tailieunhanh - Báo cáo y học: "A successfully thrombolysed acute inferior myocardial infarction due to type A aortic dissection with lethal consequences: the importance of early cardiac echocardiography"

Tuyển tập các báo cáo nghiên cứu về y học được đăng trên tạp chí y học Wertheim cung cấp cho các bạn kiến thức về ngành y đề tài: A successfully thrombolysed acute inferior myocardial infarction due to type A aortic dissection with lethal consequences: the importance of early cardiac echocardiography. | Tsigkas et al. Journal of Cardiothoracic Surgery 2011 6 101 http content 6 1 101 JCTS JOURNAL OF CARDIOTHORACIC SURGERY CASE REPORT Open Access A successfully thrombolysed acute inferior myocardial infarction due to type A aortic dissection with lethal consequences the importance of early cardiac echocardiography 1 f I 1 1 1 Grigorios Tsigkas Georgios Kasimis Konstantinos Theodoropoulos Konstantinos Chouchoulis Nikolaos G Baikoussis2 Efstratios Apostolakis2 Eleni Bousoula1 Athanasios Moulias1 and Dimitrios Alexopoulos1 Abstract Thrombolysis a standard therapy for ST elevation myocardial infarction STEMI in non-PCI-capable hospitals may be catastrophic for patients with aortic dissection leading to further expansion rupture and uncontrolled bleeding. Stanford type A aortic dissection rarely may mimic myocardial infarction. We report a case of a patient with an inferior STEMI thrombolysed with tenecteplase and followed by clinical and electrocardiographic evidence of successful reperfusion which was found later to be a lethal acute aortic dissection. Prognostic implications of early diagnosis applying transthoracic echocardiography TTE are described. Background Acute myocardial infarction AMI usually results from an occlusive coronary thrombus at the site of a ruptured atherosclerotic plaque 1 . Reperfusion therapies such as primary percutaneous coronary intervention PPCI and thrombolysis are mandatory steps for reducing mortality and limiting the infarct size in patients with ST segment elevation myocardial infarction STEMI . The greatest benefit occurs if reperfusion therapy is initiated within the first hours from the onset of symptoms and there is no preference for either strategy if these symptoms are present for less than 3 hours 2 . Clinically speaking many conditions such as acute aortic dissection pericarditis pulmonary embolism and myocarditis may mimic acute myocardial infarction. Thrombolysis in most of these situations is .