Abstract:
:To analyze the paradox of acute myocardial infarction (AMI) with an initially normal electrocardiogram (ECG), we reviewed the records of 732 patients discharged with a final diagnosis of AMI over a 2-year period. Twenty-one patient were identified whose initial ECG was normal and who underwent coronary arteriography during the index hospitalization. According to the ECG evolution, three distinct groups were identified: Group 1: those who subsequently developed ST elevation or Q waves (n = 7), Group 2: those who developed ST depression or T-wave inversion (n = 8), and Group 3: those whose ECG remained normal ( n = 6). Peak creatine kinase (CK), timing of the first ECG change, life-threatening complications, and location of the infarct-related coronary lesion were recorded. Infarct-related coronary lesions were also classified into those in a major coronary trunk versus those in secondary branches. The incidence of AMI with a normal ECG was 3.7%. There was no difference in the frequency of coronary artery involvement in the groups studied: left anterior descending (33%), right coronary artery (38%), and circumflex (28%). All ECG changes developed within the first 48 h of hospitalization; 17 +/- 15 in Group 1, and 24 +/- 12 h in Group 2. All six patients who had a persistently normal ECG (Group 3) had lesions in branch vessels (p < 0.05 when compared with Group 1 plus Group 2). Patients who developed ST elevation or Q waves (Group 1) always had a major artery trunk involved (p < 0.05 when compared with Group 2 plus Group 3). Patients in Group 3 had less myocardial damage and fewer complications compared with the other two groups. Myocardial infarction with an initial normal ECG is uncommon and may result from involvement of any of the three coronary arteries. Electrocardiographic evolution usually occurs within the first 48 h of hospitalization. Patients whose ECGs remain normal appear to have culprit lesions in coronary branches, smaller infarctions, and fewer in-hospital complications.
journal_name
Clin Cardioljournal_title
Clinical cardiologyauthors
Caceres L,Cooke D,Zalenski R,Rydman R,Lakier JBdoi
10.1002/clc.4960181006subject
Has Abstractpub_date
1995-10-01 00:00:00pages
563-8issue
10eissn
0160-9289issn
1932-8737journal_volume
18pub_type
杂志文章abstract::The long-term survival rate following acute myocardial infarction (AMI) was studied in 358 patients in central Japan who were monitored for 8 to 20 years after discharge from hospital for AMI. Fifteen-year cardiac survival rates were 65% in males and 72% in females. In both sexes, the survival rate decreased with incr...
journal_title:Clinical cardiology
pub_type: 杂志文章
doi:10.1002/clc.4960120905
更新日期:1989-09-01 00:00:00
abstract::A case of aortic ball valve prosthesis malfunction is described in which the poppet became alternately stuck in the open and closed position. The patient experienced chest pain followed by pulmonary edema and cardiac arrest. Malfunction of prosthetic valve was diagnosed on echocardiogram and cardiopulmonary resuscitat...
journal_title:Clinical cardiology
pub_type: 杂志文章
doi:10.1002/clc.4960051105
更新日期:1982-11-01 00:00:00
abstract:BACKGROUND:Early reperfusion therapy has reduced the infarct size and mortality rate in patients with acute myocardial infarction (AMI). The occurrence of bundle-branch block in AMI is related to the amount of myocardial damage and the insult to the conduction system. HYPOTHESIS:To evaluate the clinical and angiograph...
journal_title:Clinical cardiology
pub_type: 杂志文章
doi:10.1002/clc.4960241204
更新日期:2001-12-01 00:00:00
abstract::Various types of pulmonary venous return abnormalities have been described in the literature. This report presents a case in which a 4-h-old neonate presented with cyanotic heart disease and respiratory distress. This neonate was subsequently shown to have complete absence of the pulmonary veins (CAPV), a previously u...
journal_title:Clinical cardiology
pub_type: 杂志文章
doi:10.1002/clc.4960110415
更新日期:1988-04-01 00:00:00
abstract::Sertraline is a selective serotonin reuptake inhibitor with established safety for the treatment of depression. Among the common adverse effects associated with sertraline are nausea, insomnia, diarrhea, somnolence, and dizziness. Cardiac arrest had not been reported in the literature, although tachycardia was frequen...
journal_title:Clinical cardiology
pub_type: 杂志文章
doi:10.1002/clc.20647
更新日期:2010-06-01 00:00:00
abstract::Lipoprotein (a) [Lp(a)] concentrations were determined in 365 patients undergoing coronary angiography for stable angina (n = 159), unstable angina (n = 99), recent myocardial infarction (n = 45), and nonischemic heart disease (cardiomyopathy or valvular disease, n = 62, non-IHD). Mean +/- SD and median Lp(a) concentr...
journal_title:Clinical cardiology
pub_type: 杂志文章
doi:10.1002/clc.4960180909
更新日期:1995-09-01 00:00:00
abstract::Specific properties of the vessel wall of arteries employed as coronary bypass grafts are thought to play an important role in the short- and long-term performance of these conduits. Heterogeneity in the endothelial and smooth muscle cell function between different arteries may provide particular vessels with properti...
journal_title:Clinical cardiology
pub_type: 杂志文章,评审
doi:10.1002/clc.4960190307
更新日期:1996-03-01 00:00:00
abstract::An unusual case of metastatic disease of the right ventricle is described in a 74-year-old woman who had presented with a malignant fibrous histiocytoma of the right thigh previously treated with surgery and radiotherapy. Two years later she presented with signs and symptoms of tricuspid regurgitation and right ventri...
journal_title:Clinical cardiology
pub_type: 杂志文章
doi:10.1002/clc.4960140216
更新日期:1991-02-01 00:00:00
abstract:BACKGROUND:Compared with medical therapy, percutaneous coronary intervention (PCI) does not reduce mortality or myocardial infarction in patients with stable angina. Therefore, PCI should be guided by refractory anginal symptoms and not just lesion characteristics. HYPOTHESIS:We hypothesized that angiographic lesion c...
journal_title:Clinical cardiology
pub_type: 杂志文章
doi:10.1002/clc.22510
更新日期:2016-04-01 00:00:00
abstract:BACKGROUND:Left ventricular ejection fraction (LVEF) ≤35% is the cutoff value used to identify patients at high risk of sudden cardiac death. However, whether patients who have moderate left ventricular dysfunction and left ventricular enlargement (LVE) have a high risk of ventricular arrhythmias (VAs) and cardiac deat...
journal_title:Clinical cardiology
pub_type: 杂志文章
doi:10.1002/clc.22588
更新日期:2016-12-01 00:00:00
abstract:BACKGROUND:When used in appropriately selected heart failure (HF) patients, cardiac resynchronization therapy (CRT) reduces mortality and hospitalization. It is not understood whether CRT implantation during hospitalization for HF is associated with similar benefits. HYPOTHESIS:Timing of CRT implantation relative to h...
journal_title:Clinical cardiology
pub_type: 杂志文章,多中心研究
doi:10.1002/clc.23135
更新日期:2019-02-01 00:00:00
abstract:BACKGROUND:The objective of this study was to estimate the prevalence of prehypertension and hypertension in the rural adults of Liaoning province of China. METHODS:The study was conducted in 2004-2006, using a multistage cluster sampling method to select a representative sample. A total of 45925 adults, 35 years or o...
journal_title:Clinical cardiology
pub_type: 杂志文章
doi:10.1002/clc.20073
更新日期:2007-04-01 00:00:00
abstract::Triglyceride (TG) has long been associated as a risk factor for coronary artery disease. A recent meta-analysis of various epidemiologic studies has confirmed this link. An important issue is to assess further the appropriate cutpoints to classify desirable TG because recent data indicate that levels < 200 mg/dl confe...
journal_title:Clinical cardiology
pub_type: 杂志文章,评审
doi:10.1002/clc.4960221402
更新日期:1999-06-01 00:00:00
abstract::Dynamic cardiomyoplasty is a new surgical procedure proposed for treatment of the failing heart. Clinically, the latissimus dorsi muscle is raised as a pedicled flap and wrapped around the heart. The skeletal muscle is transformed to produce a myocardium-like fatigue-resistant muscle. It is stimulated to contract in s...
journal_title:Clinical cardiology
pub_type: 杂志文章,评审
doi:10.1002/clc.4960121203
更新日期:1989-12-01 00:00:00
abstract::Isolated tricuspid insufficiency (TI) is relatively uncommon and mostly of traumatic origin. We report clinical noninvasive and invasive findings and surgical results in 5 cases. All patients had complete clinical, noninvasive and invasive studies including right and left catheterization, and coronary angiographies in...
journal_title:Clinical cardiology
pub_type: 杂志文章
doi:10.1002/clc.4960070509
更新日期:1984-05-01 00:00:00
abstract::Three cases are presented where acute myocardial infarction occurred in young individuals after an episode of heavy alcohol intake. Subsequent coronary arteriograms demonstrated normal coronary arteries. Several mechanisms by which acute ethanol intoxication might precipitate myocardial infarction are discussed. To ou...
journal_title:Clinical cardiology
pub_type: 杂志文章
doi:10.1002/clc.4960050707
更新日期:1982-07-01 00:00:00
abstract::The hemodynamic and myocardial energetic changes due to pulsus alternans were investigated by left and right heart catheterization and by oxygen consumption measurements in three patients with dilative cardiomyopathy. In all three patients, pulsus alternans developed after intravenous administration of the phosphodies...
journal_title:Clinical cardiology
pub_type: 杂志文章
doi:10.1002/clc.4960100506
更新日期:1987-05-01 00:00:00
abstract:BACKGROUND:Massive evidence supports that increase of lipids bring more risk of atherosclerosis. However, it is not clear if lipids measured a long time ago bear more risk than the current measurement. HYPOTHESIS:Lipids measured currently is more associated with carotid atherosclerosis than lipids measured long time a...
journal_title:Clinical cardiology
pub_type: 杂志文章
doi:10.1002/clc.22015
更新日期:2012-08-01 00:00:00
abstract:BACKGROUND:Guidelines suggest that "upstream" P2Y12 receptor antagonists should be considered in patients with non-ST-segment elevation acute coronary syndromes (NSTE-ACS). HYPOTHESIS:Early use of ticagrelor in patients managed with an invasive strategy would be more effective than clopidogrel because of its more rapi...
journal_title:Clinical cardiology
pub_type: 杂志文章,多中心研究,随机对照试验
doi:10.1002/clc.22733
更新日期:2017-06-01 00:00:00
abstract::To determine the accuracy of two-dimensional echocardiography (2-D echo) for assessment of exercise-induced wall motion abnormalities in patients with coronary artery disease, the results of stress echocardiography were compared with exercise cineventriculography. In 56 consecutive patients, biplane cineventriculograp...
journal_title:Clinical cardiology
pub_type: 杂志文章
doi:10.1002/clc.4960110808
更新日期:1988-08-01 00:00:00
abstract::During the last several years dilating balloons have been applied in the treatment of stenotic cardiac valves. This interest has been extended to stenotic porcine bioprosthetic valves. Part I of this review discusses the pathologic changes producing stenotic porcine prosthetic valves. Part II of this review describes ...
journal_title:Clinical cardiology
pub_type: 杂志文章
doi:10.1002/clc.4960140912
更新日期:1991-09-01 00:00:00
abstract::A 56-year-old male with atrial fibrillation developed rapid ventricular response up to 200 beats/min or more in the postoperative stage of emergency aortocoronary bypass surgery. Resuscitation for cardiac arrest triggered this rapid ventricular rate. The idea that retrograde conduction into atrioventricular node may p...
journal_title:Clinical cardiology
pub_type: 杂志文章
doi:10.1002/clc.4960100412
更新日期:1987-04-01 00:00:00
abstract::We investigated 26 patients admitted to our catheterization laboratory with a diagnosis of acute myocardial infarction. In each case acute revascularization was unsuccessful, but the diagnosis was confirmed by angiography. In 11 patients with an uncomplicated course of acute myocardial infarction magnetic resonance im...
journal_title:Clinical cardiology
pub_type: 杂志文章
doi:10.1002/clc.4960091102
更新日期:1986-11-01 00:00:00
abstract:BACKGROUND:Pulmonary capillary wedge pressure (PCWP) is a useful index of preload and an important determinant of cardiac function. HYPOTHESIS:We postulated that the rate of blood propagating into the left atrium (LAIF-PR) would be a useful measure of PCWP in critically ill patients. METHODS:Fifty-two critically ill ...
journal_title:Clinical cardiology
pub_type: 杂志文章
doi:10.1002/clc.4960260412
更新日期:2003-04-01 00:00:00
abstract::A total of 140 consecutive patients with acute Q-wave myocardial infarction was evaluated to assess the relationship between different electrocardiographic patterns of evolution and the incidence of recurrent ischemia within 10 days of infarction. Patients were allocated to three groups according to the electrocardiog...
journal_title:Clinical cardiology
pub_type: 杂志文章
doi:10.1002/clc.4960181205
更新日期:1995-12-01 00:00:00
abstract::The coronary sinus (CS) is a small tubular structure just above the posterior left atrioventricular junction. The CS can be imaged in several different echocardiographic views. Using zoom M-mode recordings of the CS in apical two-chamber view, CS caliber can be sharply imaged and easily measured during different phase...
journal_title:Clinical cardiology
pub_type: 杂志文章,评审
doi:10.1002/clc.4960230304
更新日期:2000-03-01 00:00:00
abstract:BACKGROUND:An experimental study showed that nebivolol is an effective agent in contrast-induced nephropathy (CIN) prophylaxis. HYPOTHESIS:We hypothesized that prophylactic nebivolol use had protective effects on renal function in human beings subjected to iodinated contrast agent since it has vasodilatory effect and ...
journal_title:Clinical cardiology
pub_type: 杂志文章,随机对照试验
doi:10.1002/clc.21013
更新日期:2012-04-01 00:00:00
abstract:BACKGROUND:Advanced practice providers (APPs) can fill care gaps created by physician shortages and improve adherence/compliance with preventive ASCVD interventions. HYPOTHESIS:APPs utilizing guideline-based algorithms will more frequently escalate ASCVD risk factor therapies. METHODS:We retrospectively reviewed data...
journal_title:Clinical cardiology
pub_type: 杂志文章
doi:10.1002/clc.22963
更新日期:2018-06-01 00:00:00
abstract::Remote ischemic preconditioning (RIPC) has been studied in models of different cardiovascular entities. Recently, a beneficial effect of RIPC on incidence of atrial fibrillation (AF) in postsurgical patients has been suggested. However, the potential impact of RIPC on electrophysiological- and thrombogenesis-related p...
journal_title:Clinical cardiology
pub_type: 杂志文章,随机对照试验
doi:10.1002/clc.22584
更新日期:2016-11-01 00:00:00
abstract:BACKGROUND:Low levels of high-density lipoprotein cholesterol (HDL-C; <40 mg/dL) are associated with increased risk of cardiovascular events, but it is unclear whether lower thresholds (<30 mg/dL) are associated with increased hazard. HYPOTHESIS:Very low levels of HDL-C may provide prognostic information in acute coro...
journal_title:Clinical cardiology
pub_type: 杂志文章,多中心研究,随机对照试验
doi:10.1002/clc.22533
更新日期:2016-06-01 00:00:00