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Related Concept Videos

Acute Coronary Syndrome I: Introduction01:30

Acute Coronary Syndrome I: Introduction

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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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Imbalances in Cardiac Output01:26

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The heart's primary function is to pump blood throughout the body, maintaining a balance between blood sent out (cardiac output) and blood returning (venous return). If this balance is disrupted, it can result in congestive heart failure (CHF), a severe condition where the heart becomes an inefficient pump, leading to inadequate blood circulation.
CHF can occur due to the failure of either side of the heart. Left-side failure leads to pulmonary congestion—the right side continues to send...
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Acute Coronary Syndrome II: Pathophysiology and Clinical Manifestations01:19

Acute Coronary Syndrome II: Pathophysiology and Clinical Manifestations

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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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Mitral Stenosis I: Introduction01:22

Mitral Stenosis I: Introduction

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Mitral Valve Stenosis (MVS) is a heart condition where the mitral valve narrows, impeding blood circulation from the left atrium to the left ventricle. The etiology and pathophysiology of this condition are multifaceted, leading to a cascade of cardiovascular complications.Causes of Mitral Valve StenosisRheumatic Heart Disease: It is the main cause of mitral valve stenosis, particularly in developing nations. This condition arises from rheumatic fever, an inflammatory illness resulting from...
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Coronary Circulation01:21

Coronary Circulation

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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.
Coronary circulation begins at the base of the aorta, where two main arteries arise—the left and right coronary arteries. These arteries encircle the heart in the coronary sulcus and supply the...
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Ischemic Heart Disease: Overview01:17

Ischemic Heart Disease: Overview

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Ischemic heart disease occurs when the heart's blood supply dwindles, causing an ominous lack of oxygen and nutrients. This deficiency, stemming from reduced or obstructed blood flow, spells danger, leading to heart muscle damage and dysfunction.
Atherosclerosis, the primary malefactor, orchestrates this dangerous condition. It manifests as the accumulation of fatty deposits, akin to insidious plaques, within arterial walls. As time elapses, these plaques metamorphose, hardening and...
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Related Experiment Video

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Postconditioning with Lactate-enriched Blood for Cardioprotection in ST-segment Elevation Myocardial Infarction
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A Unique Case of STEMI STEALing the Flow.

Asra Khalid Butt1, Nureddin Almaddah2, Qasim M Mirza3

  • 1Department of Internal Medicine, University of Tennessee School of Medicine, Memphis, Tennessee, USA.

JACC. Case Reports
|July 28, 2021
PubMed
Summary

A 55-year-old woman experienced acute ST-segment elevation myocardial infarction due to left subclavian artery occlusion. This rare complication reduced flow in her internal mammary artery graft to the left anterior descending artery.

Keywords:
CABG, coronary artery bypass graftingCAD, coronary artery diseaseCSSS, coronary subclavian steal syndromeCT, computed tomographyECG, electrocardiogramLAD, left anterior descending arteryLIMA, left internal mammary arterycoronary artery bypassmyocardial infarctionthrombosis

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A Research Method For Detecting Transient Myocardial Ischemia In Patients With Suspected Acute Coronary Syndrome Using Continuous ST-segment Analysis
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Area of Science:

  • Cardiology
  • Vascular Surgery
  • Interventional Cardiology

Background:

  • Coronary artery bypass grafting (CABG) is a common procedure for coronary artery disease.
  • The internal mammary artery (IMA) is frequently used as a conduit for CABG, particularly to the left anterior descending artery (LAD).
  • Complications of CABG, though rare, can significantly impact patient outcomes.

Observation:

  • A 55-year-old woman with a history of CABG presented with acute ST-segment elevation myocardial infarction.
  • The infarction was found to be secondary to occlusion of the proximal left subclavian artery.
  • This occlusion led to reduced blood flow in her LIMA-LAD graft.

Findings:

  • Proximal left subclavian artery occlusion can precipitate acute myocardial infarction in patients with LIMA-LAD grafts.
  • Reduced graft flow due to external arterial compression is a potential mechanism.
  • This case underscores the importance of considering non-coronary arterial pathology in graft-related ischemia.

Implications:

  • Clinicians should consider subclavian artery stenosis/occlusion in patients with prior CABG presenting with myocardial infarction.
  • Further investigation into the patency of major arteries supplying grafts is warranted.
  • This finding may influence surgical planning and postoperative monitoring for CABG patients.