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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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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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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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Coronary Artery Disease (CAD) originates from a series of events that impair the function of coronary arteries, the blood vessels responsible for delivering oxygen-rich blood to the heart muscle. The pathophysiology of CAD is closely linked to atherosclerosis, a chronic inflammatory and lipid-driven condition affecting the vascular endothelium.1. Endothelial DamageThe process begins with damage to the vascular endothelium, which serves as a protective barrier between the blood and the vessel...
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Coronary Artery Disease (CAD) is a primary health risk worldwide, leading to significant morbidity and mortality. The condition arises from the buildup of atherosclerotic plaques within the coronary arteries, resulting in diminished blood supply to the heart muscle.The clinical manifestations of CAD vary widely, from asymptomatic stages to severe, life-threatening conditions. Understanding these manifestations is crucial for early diagnosis and effective management.Angina Pectoris: The Warning...
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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.
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ST Elevation MI with Normal Coronary Arteries: A MINOCA Case.

Hilal Olgun Kucuk1, Ugur Kucuk1, Muhammed Hamza Saad Shaukat2

  • 1Department of Internal Medicine, University of South Dakota Sanford School of Medicine, Sioux Falls, South Dakota.

South Dakota Medicine : the Journal of the South Dakota State Medical Association
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Summary

Myocardial infarction with nonobstructive coronary arteries (MINOCA) is a common cause of heart attacks, especially in young women. Further investigation is crucial as MINOCA outcomes are comparable to traditional heart attacks.

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Area of Science:

  • Cardiology
  • Cardiovascular Imaging
  • Acute Myocardial Infarction

Background:

  • Myocardial infarction with nonobstructive coronary arteries (MINOCA) presents as myocardial infarction despite normal or near-normal coronary arteries on angiography.
  • MINOCA is increasingly recognized and affects specific demographics, including younger women and nonwhite individuals.

Observation:

  • A case of a 35-year-old female with MINOCA is presented, detailing symptoms, EKG findings, and elevated troponin levels.
  • Coronary angiography revealed normal coronary arteries, while echocardiography showed reduced ejection fraction and lateral wall hypokinesis.
  • Cardiac magnetic resonance imaging confirmed myocardial scar with transmural late gadolinium enhancement in the lateral wall, indicative of myocardial infarction.

Findings:

  • MINOCA is a frequent presentation of acute myocardial infarction (AMI), often seen in younger women and nonwhites.
  • Patients with MINOCA typically have fewer traditional cardiovascular risk factors and may present with non-ST-segment elevation myocardial infarction.
  • Diagnostic imaging, including CMR, is essential for identifying myocardial scar and confirming infarction in MINOCA.

Implications:

  • MINOCA is not a benign condition, with outcomes comparable to AMI with coronary artery disease (CAD), particularly in younger patients.
  • Identifying the underlying etiology of MINOCA is critical for guiding appropriate treatment strategies.
  • Further research into MINOCA pathogenesis and management is warranted to improve patient outcomes.