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Acute Coronary Syndrome II: Pathophysiology and Clinical Manifestations01:19

Acute Coronary Syndrome II: Pathophysiology and Clinical Manifestations

The pathophysiology of Acute Coronary Syndrome [ACD] involves several key processes:The main underlying cause of ACD is atherosclerosis, a chronic inflammatory disease characterized by the buildup of lipid-laden plaques within the coronary arteries.As the atherosclerotic plaque grows in the coronary artery, it may become unstable due to the formation of a lipid-rich core and a thin fibrous cap. Inflammatory cells within the plaque, such as macrophages, secrete enzymes that degrade the...
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Acute Coronary Syndrome I: Introduction

Acute Coronary Syndrome (ACS) encompasses a spectrum of heart conditions caused by sudden obstruction of coronary arteries, typically resulting from the rupture of an atherosclerotic plaque and subsequent thrombus (blood clot) formation. This obstruction can lead to partial or complete blockage of blood flow, causing varying degrees of myocardial ischemia or infarction.ACS includes the following clinical entities:Unstable Angina (UA)Non-ST-Elevation Myocardial Infarction (NSTEMI)ST-Elevation...
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Diagnosing acute coronary syndrome or ACS begins with a thorough patient history. Notable symptoms include central, crushing chest pain radiating to the left arm, neck, jaw, or back, along with shortness of breath, sweating (diaphoresis), nausea, vomiting, dizziness, and palpitations.It is crucial to note any history of cardiac illnesses and assess risk factors, including age, gender, smoking, hypertension, diabetes, hyperlipidemia, and a sedentary lifestyle.During physical examination, vital...
Coronary Circulation01:21

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The heart, an organ critical to survival, gets nourishment not from the blood it pumps but from a separate circulation system known as coronary circulation. This is the shortest circulation in the body and is responsible for supplying the heart with the nutrients it needs to function effectively.
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Remote Magnetic Navigation for Accurate, Real-time Catheter Positioning and Ablation in Cardiac Electrophysiology Procedures
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Coronary sinus lead fragmentation and migration.

Miguel A Arias1, Marta Pachón, Alberto Puchol

  • 1Unidad de Arritmias y Electrofisiología Cardiaca, Servicio de Cardiología, Hospital Virgen de la Salud, Toledo, Spain. maapalomares@secardiologia.es

Pacing and Clinical Electrophysiology : PACE
|April 24, 2012
PubMed
Summary
This summary is machine-generated.

A patient with ischemic cardiomyopathy experienced coronary sinus lead failure after cardiac resynchronization therapy. Lead extraction led to an unusual complication, but outcomes were positive.

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Area of Science:

  • Cardiology
  • Medical Devices
  • Cardiac Surgery

Background:

  • Ischemic cardiomyopathy necessitates advanced therapies like cardiac resynchronization therapy (CRT).
  • CRT systems, particularly coronary sinus leads, can be subject to long-term complications and require revision.
  • Lead failure is a known issue in patients with implanted cardiac devices.

Observation:

  • A patient with a history of ischemic cardiomyopathy and CRT presented with coronary sinus lead failure.
  • Surgical revision was planned, involving percutaneous lead extraction.
  • An unexpected complication arose during the lead extraction procedure.

Findings:

  • Percutaneous extraction of a damaged coronary sinus lead was successfully performed.
  • An unusual complication directly related to the damaged lead occurred during extraction.
  • Despite the complication, the patient experienced relatively positive outcomes post-procedure.

Implications:

  • This case highlights potential complications associated with percutaneous lead extraction in CRT systems.
  • It underscores the importance of careful technique and awareness of rare adverse events during device revision.
  • Positive outcomes suggest that even complex complications can be managed effectively in cardiac device therapy.