Keywords Parole chiave: Acute Myocardial Infarction, Helical, Article, Case Report, Heart Infarction, Human, Middle Aged, Radiography, Unstable Angina Pectoris,
Affiliations Affiliazioni: *** IBB - CNR ***
Department of Radiology, University Federico II, Naples, Italy Dept. of National Research Council, Inst. of Bio-Images and Bio-Struct., Naples, Italy Department of Internal Medicine, University Federico II, Naples, Italy IRCCS Neuromed, Pozzilli (IS), Italy
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Agrawal, G. G., Parekh, H. H., Tirtaman, C., Nanda, N. C., Transesophageal echocardiographic imaging of the left atrium behind the ascendent aorta mimicking aortic dissection (1997) Echocardiography, 14, p. 41
Ambrose, J. A., Dangas, G., Unstable angina. Current concepts of pathogenesis and treatment (2000) Arch. Intern. Med., 160, p. 25
Becker, C. R., Kleffel, T., Crispin, A., Coronary artery calcium measurement. Agreement of multirow detector and electron beam CT (2001) AJR, 176, p. 1295
Edwards, B. S., Edwards, J. E., Pathology of acute myocardial infarction (1995) Modern Coronary Care, 2nd Edn, p. 58. , Edited by G. S. Francis & J. S. Alpert. Little, Brown
Little, W. C., Constantinescu, M., Applegate, R. J., Can coronary angiography predict the site of subsequent myocardial infarction in patients with mild-to-moderate coronary artery disease? (1988) Circulation, 78, p. 1157
Mautner, G. C., Mautner, S. L., Froehlich, J., Coronary artery calcification. Assessment with electron beam CT and histomorphometric correlation (1994) Radiology, 192, p. 619
Rude, R. E., Poole, W. K., Muller, J. E., Electrocardiographic and clinical criteria for recognition af acute myocardial infarction based on analysis of 3, 697 patients (1983) Am. J. Cardiol., 52, p. 936
Wu, A. H. B., Apple, F. S., Gibler, W. B., Jesse, R. L., Warshaw, M. M., Valdes R., Jr., National academy of clinical biochemistry standards of laboratory practice. Recommendations for the use of cardiac markers in coronary artery disease (1999) Clin. Chem., 45, p. 1104
Acute myocardial infarction in a patient with unstable angina
A 58-year-old-man with unstable angina developed a violent retrosternal and interscapular pain during coronary angiography with no associated ECG abnormalities. The patient was immediately submitted to transesophageal echocardiography, which revealed an echo-free space behind the ascending aorta thought to be consistent with an aortic dissection. To confirm this finding the patient underwent contrast-enhanced helical CT, which ruled out a dissection but revealed a small hypoattenuating, ill-defined area within the lateral wall of the left ventricle, consistent with an acute myocardial infarction. The finding was first confirmed by bedside echocardiography and later validated by laboratory tests. Review of the left coronary angiogram showed the culprit lesion at the origin of a major acute marginal branch of the circumflex artery.
Acute myocardial infarction in a patient with unstable angina
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