BACKGROUND Patients with acute myocardial infarction (MI) complicated by heart failure (HF) are subject to higher mortality during the index hospitalization. Early risk prediction and intervention may help prevent HF-related morbidity and mortality. METHODS AND RESULTS We examined 77 675 ST-elevation MI and 110 128 non-ST-elevation patients with MI without cardiogenic shock or HF at presentat...

Anticoagulant therapy is a major component in the management of acute coronary syndromes (ACS). Anticoagulant-associated adverse events like heparin-induced thrombocytopenia, bleeding complications and need of close monitoring of anticoagulation led to focus on developing agents causing anticoagulation without affecting primary haemostasis. Fondaparinux, a new-age synthetic anticoagulant, acts ...

Acute coronary syndromes are usually classified on the basis of the presence or absence of ST elevation on the ECG: ST-elevation myocardial infarction or non-ST-elevation myocardial infarction (NSTEMI)patients with acute myocardial infarction (AMI) need immediate therapy, without unnecessary delay and primary percutaneous coronary intervention (PPCI) should preferably be performed within 90 min...

A consecutive series of 179 survivors of acute myocardial infarction had a symptom-limited 12-lead electrocardiographic treadmill exercise test, coronary angiographic studies, and left ventriculograms six to eight weeks after infarction. The exercise-induced ST-segment responses were correlated with the presence of multivessel disease, the presence of advanced left ventricular wall motion abnor...

OBJECTIVE To assess the relation between ST segment elevation during the dobutamine stress test and late improvement of function after acute Q wave myocardial infarction. PATIENTS AND DESIGN 70 patients were studied a mean (SD) 8 (3) days after acute myocardial infarction with high dose dobutamine-atropine stress echocardiography and a follow up echocardiogram at 85 (10) days. A score model b...

We describe the case of a 61-year-old man who presented with chest pain and ST-segment elevation in the anterior precordial leads (V1-V5) due to proximal occlusion of the right ventricular branch of a codominant right coronary artery. Primary coronary angioplasty and stenting of this branch was performed resulting in resolution of the chest pain and ST-segment elevation. Our description illustr...

Coronary angiography is an invasive procedure that utilises X-ray imaging and contrast medium to visualise the coronary vasculature guide management. Current National Institute for Health Care Excellence guidance aims provide within 72-hours patients with high-risk (GRACE>3%) non-ST elevation myocardial infarction (NSTEMI) late-presenting (>12 hours) ST-elevation (STEMI).

The electrocardiogram (ECG) is the initial test in patients with suspected ACS. The ECG is the defining element of ST-segment elevation myocardial infarction (STEMI). Its most important use is in the detection of acute coronary obstruction, and it is the most important, cost-effective, and immediately available initial test in the decision for emergency reperfusion therapy. There is a recent in...

Benefits of early reperfusion in patients presenting with acute ST elevation myocardial infarction (STEMI) are well known. The American College of Cardiology / American Heart Association guidelines recommend triage decisions are made within 10 minutes of performing initial electrocardiogram (ECG). Since many patients presenting with ischemic symptoms may have ST elevation (STE) at baseline, not...

Pulmonary embolism (PE) is an uncommon and often overlooked cause of ST-segment elevation on the electrocardiogram (ECG). Emergent echocardiography has been cited as a means to rapidly distinguish acute myocardial infarction from PE. However, both of these conditions can present with focal wall motion abnormalities. We report a case of a 51-year-old asymptomatic male who presented to our emerge...