Headache: An unusual presentation of acute myocardial infraction.

Acute myocardial infarction should be diagnosed as early as possible for the appropriate management to salvage ischemic myocardium. Accurate diagnosis is typically based on the typical symptoms of angina. Headache is an unusual symptom in patients with acute myocardial infraction. We report a patient with ST-segment elevation acute myocardial infarction who presented to the emergency department complaining of severe occipital headache without chest discomfort.

Clinical outcome and angiographic results with novel polysulfone polymer coating paclitaxel eluting stent in real-world clinical practice: a clinical centre registry.

BACKGROUND: The Intek-Apollo stent (Switzerland) employs a polysulfone polymer coating which has demonstrated low interaction with blood and high thrombo-resistance. The aim of this study was to assess the clinical and angiographic outcomes after Intek-Apollo stent utilisation in a real-world setting. MATERIAL/METHODS: A total of 130 patients (77.7% males) were enrolled with 174 lesions in native coronary arteries (92.4%), saphenous vein grafts (7.5%) and in-stent restenosis (6.3%). Indications for stenting were stable coronary artery disease (CAD) 52.3%, acute coronary syndrome (ACS) 37.7% and STEMI 10%. Clinical follow-up and coronary angiography (after symptoms occurrence or positive stress test) was performed at 6 and 12 months.The primary end points were target lesion revascularization (TLR) and target vessel revascularization (TVR), while secondary end points were major adverse cardiac events (MACE) during the follow-up period. RESULTS: The mean age of patients included was 61.62±11.13 years. Complex lesions treatment (ostial, bifurcation) reached 13.7%. Mean stenosis diameter was 83.52±10.5%. Reference vessel diameter was 2.85±0.39 mm with a mean lesion length of 14.66±4.5mm. Average stent size was 2.93±0.39mm × 16.6±4.73 mm. At 15±3 months, primary events included TLR (4.6%), TVR (4.6%) and MACE (2.3%). There was 1one myocardial infarction and no cardiac death). No incidence of early or late stent thrombosis was demonstrated. CONCLUSIONS: Intek-Apollo stent implantation is safe and efficient in a real world population. The unique properties of polysulfone polymer coating can effectively protect from late stent thrombosis and lead to reduced rates of TLR, TVR and MACE.

Severe accordion effect: Myocardial ischemia due to wire complication during percutaneous coronary intervention: A case report.

A mechanical alteration during manoeuvring of stiff guidewires in tortuous coronary arteries frequently induces vessel wall shortening and coronary psedostenosis, referred as accordion phenomenon. Subtraction of the guidewires normally leads to the entire resolution of the lesions. A case of this transient angiographic finding, during percutaneous coronary intervention in a tortuous right coronary artery, which resulted in a flow limiting effect and myocardial ischemia, is described in the present report. Differential diagnosis from potential procedure complications and interventional methodology issues are discussed, while similar reports are reviewed.

Post-mortem angiographic and histologic findings of coronary artery fibromuscular dysplasia.

The present report highlights on exceptional angiographic and histologic features of coronary artery fibromuscular dysplasia in a young man complaining of chest discomfort during strenuous exercise. The striking features of fibromuscular dysplasia were the relative proximal localization of the lesion in left anterior descending coronary artery, the extensive length of the lesion, and the exclusive involvement of the intima producing a diffuse regular narrowing lesion. An eccentric intimal proliferation of the small left anterior descending coronary artery branches along their epicardial and intramural course was additionally demonstrated. No involvement of other coronary arteries or arteries of any other organs was observed.