Acute Anterior Wall Myocardial Infarction Research Articles

Two Cases of Acute Myocarditis with Suspected Acute Myocardial Infarction

Case 1: The patient is a 19-year-old male who was admitted to the hospital with a cough for three days and chest pain for a day, aggravated for two hours. Electrocardiogram showed 1. Sinus tachycardia 2. First-degree atrioventricular block 3. ST-T changes, not excluding acute extensive anterior wall myocardial infarction. Case 2: The patient was a 47-year-old woman admitted to the hospital with a fever for three days. Electrocardiogram showed: 1. Sinus tachycardia, 2. Complete block of the right bundle branch, 3. ST-T changes, not excluding acute extensive anterior myocardial infarction. The study of these two cases strengthened the departmental staff’s knowledge of ECG in acute myocarditis and provided a rapid and accurate ECG diagnosis in the clinic.

Unraveling genetic causality between metformin and myocardial infarction on the basis of Mendelian randomization.

In recent years, several studies have explored the effect of metformin on myocardial infarction (MI), but whether metformin has an improvement effect in patients with MI is controversial. This study was aimed to investigate the causal relationship between metformin and MI using Mendelian randomization (MR) analysis. The genome-wide significant (P<5×10-8) single-nucleotide polymorphisms (SNPs) in patients with metformin and patients with MI were screened from the Open genome-wide association study (GWAS) project as instrumental variables (IVs). The study outcomes mainly included MI, old MI, acute MI, acute transmural MI of inferior wall, and acute transmural MI of anterior wall. The inverse variance weighted (IVW) method was applied to assess the main causal effect, and weighted median, simple mode, weighted mode methods, and MR-Egger regression were auxiliary applied for supplementary proof. The causal relationship between metformin and MI was assessed using odds ratios (OR) and 95% confidence intervals (95% CI). A leave-one-out method was used to explore the effect of individual SNPs on the results of IVW analyses, and a funnel plot was used to analyze the potential bias of the study results, thus ensuring the robustness of the results. In total, 16, 84, 39, 26, and 34 SNPs were selected as IVs to assess the genetic association between metformin and outcomes of MI, old MI, acute MI, acute transmural MI of inferior wall, and acute transmural MI of anterior wall, respectively. Treatment with metformin does not affect the risk of acute transmural MI of anterior wall at the genetic level (P>0.05; OR for inverse variance weighted was 1.010). In the cases of MI, old MI, acute MI, and acute transmural MI of inferior wall, metformin may even be a risk factor for patients (P<0.05; ORs for inverse variance weighted were 1.078, 1.026, 1.022 and 1.018 respectively). There was no horizontal pleiotropy or heterogeneity among IVs. The results were stable when removing the SNPs one by one. Metformin is not protective against the risk of myocardial infarction in patients and may even be a risk factor for MI, old MI, acute MI, and acute transmural MI of inferior wall.

A Rare Combination of Mechanical Complications Following Myocardial Infarction: Ventricular Septal Rupture and an Extensive Ventricular Aneurysm

Mechanical complications following acute myocardial infarction (MI) are rare and account for &lt;1% of the total cases, with the advent of the newest revascularization methods. Although this low incidence, the mortality rate is high, especially among older patients. A 51 years old female, with a history of diabetes and asthma, was admitted to our cardiac intensive care unit for heart failure symptoms. She was diagnosed about 3 weeks ago, with acute anterior wall MI. She did not undergo any revascularization because of the lack of means and was on optimal medical therapy. Transthoracic echocardiography (TTE) revealed akinesia of the inferior, septal, and lateral wall, and all apical segments with a giant aneurysm of 10mm, and a posterior interventricular rupture with a left-right shunt, with a reduced left ventricular (LV) ejection fraction of 19%. An enhanced computed tomography (CT) scan revealed a ventricular septal (VS) defect with a giant left ventricular aneurysm (LVA), which was connected to the LV posterior wall. Urgent cardiac surgery after a percutaneous cardiac intervention was not realized because of lack of means. The association of VS rupture and LVA, found in our patient, is an extremely rare and highly lethal complication requiring urgent surgical management. Its incidence is between 1% and 2% of MIs. TTE has very high sensitivity and specificity, to provide diagnosis and evaluation of VS rupture and LVA. Color-flow Doppler identifies abnormal flow within the aneurysm and helps to highlight ventricular ruptures as an additional image in the endocardium. CT is fast, provides a clear resolution of the LV, and may be used to demonstrate the complications of infarction. The management of VSD is surgical, with the difficulty of repair from fragile infarcted tissue. Medical therapy should stabilize the hemodynamics and act as a bridge to surgery. The simultaneous presence of a VS rupture and LVA is rare and usually occurs within the MI. However, as shown in ..

A Study on Clinical Profile, Angiographic Profile, Predictors of Mortality and Outcome of Patients Having Acute Anterior Wall Myocardial Infarction with Right Bundle Branch Block and Right Precordial Q-Waves (QRBBB AWMI ) in a Tertiary Care Centre

A Study on Clinical Profile, Angiographic Profile, Predictors of Mortality and Outcome of Patients Having Acute Anterior Wall Myocardial Infarction with Right Bundle Branch Block and Right Precordial Q-Waves (QRBBB AWMI ) in a Tertiary Care Centre

Risk Factors of Suboptimal Coronary Blood Flow after a Percutaneous Coronary Intervention in Patients with Acute Anterior Wall Myocardial Infarction.

Primary percutaneous coronary intervention (PCI) is regarded as the most preferred strategy in ST-segment elevation myocardial infarction (STEMI). Thrombolysis in Myocardial Infarction (TIMI) flow grade has been an important and cohesive predictor of outcomes in STEMI patients. We sought to evaluate potential variables associated with the risk of suboptimal TIMI flow after PCI in patients with anterior wall STEMI. We evaluated 107 patients admitted to our hospital between 1 January 2019 and 31 December 2021 with a diagnosis of anterior wall STEMI treated with primary PCI. Suboptimal TIMI flow grade (≤2) after PCI occurred in 14 (13%) patients while grade 3 was found in 93 (87%) of them presenting with anterior wall STEMI. Failure to achieve optimal TIMI 3 flow grade after PCI was associated with lower TIMI grade prior to PCI (OR 0.5477, 95% CI 0.2589-0.9324, p = 0.02), greater troponin concentration before (OR 1.0001, 95% CI 1-1.0001, p = 0.0028) and after PCI (OR 1.0001, 95% CI 1-1.0001, p = 0.0452) as well as lower mean minimal systolic blood pressure (OR 0.9653, 95% CI 0.9271-0.9985, p = 0.04). Among predictors of suboptimal TIMI flow grade after PCI, we noted lower TIMI grade flow pre-PCI, greater serum troponin concentrations in the periprocedural period and lower mean minimal systolic blood pressure.

Retracted: Preventive Effect Observation of Dapagliflozin on Middle and Later Ventricular Remodeling in Patients with Acute ST Segment Elevation Anterior Wall Myocardial Infarction: A Single-Center, Retrospective Cohort Study.

[This retracts the article DOI: 10.1155/2022/3955914.].

FREQUENCY OF HIGH DEGREE ATRIOVENTRICULAR BLOCK IN PATIENTS WITH ACUTE ANTERIOR WALL MYOCARDIAL INFARCTION

Atrioventricular (AV) block is an AV conduction disorder that can manifest in various settings, with varying symptomaticity and severity. Complications of acute ST-elevation myocardial infarction (STEMI) as AV blocks are often observed. The first degree of atrioventricular block is the most common and requires no treatment. The second-degree block is sub-classified in Mobitz type I and Mobitz type II. This study aimed to determine the frequency of high-degree atrioventricular block in acute anterior wall myocardial infarction cases. The current cross-sectional analysis was conducted at the Department of Cardiology, Rehmat-ul-Lil-Alameen Institute of Cardiology, Lahore, from 19-02-2021 to 18-08-2021. A total of 311 patients were enrolled in the study. Cases underwent an electrocardiogram, and high degree AV Block was labeled per operational definitions. The results were noted and recorded on the same proforma. The overall mean age of the patients was 55.6±8.4 years. Gender distribution of patients shows a higher frequency of 57.9% males compared to 42.1% females with a female-to-male ratio of 1:1.4. High degree of atrioventricular block was found among 5.8% of the total patients. Around 5.8% of AWMI patients presented with high-grade AV block in this study are in-concomitant with other studies. No association of risk factors (p-value &gt;0.05) was presented regarding age, gender, DM, hypertension, dyslipidemia, family history of CAD, and smoking in this study.

The Diagnostic Accuracy of Electrocardiogram in Differentiating Takotsubo Cardiomyopathy in Patients Presenting as Anterior Wall St-Segment Elevation Myocardial Infarction and Taking Coronary Angiography as Gold Standard

Myocardial infarction: Myocardial infarction is the irreparable damage to heart muscles resulting in necrosis &amp; is the leading cause of death; resulting in 500,000-700,000 important deaths related to the coronary artery occur each year. Cardiovascular disease is the most common reason resulting in premature mortality as well as morbidity among various ethnic group of white, black and Hispanic populations. Takotsubo Cardiomyopathy: TCM is a condition that affects the heart reversible syndrome, characteristic of decrease(hypokinesia)/ near absent movement (akinesia) of distal half of interventricular septum &amp; cardiac apex showed as apical ballooning on echocardiogram with absence of an obstructive defect in epicardial coronary arteries following an emotional disturbance. Objective: To determine the diagnostic accuracy of electrocardiographic findings (elevation &lt; 1mm Takotsubo cardiomyopathy can be identified in lead V1 in patients who have anterior wall ST-segment elevation myocardial infarction by taking coronary angiography as gold standard. Design: Cross-sectional survey Subjects &amp; Methods: Using 250 incidences in the sample, and a 95% confidence level, a 13% error margin, and the anticipated percentage of Takotsubo cardiomyopathy i.e, 18% by using 74.2% sensitivity and 80.6% specificity of electrocardiographic findings i.e, ST-elevation of &gt; 1mm in V1 in the detection of Takotsubo cardiomyopathy when myocardial infarction with ST-elevation in the anterior wall is the presenting symptom and coronary angiography as gold standard2. Results: The patients were 49 + 13 years old on average. Sensitivity &amp; specificity of ECG criteria were 40.78% &amp; 78.65%. The positive &amp; negative predictive values were 43.28% &amp; 76.5% respectively. Practical Implication: Our study showed negative association of ST-elevation of &gt;1mm in ECG lead V1 to differentiate TC from anterior wall myocardial infarction. Further studies should be done to probe into the diagnostic accuracy of ECG in differentiating TC from acute anterior wall myocardial infarction. Conclusion: Electrocardiography is not diagnostic for distinguishing acute anterior wall pain from Takotsubo cardiomyopathy myocardial infarction so additional investigations need to be performed to diagnose the Takotsubo Cardiomyopathy. Keywords: Myocardial infarction, Takotsubo cardiomyopathy, Electrocardiogram, diagnostic accuracy Coronary angiography.

Frequency of Mitral Regurgitation in Patients with Acute Myocardial Infarction

BACKGROUND: Mechanical complications can occur after acute myocardial infarction. Most commonly mitral regurgitation (MR) occurs after infero-basal myocardial infarction (MI) due to papillary muscles dysfunction. MR may also develop with antero-apical MI. The objective of the study was to determine the frequency of mitral regurgitation in acute MI patients and to risk stratify the patients with MR for anterior and inferior wall MI. AIMS &amp; OBJECTIVE: To assess the frequency of mitral regurgitation in patients with acute myocardial infarction. MATERIAL &amp; METHODS: This was a descriptive case series carried out at the Cardiology department of Jinnah Hospital, Lahore from: 29-10-2013 to 29-04-2014. A total of 340 patients of MI were included. Echocardiography examination was carried out on all subjects on day 3-4 post MI. Frequency of mitral regurgitation in each group was measured by color flow Doppler technique. RESULTS: Out of study population, 153 (45%) were in between 30-50 years and 187 (55%) were in between 51-75 years. The mean of age was calculated as 55.09+11.81 years. In our data 181 (53.24%) were male and 159 (46.76%) were female. Frequency of MR in acute MI patients was recorded in 69 (20.29%) while 271 (79.71%) had no findings of MR. From the total of 69 cases, MR was recorded in 13 (18.84%) as anterior wall MI and 16 (23.19%) as inferior wall MI, p value was calculated as 0.532 which shows insignificant difference. There was a significant difference in hospital stay and mortality between both groups p-value 0.04. CONCLUSION: Mechanical complications develop after acute myocardial infarction and may be associated with serious outcomes. KEYWORDS: Acute MI, mitral regurgitation, anterior and inferior wall MI.

FREQUENCY OF LEFT VENTRICULAR THROMBUS IN PATIENTS WITH ACUTE ANTERIOR WALL MYOCARDIAL INFARCTION

Acute myocardial infarction (AMI) can be fatal and, if not, can result in many short- and long-term complications. Left ventricular thrombus (LVT) is an underrated complication that can lead to systemic embolization and, ultimately, stroke or end-organ damage. The current cross-sectional study is designed to determine the frequency of left ventricular thrombus after acute anterior wall myocardial infarction at the Department of Cardiology, Rehmatul-lil-Alameen Institute of Cardiology, Lahore, from 12-09-2020 to 11-03-2021. All patients of 20 to 60 years of either gender meeting the operational definition of the acute anterior wall were included. LV thrombus was diagnosed on echocardiography as an amorphous echogenic structure with variable shape and adherent to the endocardium. In this study, there were 87 cases; out of these, there were 57 (65.52%) males, and 30 (34.48%) females. The mean age of the subjects was 49.90±6.27 years. Out of 87 cases, 37 (42.53%) had a history of DM, 30 (45.98%) were hypertensive, and 31 (35.63%) were smokers. Left ventricular thrombus (LVT) was found in 16 (18.39%) cases. LVT was seen in 9 (15.79%) males vs. 7 (23.33%) females with p= 0.39. LVT was seen in 5 (13.51%) cases with DM and 11 (22%) with no DM, 7 (17.50%) cases with HTN, and 9 (19.15%) normotensives with p= 0.41 and 1.0. LVT was found in 5 (22.72%) cases with ejection fraction (EF) up to 40% and 11 (16.92%) cases with EF more than this with p= 0.18. Based on the results, the left ventricular thrombus is not uncommon after acute anterior wall MI and is nearly seen in every one out of five cases and is more common in cases with ejection fraction up to 40%.

Recovery and prognostic values of myocardial strain in acute anterior and non-anterior wall myocardial infarction.

To assess the recovery and prognostic values of myocardial strain using cardiac magnetic resonance (CMR)- feature tracking (FT) in acute anterior and non-anterior wall myocardial infarction. 103 reperfused patients after STEMI who underwent CMR at about 4 days (baseline) and 4 months (follow-up) were included, including 48 and 55 patients with anterior wall myocardial infarction (AWMI) and non-anterior wall myocardial infarction(NAWMI). CMR-FT analysis was performed using cine images to measure LV global radial, circumferential, and longitudinal peak strains (GRS, GCS, and GLS, respectively). Infarct size (IS) and microvascular obstruction (MVO) were estimated by late-gadolinium enhancement imaging. The primary clinical endpoint was the occurrence of major adverse cardiac events (MACE) after infarction. Patients with AWMI had higher IS, higher MVO, lower ejection fraction, and more significantly impaired CMR-FT strain values than patients with NAWMI (all p<0.05). Global strain significantly improved at 4 months (all p<0.01), especial in NAWMI. GLS was an independent predictor (odds ratio = 2.08, 95% confidence interval = 1.032-4.227, p = 0.04] even after adjustment for IS and MVO. The optimal cutoff of GLS was -7.9%, with sensitivity and specificity were 73.3% and 75.0%, respectively. In receiver operating characteristic analysis, IS remained the strongest predictor (area under the curve [AUC] = 0.83, p<0.01), followed by MVO (AUC = 0.81, p<0.01) and GLS (AUC = 0.78, p<0.01). CMR-FT-derived global myocardial strains significantly improved over time, especial in NAWMI. GLS measurement independently predicted the occurrence of medium-term MACE.

Hyperdominant Right Coronary Artery Occlusion Presenting with Acute Anterior Wall Myocardial Infarction

This case report describes a 69-year-old male who presented with acute anterior myocardial infarction and was detected to have a hyperdominant right coronary artery (RCA) with a large posterior descending branch coursing from the posterior interventricular groove into the apical part of the anterior interventricular space and posterior left ventricular branch coursing in the left atrioventricular groove and supplying the entire free wall. Primary percutaneous intervention of the proximally occluded posterior descending artery resulted in resolution of ST-segment elevation in anterior and inferior leads and also revealed the large vascular territory of the RCA. The occurrence of superdominant RCA and intact left circumflex artery presenting with acute anterior wall myocardial infarction has not been described earlier. Precise morphological and physiological knowledge and evaluation of such a variation assists in opting for the best available therapeutic modality and prognosis.

Echocardiographic Assessment of Right Ventricular Function in Patients with Acute Anterior wall Myocardial Infarction

Echocardiographic Assessment of Right Ventricular Function in Patients with Acute Anterior wall Myocardial Infarction

Acute myocarditis masquerading as anterior wall myocardial infarction: A case report

Myocarditis is the inflammation of the myocardium. The clinical presentation of myocarditis ranges from asymptomatic state to acute heart failure which may mimic acute coronary events. Because of the similar presentation of chest pain, elevated cardiac enzymes, and electrocardiographic (ECG) changes, acute myocarditis may rarely masquerade as acute myocardial infarction (AMI). High suspicion is often necessary for treating such patients, keeping in mind the different treatment protocols required for managing each pathology. SCARE 2020 Guidelines. We report a case of a young female presenting with sudden onset chest pain with ECG changes suggestive of acute anterior wall myocardial infarction (AWMI). Further investigations ruled out AWMI, and she was diagnosed with acute myocarditis. She was treated for myocarditis and showed a prompt recovery. Acute myocarditis may present clinically similarly to ACS; hence a high level of suspicion is required to differentiate the two entities. The absence of significant cardiovascular risk factors for atherosclerotic coronary artery disease, absence of RWMA, and normal coronary angiogram are further suggestive of myocarditis.

A study on clinical, electrocardiographic and angiographic predictors of mortality in acute anterior wall myocardial infarction with right bundle branch block and right precordial Q waves (qRBBB) pattern

A study on clinical, electrocardiographic and angiographic predictors of mortality in acute anterior wall myocardial infarction with right bundle branch block and right precordial Q waves (qRBBB) pattern

A CASE OF VENTRICULAR SEPTAL RUPTURE AFTER ACUTE MYOCARDIAL INFARCTION

When ventricular septal rupture (VSR) complicates acute myocardial infarction the mortality is usually high. Reperfusion therapy has reduced its incidence. However if VSR has developed then rapid diagnosis, aggressive medical management, and surgical intervention are required to optimize recovery and survival. In the era before reperfusion therapy, septal rupture complicated 1 to 3 percent of acute myocardial infarctions. Among the 41,021 patients in the Global Utilization of Streptokinase and Tissue Plasminogen Activator for Occluded Coronary Arteries (GUSTO-I) trial, ventricular septal rupture was suspected in 140 patients (0.34 percent) and confirmed by a retrospective review in 84 (0.2 percent). Thus, reperfusion therapy has decreased the incidence of septal rupture. Septal rupture occurs more frequently with anterior wall acute myocardial infarction than other types of acute myocardial infarction. Risk factors for septal rupture included hypertension, advanced age (60 to 69 years), female sex and the absence of a history of angina or myocardial infarction. Angina or previous infarction may lead to myocardial preconditioning as well as to the development of coronary collaterals, both of which reduce the likelihood of septal rupture. In patients undergoing thrombolysis advanced age, female sex, and the absence of smoking are often associated with an increased risk of septal rupture, whereas the absence of antecedent angina has not been associated with an increased risk. In the GUSTO-I trial, there was a nonlinear relation between the systolic and diastolic blood pressures at enrolment and septal rupture, since hypertension and extensive myocardial infarction and right ventricular infarction are also risk factors for septal rupture

ACUTE ANTERIOR WALL MYOCARDIAL INFARCTION BY AN ANOMALOUS MID LEFT ANTERIOR DESCENDING ARTERY ORIGINATING FROM THE PROXIMAL RIGHT CORONARY ARTERY

SESSION TITLE: Etiologies of Cardiovascular Disease Case Report PostersSESSION TYPE: Case Report PostersPRESENTED ON: 10/19/2022 12:45 pm - 01:45 pmINTRODUCTION: The estimated incidence of coronary artery anomalies is up to 1%.CASE PRESENTATION: A 50-year-old man with peripheral artery disease and drug abuse was brought to the emergency department unresponsive post cardiac arrest.Before arrival, he had ventricular fibrillation which progressed to asystole.He received two defibrillations, cardiopulmonary resuscitation, epinephrine, and amiodarone before return of spontaneous circulation. On arrival, he was intubated.EKG showed ST-segment anterior ST-elevations.The patient emergently transported to the cardiac catheterization laboratory.Diagnostic coronary angiography showed a 100% thrombotic stenosis of the second diagonal branch and an anomalous mid and distal LAD originating from the proximal RCA.The D2 was repaired successfully with a 2.5 x 34 mm Resolute Onyx drug-eluting stent.Following decision was made to pursue a dual injection to evaluate for a mid and distal LAD arising as a branch from the conus. Following a 6F JR5 catheter was used to engage the RCA.Dual injections were performed in multiple projections, and a mid and distal LAD arising from the conus was confirmed.At the end of the procedure, the EKG showed resolution of the ST elevations. The patient was transferred to the intensive care unit.DISCUSSION: These anomalies are generally asymptomatic, but rarely may lead to myocardial ischemia/infarction and/or sudden death.In particular, STEMI is a rare clinical presentation and identification of the culprit lesion with subsequent emergent PCI can be challenging in this setting.CONCLUSIONS: We report a rare case of cardiac arrest due to 100% thrombotic occlusion of culprit anomalous LAD originating from RCA leading to acute anterior wall myocardial infarction.Reference #1: Kheirkhah J, Sadeghipour P, Kouchaki A. An anomalous origin of left anterior descending coronary artery from right coronary artery in a patient with acute coronary syndrome. J Tehran Heart Cent. 2011 Nov;6(4):217-9. Epub 2011 Nov 30. PMID: 23074373; PMCID: PMC3467955.DISCLOSURES: No relevant relationships by Samiullah ArshadNo relevant relationships by Huzefa BhopalwalaNo relevant relationships by Nakeya Dewaswalano disclosure on file for Hussam Fawzi Ahmad Hawamdeh;no disclosure submitted for Andrew Leventhal;no disclosure submitted for Adrian Messerli;No relevant relationships by Vinayak Mishra SESSION TITLE: Etiologies of Cardiovascular Disease Case Report Posters SESSION TYPE: Case Report Posters PRESENTED ON: 10/19/2022 12:45 pm - 01:45 pm INTRODUCTION: The estimated incidence of coronary artery anomalies is up to 1%. CASE PRESENTATION: A 50-year-old man with peripheral artery disease and drug abuse was brought to the emergency department unresponsive post cardiac arrest. Before arrival, he had ventricular fibrillation which progressed to asystole. He received two defibrillations, cardiopulmonary resuscitation, epinephrine, and amiodarone before return of spontaneous circulation. On arrival, he was intubated. EKG showed ST-segment anterior ST-elevations. The patient emergently transported to the cardiac catheterization laboratory. Diagnostic coronary angiography showed a 100% thrombotic stenosis of the second diagonal branch and an anomalous mid and distal LAD originating from the proximal RCA. The D2 was repaired successfully with a 2.5 x 34 mm Resolute Onyx drug-eluting stent. Following decision was made to pursue a dual injection to evaluate for a mid and distal LAD arising as a branch from the conus. Following a 6F JR5 catheter was used to engage the RCA. Dual injections were performed in multiple projections, and a mid and distal LAD arising from the conus was confirmed. At the end of the procedure, the EKG showed resolution of the ST elevations. The patient was transferred to the intensive care unit. DISCUSSION: These anomalies are generally asymptomatic, but rarely may lead to myocardial ischemia/infarction and/or sudden death. In particular, STEMI is a rare clinical presentation and identification of the culprit lesion with subsequent emergent PCI can be challenging in this setting. CONCLUSIONS: We report a rare case of cardiac arrest due to 100% thrombotic occlusion of culprit anomalous LAD originating from RCA leading to acute anterior wall myocardial infarction. Reference #1: Kheirkhah J, Sadeghipour P, Kouchaki A. An anomalous origin of left anterior descending coronary artery from right coronary artery in a patient with acute coronary syndrome. J Tehran Heart Cent. 2011 Nov;6(4):217-9. Epub 2011 Nov 30. PMID: 23074373; PMCID: PMC3467955. DISCLOSURES: No relevant relationships by Samiullah Arshad No relevant relationships by Huzefa Bhopalwala No relevant relationships by Nakeya Dewaswala no disclosure on file for Hussam Fawzi Ahmad Hawamdeh; no disclosure submitted for Andrew Leventhal; no disclosure submitted for Adrian Messerli; No relevant relationships by Vinayak Mishra

Frequency of Left Ventricular Thrombus after Acute Anterior Wall Myocardial Infarction at Karachi

Background: The left ventricular problem is a prominent acute myocardial infarction (AMI) complication. It has been demonstrated that rapid reperfusion reduces mortality and improves left ventricular (LV) function. There is a dearth of information on left ventricular thrombus (LVT) in the current era of primary percutaneous coronary intervention (PPCI). Aim: To estimate the frequency of left ventricular thrombus in patients who have experienced an acute anterior wall myocardial infarction at Karachi's leading cardiac hospital. Study design: Cross-sectional study Place and duration of study: Department of Cardiology, National Institute of Cardiovascular Disease, Karachi from 1st July 2021 to 31st December 2021. Methodology: Three hundred and fifty five patients of both genders age between 40 and 80 years were diagnosed with acute anterior wall myocardial infarction and underwent purcutaneous coronary intervention were enrolled. Results: There were 286 (80.6%) males and 69 (19.4%) females. The mean age was 56.29±11.04 years. Two patients (6%) experienced in-hospital mortality, while 56 patients (15.8%) had left ventricular thrombus. Conclusion: Acute ST-elevation myocardial infarction frequently results in the development of left ventricular thrombus. Keywords: Myocardial infarction, Left ventricular thrombus, Frequency

Peripheral Embolism From Left Ventricular Thrombus

Left ventricular thrombus formation is common in acute anterior wall myocardial infarction. It imposes a significant risk of systemic embolization resulting in various degree of morbidity and mortality. Echocardiogram is a useful investigation to detect their occurrence and anticoagulation is the mainstay of treatment.

Frequency of acute heart failure in patients undergoing thrombolysis for anterior wall myocardial infarction.

Objective: To determine frequency of acute heart failure in patient undergoing thrombolysis for anterior wall MT. Study Design: Cross-sectional study. Setting: Faisalabad Institute of Cardiology, Faisalabad. Period: July 2017 to December 2019. Material &amp; Methods: After approval from hospital Ethical committee of Faisalabad institute of cardiology. Results: 150 patients with acute anterior wall myocardial infarction were recruited from the emergency department of Faisalabad institute of cardiology. They were thrombolysed as per local protocol i.e 1.5 million units of Streptokinase intravenous with proper monitoring. Then patients were evaluated for sign and symptoms of heart failure (as per operational definition) within 3 days of admission. In our study, out of 150 cases, 51.33% (n=77) were between 25-50 years of the age whereas 48.67% (n=73) were between 51-70 years of age, mean+sd was calculated as 50.09±9.14 years, 46% (n=69) were male whereas 54% (n=81) were females. Frequency of acute heart failure in patients undergoing thrombolysis for acute anterior wall myocardial infarction was recorded in 16% (n=24). Conclusion: We concluded that the frequency of acute heart failure is higher in patients undergoing thrombolysis for acute anterior wall myocardial infarction and needs to draw attention, however, some other trials are required to validate our results.