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An Unusual Case of STEMI from Extrinsic Obstruction-Juniper Publishers

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JUNIPER PUBLISHERS - OPEN ACCESS JOURNAL OF CARDIOLOGY & CARDIOVASCULAR THERAPY   Abstract We present a patient with symptomatic multi-vessel ischemic heart disease requiring surgical intervention. The saphenous veins and radial arteries were unsuitable conduits and the ascending aorta was near porcelain. Six off-pump coronary artery bypass (OP-CAB) were performed utilizing five grafts derived from the basilic-cephalic veins and one from the internal mammary artery. Coronary angiography one year later showed complete patency of all the grafts. Background Although uncommon, cardiac fibromas can have dangerous consequences, usually arise in the ventricular muscle and may become quite large. Heart failure is the most common symptom, due to obstruction of blood flow or interference with alvular function and conduction disturbances. Here we present a rare case of acute occlusion of coronary arteries due to an interventricular cardiac fibroma ...
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Reperfusion Therapy of Myocardial Infarction: From Classic to Modern Fibrinolysis-Juniper Publishers

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JUNIPER PUBLISHERS - OPEN ACCESS JOURNAL OF CARDIOLOGY & CARDIOVASCULAR THERAPY   Opinion One of the main changes occurred in medicine in the last 25 years has been reperfusion treatment in acute myocardial infarction. From management of complications to immediate intervention in STEMI has come a long way. Four decades ago, STEMI treatment pointed to complications management, mainly arrhythmic (Ventricular fibrillation or AV block) or mechanics (cardiogenic shock, VSD, cardiac rupture or expansion). Intervention era started with intracoronary fibrinolysis, which quickly evolved to endovenous approach. Fibrinolytic treatment was a landmark as the beginning of the “reperfusion era” in STEMI. But it also was the beginning of bleeding complications in acute coronary syndromes, and its most dreaded form, intracranial hemorrhage. Streptokinase, the historically (and currently) most used fibrinolytic drug is far from ideal: in addition to a low reperfusion rate (TIMI 3 flo...
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