Related Experiment Video

Updated: Jan 18, 2026

A Research Method For Detecting Transient Myocardial Ischemia In Patients With Suspected Acute Coronary Syndrome Using Continuous ST-segment Analysis
18:11

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

Published on: December 28, 2012

24.7K

A Patient Presenting with Joint Deformities and ST-Elevation Myocardial Infarction

Emil J Dąbrowski1, Wiktoria U Kozłowska1, Patrycja O Lipska1

  • 1Department of Invasive Cardiology, Medical University of Białystok, 15-089 Białystok, Poland.

Diagnostics (Basel, Switzerland)
|September 13, 2025
PubMed

Insights

This case study shows that severe tophaceous gout can lead to serious heart and kidney problems, even with standard treatment. Advanced therapies may be needed for refractory gout with multi-organ involvement.

Area of Science:

  • Rheumatology
  • Cardiology
  • Nephrology

Background:

  • Tophaceous gout, a severe form of gout, is associated with significant systemic complications.
  • Patients with refractory gout often have comorbidities like cardiovascular and renal disease.
  • Long-term urate-lowering therapy may not always prevent disease progression in severe cases.

Purpose of the Study:

  • To present a case of ST-elevation myocardial infarction in a patient with advanced, treatment-refractory tophaceous gout.
  • To highlight the cardiovascular and renal sequelae of severe gout.
  • To discuss the management of refractory tophaceous gout with multi-organ involvement.

Main Methods:

  • A 62-year-old male patient with a history of chronic kidney disease, hypertension, heart failure, and atrial fibrillation presented with ST-elevation myocardial infarction.
  • Coronary angiography revealed multivessel disease, treated with percutaneous coronary intervention.
  • The patient underwent hybrid coronary artery bypass grafting and left atrial appendage occlusion.

Main Results:

  • The patient had advanced tophaceous gout with severe joint deformities and tophi despite urate-lowering therapy.
  • He experienced ST-elevation myocardial infarction and multivessel coronary artery disease.
  • Despite initial interventions, disease progression necessitated consideration of advanced therapies like pegloticase and canakinumab.

Conclusions:

  • Treatment-refractory tophaceous gout poses a systemic burden, leading to progressive cardiovascular and renal complications.
  • Tophaceous gout is a high-risk phenotype associated with increased mortality and reduced quality of life.
  • Multidisciplinary care and personalized strategies are crucial for managing severe, refractory gout with multi-organ involvement.

Keywords:
coronary artery diseasegoutmyocardial infarction

More Related Videos

Postconditioning with Lactate-enriched Blood for Cardioprotection in ST-segment Elevation Myocardial Infarction05:26

Postconditioning with Lactate-enriched Blood for Cardioprotection in ST-segment Elevation Myocardial Infarction

Published on: May 28, 2019

9.6K
Confirmation of Myocardial Ischemia and Reperfusion Injury in Mice Using Surface Pad Electrocardiography09:23

Confirmation of Myocardial Ischemia and Reperfusion Injury in Mice Using Surface Pad Electrocardiography

Published on: November 24, 2016

13.8K

Related Concept Videos

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...
363
Acute Coronary Syndrome I: Introduction01:30

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...
828
Acute Coronary Syndrome III: Diagnostic Studies01:30

Acute Coronary Syndrome III: Diagnostic Studies

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...
218
Coronary Artery Disease III: Clinical Manifestations01:30

Coronary Artery Disease III: Clinical Manifestations

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...
330
Rheumatic Heart Disease II: Clinical Manifestations and Diagnostic Studies01:22

Rheumatic Heart Disease II: Clinical Manifestations and Diagnostic Studies

The key clinical manifestations of Rheumatic heart disease (RHD) include several distinct cardiac symptoms.Carditis, a hallmark of acute rheumatic fever, involves inflammation of the heart's endocardium, myocardium, and pericardium. Chronic RHD often results from recurrent episodes of carditis. Its symptoms include the following:Murmurs are caused by valvular damage, especially to the mitral and aortic valves. Mitral stenosis or regurgitation is common, with characteristic heart murmurs...
500
Myocarditis II: Clinical Features and Diagnostic Tests01:27

Myocarditis II: Clinical Features and Diagnostic Tests

Myocarditis is an inflammation of the heart muscle. The symptoms vary widely, encompassing asymptomatic presentations to severe, acute manifestations.Clinical PresentationAsymptomatic cases: In some instances, myocarditis may be asymptomatic, with the infection resolving without intervention. These cases often go undetected unless discovered incidentally through diagnostic imaging or tests conducted for other reasons.General Early Symptoms: Early symptoms of myocarditis are non-specific and can...
267