Sandbx:rinky: Difference between revisions

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* [[The electrocardiogram|EKG]]:  Inferior leads shows Inverted T waves.
* [[The electrocardiogram|EKG]]:  Inferior leads shows Inverted T waves.
*[[Troponin I]]<nowiki> : Elevated (355 ng/l --->70 ng/l 3 h later )[normal values <7 ng/l)]</nowiki>
*Elevated  [[Troponin I]]  from 355 ng/l --->70 ng/l 3 h later (Normal values <7 ng/l))


* [[Transthoracic echocardiography]]:
* [[Transthoracic echocardiography]]
**Left ventricular [[ejection fraction]] :60%  
**Left ventricular [[ejection fraction]] :60%
**No abnormalities in wall motion.
**No abnormalities in wall motion.
**Absence of [[Diastole|diastolic]] dysfunction
**Absence of [[Diastole|diastolic]] dysfunction
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* [[Coronary angiography|Coronary angiogram]] :  
* [[Coronary angiography|Coronary angiogram]] :  
**posterior
**Posterior descending artery is occluded with [[epicardial]] collateral from the left anterior descending artery.
 
**Intimal tear is present in mid-right coronary artery with a spontaneous dissecting coronary [[hematoma]]
descending artery is occluded with [[epicardial]] collateral from the left anterior descending artery.
**In tmid-right coronary artery, an intimal tear is present with a spontaneous dissecting coronary [[hematoma]]  


* Optical coherence tomography ([[Cardiac Optical Coherence Tomography (OCT)|OCT]]):  spontaneous dissecting coronary [[hematoma]] with an intimal rupture of right coronary artery
* Optical coherence tomography ([[Cardiac Optical Coherence Tomography (OCT)|OCT]]):  spontaneous dissecting coronary [[hematoma]] with an intimal rupture of right coronary artery
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|Severe , persistent chest pain ( 8/10), which started 3 hrs before admission
|Severe , persistent chest pain ( 8/10), which started 3 hrs before admission


|Smoking, [[Hypertension]], and Type 2 diabetes,
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* Smoking,
* [[Hypertension]]
* Type 2 diabetes


H/O  [[percutaneous coronary intervention]] (PCI) with implantation of a [[Drug eluting stent|drug-eluting stent]] (DES)  
* History of [[percutaneous coronary intervention]] (PCI) with implantation of a [[Drug eluting stent|drug-eluting stent]] (DES)  


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* [[Echocardiography|Echocardiogram]]:  
* [[Echocardiography|Echocardiogram]]:  
**Left ventricular [[ejection fraction]]  40–45% with [[akinesia]] in the LCx territory (old) and
**Left ventricular [[ejection fraction]] : 40–45%  
**a severe [[Hypokinesia|hypokinesis]] in the left anterior ascending (LAD).
**[[Akinesia]] in the left circumflex artery territory (old)  
* [[Coronary angiography|Coronary angiogram]]: moderate in-stent restenosis present on LCx-OM and a moderate right coronary artery (RCA) stenosis
**Severe [[Hypokinesia|hypokinesis]] in the left anterior ascending (LAD)
* [[Coronary angiography|Coronary angiogram]]: moderate in-stent restenosis present on LCx-OM and stenosis in moderate right coronary artery (RCA).


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|48‐year‐old, female  
|48‐year‐old, female
|History of severe chest pain that awoke her from sleep,9/10,severe,retrosternal tightness,pain radiates to neck and both arms.
 
* History of severe chest pain that awoke her from sleep
|Severe retrosternal chest pain,9/10,pain radiates to neck and both arms.


|[[Migraine]] and [[Hyperlipidemia]]
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* [[Migraine]]  
* [[Hyperlipidemia]]


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Revision as of 17:11, 20 July 2020

  • Here is a table presenting symptoms of the reported cases:
Patient Symptoms Past medical history and risk factors Laboratory findings Treatment
55 year old, male admitted due

to

  • fever,
  • cough
  • shortness of breath with suspected COVID-19.
Developed chest pain 48 hrs after admission Peripheral artery disease
  • EKG: Inferior leads shows Inverted T waves.
  • Elevated Troponin I from 355 ng/l --->70 ng/l 3 h later (Normal values <7 ng/l))
  • Coronary angiogram :
    • Posterior descending artery is occluded with epicardial collateral from the left anterior descending artery.
    • Intimal tear is present in mid-right coronary artery with a spontaneous dissecting coronary hematoma
  • Optical coherence tomography (OCT): spontaneous dissecting coronary hematoma with an intimal rupture of right coronary artery
  • Coronary angiogram was planned.
70-year-old, male Severe , persistent chest pain ( 8/10), which started 3 hrs before admission
  • EKG: precordial leads shows new ST-T abnormalities which was not present previously.
ST-T abnormalities in the precordial leads.


48‐year‐old, female
  • History of severe chest pain that awoke her from sleep
Severe retrosternal chest pain,9/10,pain radiates to neck and both arms.