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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...

Dysrhythmias IV: Characteristics of Bradyarrhythmias

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Bradyarrhythmias are cardiac rhythm disorders characterized by a slower-than-normal heart rate, typically defined as fewer than 60 beats per minute. Some of which are discussed here:Sinus BradycardiaSinus bradycardia presents a heart rate lower than 60 beats per minute, with a regular rhythm originating from the SA node. The ECG typically shows normal P waves preceding each QRS complex, a normal PR interval (0.12 to 0.20 seconds), and a normal QRS duration (0.06 to 0.10 seconds).First-Degree AV...

Electrocardiogram

Electrocardiogram

An electrocardiogram (ECG or EKG) is a critical diagnostic tool that records the electrical signals produced by the heart during each heartbeat. This recording is achieved through electrodes placed strategically on the arms, legs, and chest. The electrocardiograph amplifies these signals and produces 12 distinct tracings, offering a comprehensive understanding of the heart's electrical activity.
Three major waveforms are present in a typical ECG recording: the P wave, the QRS complex, and...

Disturbances in Heart Rhythm

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The electrical signals recorded on an electrocardiogram (ECG) occur before the mechanical processes of contraction and relaxation during the cardiac cycle.
A cardiac action potential originates in the SA node and spreads throughout the atria and the AV node in approximately 0.03 seconds. This results in the P wave in an ECG and triggers atrial contraction. The action potential is then briefly slowed at the AV node, allowing the atria to contract and fill the ventricles with blood before...

Acute Coronary Syndrome III: Diagnostic Studies

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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...

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Pathological Q-Waves With Coronary Artery Spasm.

Yumi Hirota¹, Shiro Nakamori¹, Daisuke Hiramatsu¹

¹Department of Cardiology and Nephrology, Mie University Graduate School of Medicine, Tsu, Mie, Japan.

JACC. Case Reports

|July 28, 2021

Summary

Fulminant myocarditis can be challenging to diagnose, particularly with concurrent coronary spasm. Clinicians should consider this possibility with hemodynamic instability or ECG changes, necessitating endomyocardial biopsy for treatment guidance.

Keywords:

CMR, cardiovascular magnetic resonance ECG, electrocardiography IABP, intra-aortic balloon pump electrocardiogram giant cell myocarditis multivessel coronary spasm myocardial infarction

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Area of Science:

Cardiology
Pathology

Background:

Myocarditis presents diagnostic challenges, often complicated by coronary artery spasm.
Coronary artery spasm can mimic other cardiac conditions, complicating diagnosis.

Observation:

A case is presented highlighting the diagnostic difficulties of myocarditis co-occurring with coronary spasm.
The patient exhibited hemodynamic instability and unexplained electrocardiogram abnormalities.

Findings:

Coronary spasm coupled with hemodynamic instability or widespread ECG changes suggests fulminant myocarditis.
Endomyocardial biopsy is crucial for definitive diagnosis and treatment planning in such cases.

Implications:

Early recognition of this presentation is vital for timely intervention.
This case underscores the importance of considering myocarditis in patients with unexplained cardiac events and spasm.