A subset of women referred to the cardiac catheterization lab for suspected myocardial infarction thought to be due to a culprit artery are found to have no obstructive coronary artery disease by angiography.The mecha...A subset of women referred to the cardiac catheterization lab for suspected myocardial infarction thought to be due to a culprit artery are found to have no obstructive coronary artery disease by angiography.The mechanism by which these women have myocardial injury varies and is not usually clear by history and angiography alone.Additional imaging,including modalities such as cardiac MRI,intravascular imaging,and computed tomography may be helpful to clarify diagnoses and direct treatment.展开更多
Introduction: Precordial pain is a common reason for admission in cardiology, and has many causes. Acute myocarditis in its pseudo-infarctoid form is sometimes difficult to differentiate from myocardial infarction. Ca...Introduction: Precordial pain is a common reason for admission in cardiology, and has many causes. Acute myocarditis in its pseudo-infarctoid form is sometimes difficult to differentiate from myocardial infarction. Cardiac magnetic resonance imaging (MRI) helps to differentiate these two disease entities. We report the respective cases of two young patients, one presenting with myocarditis whilst the other with myocardial infarction. Case Report: We present the cases of two patients. The first who had a recent history of febrile syndrome is a 23-year-old who stopped smoking 3 months prior to presentation whilst the second is a 22-year-old professional footballer with a history of stress with no other cardiovascular risk factors. They were respectively admitted in our emergency department for a constrictive, intense chest pain. Physical examination was normal. The chest pain in both patients was associated with elevated cardiac markers, primary repolarisation abnormalities on ECG, wall motion abnormalities as well as left ventricular systolic dysfunction on transthoracic echocardiography. Coronary angiograms were normal in both patients. In the first patient, MRI concluded with an acute myocarditis with apical akinesia extending to the anterior wall, a T2 hypersignal indicative of myocardial edema, and uptake of a nodular heterogeneous contrast without affecting the sub-endocardial layers on the late enhancement sequences. In the second patient, MRI showed an appearance consistent with acute extensive infarction in the antero-apical region with severe hypokinesia and late quasi-transmural enhancement, impairment of the anterior papillary muscle of the mitral valve and a reduced left ventricular ejection fraction at 33%. In addition to analgesics, the first patient was treated with perindopril and bisoprolol, and the second patient received antithrombotic and anticoagulant treatment. There was clinical improvement in both patients. Conclusion: Cardiac MRI is a useful diagnostic tool for the precise diagnosis of precordial pain with elevated cardiac enzymes, especially in young patients.展开更多
目的:探讨PTCA球囊封堵猪冠状动脉建立急性心肌梗死再灌注动物模型的实验方法并进行判定。方法:选用中华小型猪8只,将PTCA球囊放至冠状动脉左回旋支第一钝缘支,堵闭血流90 m in,再灌注60 m in后,用坏死特异性对比剂(EC-60)增强MR I在活...目的:探讨PTCA球囊封堵猪冠状动脉建立急性心肌梗死再灌注动物模型的实验方法并进行判定。方法:选用中华小型猪8只,将PTCA球囊放至冠状动脉左回旋支第一钝缘支,堵闭血流90 m in,再灌注60 m in后,用坏死特异性对比剂(EC-60)增强MR I在活体确定梗死区;离体标本进行氯化三苯基四氮唑(TTC)组化染色验证梗死区。结果:成功建立8只猪急性心肌梗死动物模型,活体EC III-60增强MR I高信号区与离体TTC染色所示梗死区部位与面积一致(P>0.05)。结论:应用PTCA球囊封堵猪冠状动脉可成功建立急性心肌梗死动物模型,这种模型具有重复性好、可控性强的优点,且创伤较小,接近临床病理生理过程,可作为急性心肌梗死研究的技术平台。展开更多
文摘A subset of women referred to the cardiac catheterization lab for suspected myocardial infarction thought to be due to a culprit artery are found to have no obstructive coronary artery disease by angiography.The mechanism by which these women have myocardial injury varies and is not usually clear by history and angiography alone.Additional imaging,including modalities such as cardiac MRI,intravascular imaging,and computed tomography may be helpful to clarify diagnoses and direct treatment.
文摘Introduction: Precordial pain is a common reason for admission in cardiology, and has many causes. Acute myocarditis in its pseudo-infarctoid form is sometimes difficult to differentiate from myocardial infarction. Cardiac magnetic resonance imaging (MRI) helps to differentiate these two disease entities. We report the respective cases of two young patients, one presenting with myocarditis whilst the other with myocardial infarction. Case Report: We present the cases of two patients. The first who had a recent history of febrile syndrome is a 23-year-old who stopped smoking 3 months prior to presentation whilst the second is a 22-year-old professional footballer with a history of stress with no other cardiovascular risk factors. They were respectively admitted in our emergency department for a constrictive, intense chest pain. Physical examination was normal. The chest pain in both patients was associated with elevated cardiac markers, primary repolarisation abnormalities on ECG, wall motion abnormalities as well as left ventricular systolic dysfunction on transthoracic echocardiography. Coronary angiograms were normal in both patients. In the first patient, MRI concluded with an acute myocarditis with apical akinesia extending to the anterior wall, a T2 hypersignal indicative of myocardial edema, and uptake of a nodular heterogeneous contrast without affecting the sub-endocardial layers on the late enhancement sequences. In the second patient, MRI showed an appearance consistent with acute extensive infarction in the antero-apical region with severe hypokinesia and late quasi-transmural enhancement, impairment of the anterior papillary muscle of the mitral valve and a reduced left ventricular ejection fraction at 33%. In addition to analgesics, the first patient was treated with perindopril and bisoprolol, and the second patient received antithrombotic and anticoagulant treatment. There was clinical improvement in both patients. Conclusion: Cardiac MRI is a useful diagnostic tool for the precise diagnosis of precordial pain with elevated cardiac enzymes, especially in young patients.
文摘目的:探讨PTCA球囊封堵猪冠状动脉建立急性心肌梗死再灌注动物模型的实验方法并进行判定。方法:选用中华小型猪8只,将PTCA球囊放至冠状动脉左回旋支第一钝缘支,堵闭血流90 m in,再灌注60 m in后,用坏死特异性对比剂(EC-60)增强MR I在活体确定梗死区;离体标本进行氯化三苯基四氮唑(TTC)组化染色验证梗死区。结果:成功建立8只猪急性心肌梗死动物模型,活体EC III-60增强MR I高信号区与离体TTC染色所示梗死区部位与面积一致(P>0.05)。结论:应用PTCA球囊封堵猪冠状动脉可成功建立急性心肌梗死动物模型,这种模型具有重复性好、可控性强的优点,且创伤较小,接近临床病理生理过程,可作为急性心肌梗死研究的技术平台。
