European heart journal. Acute cardiovascular care
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Eur Heart J Acute Cardiovasc Care · Apr 2018
Case ReportsPostoperative takotsubo cardiomyopathy: an illustration of the electrocardiographic features that raise suspicion for takotsubo.
Takotsubo cardiomyopathy is an increasingly recognized clinical disorder mimicking acute coronary syndrome. It is usually preceded by physical or emotional stress and recovery of the left ventricular systolic function occurs in most cases within 1-4 weeks. Takotsubo cardiomypathy can masquerade as ST-segment elevation myocardial infarction when chest pain, ST-segment elevation, and high cardiac biomarkers coexist. ⋯ Awareness of these electrocardiographic features has several diagnostic and therapeutic implications. Nevertheless, these electrocardiographic criteria alone cannot reliably differentiate between both entities, and the diagnosis of takotsubo cardiomyopathy is only established after coronary angiography confirms the absence of occlusive coronary artery disease and the characteristic apical ballooning is evident on left ventriculogram (in the case of the apical form). Herein, we present a case of postoperative takotsubo cardiomyopathy and discuss the various electrocardiographic features that raise suspicion for this transient cardiac syndrome.
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Eur Heart J Acute Cardiovasc Care · Mar 2018
Multicenter Study Observational StudyFast assessment and management of chest pain patients without ST-elevation in the pre-hospital gateway (FamouS Triage): ruling out a myocardial infarction at home with the modified HEART score.
The first study of the FamouS Triage project investigates the feasibility of ruling out a myocardial infarction in pre-hospital chest pain patients without electrocardiographic ST-segment elevation by using the modified HEART score at the patient's home, incorporating only a single highly sensitive troponin T measurement. ⋯ It seems feasible to rule out a myocardial infarction at home in chest pain patients without ST-segment elevation by using the modified HEART score.
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Eur Heart J Acute Cardiovasc Care · Mar 2018
Multicenter Study Clinical TrialImproved risk stratification of patients with acute coronary syndromes using a combination of hsTnT, NT-proBNP and hsCRP with the GRACE score.
Clinical scores and biomarkers improve risk stratification of patients with acute coronary syndromes. However, little is known about their value in patients referred for coronary angiography. ⋯ NCT01000701.
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Eur Heart J Acute Cardiovasc Care · Mar 2018
EditorialEditor's Choice - Impact of initial hospital diagnosis on mortality for acute myocardial infarction: A national cohort study.
Early and accurate diagnosis of acute myocardial infarction is central to successful treatment and improved outcomes. We aimed to investigate the impact of the initial hospital diagnosis on mortality for patients with acute myocardial infarction. ⋯ Nearly one in three patients with acute myocardial infarction had other diagnoses at first medical contact, who less frequently received guideline indicated care and had significantly higher mortality rates. There is substantial potential, greater for NSTEMI than STEMI, to improve outcomes through earlier and more accurate diagnosis of acute myocardial infarction.