of care.2-4 National Institute for Health and Care Excellence (NICE) guidelines mandate that PPCI is not only accessible to the entire population of the UK, but also that this is delivered in a timely fashion.4 Therefore, the early identification of appropriate STEMI patients for PPCI is essential, but this can be complicated due to the volume of patients, inadequate training and experience of frontline emergency car

Introduction Myocardial infarction with persistent ST-elevation (STEMI) continues to be a major public health problem. In a recent report, the incidence of hospital admissions for STEMI in Europe varied between 44 and 142 per 100,000 inhabitants per year, and in-hospital mortality reached 13.5%.1 More than 30% of STEMI patients have chronic kidney disease (CKD).2 On the other hand, half of deaths in advanced CKD patients are of cardiovascular causes with myocardial infarction (MI) being the most frequent event.3 Patients with CKD are routinely excluded from cardiovascular clinical trials, and certain medications and treatment modalities are l

No content available