ECG PART 10 final

Editor's Notes

• #33: Acute Myocardial Infarction after Blunt Chest Trauma in A Young Man (2002. 8) Àü³²´ë ¼øȯ±â ³»°ú Á¤¸íÈ£ ±³¼ö  CaseCoronary artery injury rarely occurs after blunt chest trauma, but it can lead to extensive myocardial infarction and be frequently overlooked, and may cause severe ventricular dysfunction. A 16-year-old man presented with comatose mental state and dyspnea. He ran into guardrail while riding a motorcycle. When he arrived at the hospital, he was in comatose mental state and had a rapid respiration rate. In routine examination, his electrocardiogram showed Q wave and 2mm ST segment elevation in V1-6. The cardiac enzymes were also elevated: CK-MB was 300, and cTnI 5.7ng/ml. Due to his comatose mental state he could not complain of any chest pain. Two-dimensional echocardiography showed anteroseptal akinesia in the left ventricle with severely depressed LV function (EF=28%). He could not receive any anticoagulation or thrombolytic therapy because of his brain lesion. Three weeks later, his mental state improved and we could try an invasive study. A diagnostic coronary angiogram revealed total occlusion in the proximal LAD with collaterals from RCA and LCX. Under bilateral angiogram we could successfully pass the guide wire through the lesion, but only a 1.5mm Hayate-Pro( balloon could pass through the lesion. We dilated the balloon twice and exchanged it with a 3.0 mm balloon. Despite inflating twice, residual stenosis still remained. We deployed a 3.0(20 mm Tsunami stent in the lesion. The final angiogram showed a good coronary flow without residual stenosis. Fig.4B. Under the guidance of contralateral right coronary angiogram, guide wire was passed the lesion successfully.    Legend  Fig.1. An electrocardiogram demonstrated sinus tachycardia, Q wave and ST segment elevation over the entire precordial leads, and lead I and aVL.
• #34: Acute Myocardial Infarction after Blunt Chest Trauma in A Young Man (2002. 8) Àü³²´ë ¼øȯ±â ³»°ú Á¤¸íÈ£ ±³¼ö  CaseCoronary artery injury rarely occurs after blunt chest trauma, but it can lead to extensive myocardial infarction and be frequently overlooked, and may cause severe ventricular dysfunction. A 16-year-old man presented with comatose mental state and dyspnea. He ran into guardrail while riding a motorcycle. When he arrived at the hospital, he was in comatose mental state and had a rapid respiration rate. In routine examination, his electrocardiogram showed Q wave and 2mm ST segment elevation in V1-6. The cardiac enzymes were also elevated: CK-MB was 300, and cTnI 5.7ng/ml. Due to his comatose mental state he could not complain of any chest pain. Two-dimensional echocardiography showed anteroseptal akinesia in the left ventricle with severely depressed LV function (EF=28%). He could not receive any anticoagulation or thrombolytic therapy because of his brain lesion. Three weeks later, his mental state improved and we could try an invasive study. A diagnostic coronary angiogram revealed total occlusion in the proximal LAD with collaterals from RCA and LCX. Under bilateral angiogram we could successfully pass the guide wire through the lesion, but only a 1.5mm Hayate-Pro( balloon could pass through the lesion. We dilated the balloon twice and exchanged it with a 3.0 mm balloon. Despite inflating twice, residual stenosis still remained. We deployed a 3.0(20 mm Tsunami stent in the lesion. The final angiogram showed a good coronary flow without residual stenosis. Fig.4B. Under the guidance of contralateral right coronary angiogram, guide wire was passed the lesion successfully.    Legend  Fig.1. An electrocardiogram demonstrated sinus tachycardia, Q wave and ST segment elevation over the entire precordial leads, and lead I and aVL.
• #35: Acute Myocardial Infarction after Blunt Chest Trauma in A Young Man (2002. 8) Àü³²´ë ¼øȯ±â ³»°ú Á¤¸íÈ£ ±³¼ö  CaseCoronary artery injury rarely occurs after blunt chest trauma, but it can lead to extensive myocardial infarction and be frequently overlooked, and may cause severe ventricular dysfunction. A 16-year-old man presented with comatose mental state and dyspnea. He ran into guardrail while riding a motorcycle. When he arrived at the hospital, he was in comatose mental state and had a rapid respiration rate. In routine examination, his electrocardiogram showed Q wave and 2mm ST segment elevation in V1-6. The cardiac enzymes were also elevated: CK-MB was 300, and cTnI 5.7ng/ml. Due to his comatose mental state he could not complain of any chest pain. Two-dimensional echocardiography showed anteroseptal akinesia in the left ventricle with severely depressed LV function (EF=28%). He could not receive any anticoagulation or thrombolytic therapy because of his brain lesion. Three weeks later, his mental state improved and we could try an invasive study. A diagnostic coronary angiogram revealed total occlusion in the proximal LAD with collaterals from RCA and LCX. Under bilateral angiogram we could successfully pass the guide wire through the lesion, but only a 1.5mm Hayate-Pro( balloon could pass through the lesion. We dilated the balloon twice and exchanged it with a 3.0 mm balloon. Despite inflating twice, residual stenosis still remained. We deployed a 3.0(20 mm Tsunami stent in the lesion. The final angiogram showed a good coronary flow without residual stenosis. Fig.4B. Under the guidance of contralateral right coronary angiogram, guide wire was passed the lesion successfully.    Legend  Fig.1. An electrocardiogram demonstrated sinus tachycardia, Q wave and ST segment elevation over the entire precordial leads, and lead I and aVL.
• #36: Acute Myocardial Infarction after Blunt Chest Trauma in A Young Man (2002. 8) Àü³²´ë ¼øȯ±â ³»°ú Á¤¸íÈ£ ±³¼ö  CaseCoronary artery injury rarely occurs after blunt chest trauma, but it can lead to extensive myocardial infarction and be frequently overlooked, and may cause severe ventricular dysfunction. A 16-year-old man presented with comatose mental state and dyspnea. He ran into guardrail while riding a motorcycle. When he arrived at the hospital, he was in comatose mental state and had a rapid respiration rate. In routine examination, his electrocardiogram showed Q wave and 2mm ST segment elevation in V1-6. The cardiac enzymes were also elevated: CK-MB was 300, and cTnI 5.7ng/ml. Due to his comatose mental state he could not complain of any chest pain. Two-dimensional echocardiography showed anteroseptal akinesia in the left ventricle with severely depressed LV function (EF=28%). He could not receive any anticoagulation or thrombolytic therapy because of his brain lesion. Three weeks later, his mental state improved and we could try an invasive study. A diagnostic coronary angiogram revealed total occlusion in the proximal LAD with collaterals from RCA and LCX. Under bilateral angiogram we could successfully pass the guide wire through the lesion, but only a 1.5mm Hayate-Pro( balloon could pass through the lesion. We dilated the balloon twice and exchanged it with a 3.0 mm balloon. Despite inflating twice, residual stenosis still remained. We deployed a 3.0(20 mm Tsunami stent in the lesion. The final angiogram showed a good coronary flow without residual stenosis. Fig.4B. Under the guidance of contralateral right coronary angiogram, guide wire was passed the lesion successfully.    Legend  Fig.1. An electrocardiogram demonstrated sinus tachycardia, Q wave and ST segment elevation over the entire precordial leads, and lead I and aVL.
• #37: Acute Myocardial Infarction after Blunt Chest Trauma in A Young Man (2002. 8) Àü³²´ë ¼øȯ±â ³»°ú Á¤¸íÈ£ ±³¼ö  CaseCoronary artery injury rarely occurs after blunt chest trauma, but it can lead to extensive myocardial infarction and be frequently overlooked, and may cause severe ventricular dysfunction. A 16-year-old man presented with comatose mental state and dyspnea. He ran into guardrail while riding a motorcycle. When he arrived at the hospital, he was in comatose mental state and had a rapid respiration rate. In routine examination, his electrocardiogram showed Q wave and 2mm ST segment elevation in V1-6. The cardiac enzymes were also elevated: CK-MB was 300, and cTnI 5.7ng/ml. Due to his comatose mental state he could not complain of any chest pain. Two-dimensional echocardiography showed anteroseptal akinesia in the left ventricle with severely depressed LV function (EF=28%). He could not receive any anticoagulation or thrombolytic therapy because of his brain lesion. Three weeks later, his mental state improved and we could try an invasive study. A diagnostic coronary angiogram revealed total occlusion in the proximal LAD with collaterals from RCA and LCX. Under bilateral angiogram we could successfully pass the guide wire through the lesion, but only a 1.5mm Hayate-Pro( balloon could pass through the lesion. We dilated the balloon twice and exchanged it with a 3.0 mm balloon. Despite inflating twice, residual stenosis still remained. We deployed a 3.0(20 mm Tsunami stent in the lesion. The final angiogram showed a good coronary flow without residual stenosis. Fig.4B. Under the guidance of contralateral right coronary angiogram, guide wire was passed the lesion successfully.    Legend  Fig.1. An electrocardiogram demonstrated sinus tachycardia, Q wave and ST segment elevation over the entire precordial leads, and lead I and aVL.
• #38: Acute Myocardial Infarction after Blunt Chest Trauma in A Young Man ECG: Q wave and 2mm ST segment elevation in V1-6, I and avL Cardiac enzymes: CK-MB was 300, and cTnI 5.7ng/ml ECHO: anteroseptal akinesia in the LVe with severely depressed LV function (EF=28%) Angio: total occlusion in the proximal LAD with collaterals from RCA and LCX
• #39: Acute Myocardial Infarction after Blunt Chest Trauma in A Young Man ECG: Q wave and 2mm ST segment elevation in V1-6, I and avL Cardiac enzymes: CK-MB was 300, and cTnI 5.7ng/ml ECHO: anteroseptal akinesia in the LVe with severely depressed LV function (EF=28%) Angio: total occlusion in the proximal LAD with collaterals from RCA and LCX
• #40: Acute Myocardial Infarction after Blunt Chest Trauma in A Young Man ECG: Q wave and 2mm ST segment elevation in V1-6, I and avL Cardiac enzymes: CK-MB was 300, and cTnI 5.7ng/ml ECHO: anteroseptal akinesia in the LVe with severely depressed LV function (EF=28%) Angio: total occlusion in the proximal LAD with collaterals from RCA and LCX
• #41: Acute Myocardial Infarction after Blunt Chest Trauma in A Young Man ECG: Q wave and 2mm ST segment elevation in V1-6, I and avL Cardiac enzymes: CK-MB was 300, and cTnI 5.7ng/ml ECHO: anteroseptal akinesia in the LVe with severely depressed LV function (EF=28%) Angio: total occlusion in the proximal LAD with collaterals from RCA and LCX
• #42: Acute Myocardial Infarction after Blunt Chest Trauma in A Young Man ECG: Q wave and 2mm ST segment elevation in V1-6, I and avL Cardiac enzymes: CK-MB was 300, and cTnI 5.7ng/ml ECHO: anteroseptal akinesia in the LVe with severely depressed LV function (EF=28%) Angio: total occlusion in the proximal LAD with collaterals from RCA and LCX
• #43: Acute Myocardial Infarction after Blunt Chest Trauma in A Young Man ECG: Q wave and 2mm ST segment elevation in V1-6, I and avL Cardiac enzymes: CK-MB was 300, and cTnI 5.7ng/ml ECHO: anteroseptal akinesia in the LVe with severely depressed LV function (EF=28%) Angio: total occlusion in the proximal LAD with collaterals from RCA and LCX