acute myocardial infarction (mi) during pregnancy is rare and mi due to prinzmetal's angina is much rarer. we present a 35-year-old, obese, multigravida, and pre-eclamptic woman, who developed acute anterior wall mi at the 30th week of gestation. on coronary angiography, the second obtuse marginal branch was totally occluded and the right coronary artery (rca) was normal. three days later, she ...

BACKGROUND Myocardial infarction (MI) in the absence of electrocardiographic ST-segment elevation or new bundle branch block is the cause of hospitalization for a large and steadily increasing proportion of patients with acute ischemic chest pain. Despite its prevalence, the common demographic features, current hospital-based management, and short-term clinical outcome among patients with non-S...

Disruption of vulnerable or high-risk plaques is the common pathophysiological mechanism of acute coronary syndromes with or without ST elevation. The reflection of the same pathophysiological mechanism differs in non-ST-elevation acute coronary syndromes and ST-elevation myocardial infarction (STEMI) in terms of clinical presentation, prognosis and therapeutic approach. Diagnostic and therapeu...

Dual antiplatelet therapy with aspirin and a thienopyridine drug that blocks the platelet adenosine diphosphate receptor P2Y12 is the cornerstone of management in patients presenting with acute coronary syndrome (ACS). Clopidogrel is the most widely used thienopyridine, with evidence of benefit in non–ST-elevation myocardial infarction (MI),1 percutaneous coronary intervention (PCI),2 and ST-el...

Current guidelines support dual antiplatelet therapy with aspirin and clopidogrel (Plavix) in a number of clinical scenarios, ie, in ST-segment-elevation myocardial infarction (MI), non-ST-elevation MI, and percutaneous coronary intervention. The guidelines are based on strong evidence from several large randomized clinical trials over the last 10 years. The authors present several cases to sho...

PURPOSE Patients with unstable angina or non-ST-segment elevation myocardial infarction (MI) may be managed with either an "invasive" or "conservative" strategy. It is unclear which of these strategies is superior. METHODS We identified studies with MEDLINE and EMBASE searches (1966-September 2003) and by reviewing reference lists. Studies were included if they were randomized controlled tria...

OBJECTIVES We sought to evaluate the utility of excluding myocardial infarction (MI) in patients presenting to the emergency department (ED) with atrial fibrillation (AF) and to identify predictors of MI in this group. BACKGROUND Patients with AF are frequently admitted to the hospital, in part, to exclude an associated MI. There are no prospective data on unselected patients to support this ...

The term, acute coronary syndrome (ACS), describes a spectrum of clinical conditions ranging from ST-segment elevation myocardial infarction (STEMI) to non–ST-segment elevation MI (N–STEMI) and unstable angina (UA) (Fig. 119.1) (1). These manifestations of acute myocardial ischemia may revert to the presymptomatic state or evolve into a non-Q wave (also termed nontransmural) MI or to Q wave (or...

S everal prior studies have shown that patients with diabetes mellitus have worse in-hospital outcomes compared to non-diabetic patients when admitted for an acute myocardial infarction (MI). 2 Few studies have examined this same issue among patients admitted across the entire spectrum of acute coronary syndromes (ACS) (unstable angina, non-ST elevation MI, ST elevation MI). 4 Since patients ad...

Correspondence to: Professor Keith A A Fox, Cardiovascular Research Unit, Centre for Cardiovascular Science, University of Edinburgh, Chancellor’s Building, 49 Little France Crescent, Edinburgh EH16 4SB, UK; [email protected] _________________________ A cute coronary syndrome (ACS) describes a spectrum of clinical conditions ranging from ST segment elevation myocardial infarction (MI) to non-S...