What are the clinical manifestation of STEMI?4 answersThe clinical manifestations of ST-Segment Elevation Myocardial Infarction (STEMI) include various factors. Patients with STEMI may present with symptoms such as chest pain, shortness of breath, and EKG changes showing ST-segment elevation. Additionally, STEMI can lead to complications like cardiac rupture, which is a fatal outcome associated with STEMI patients undergoing primary percutaneous coronary intervention (PPCI). Furthermore, myocardial ischemia-reperfusion injury (MIRI) grading systems have been proposed to assess the severity of STEMI, with higher grades correlating with lower high-density lipoprotein cholesterol levels, increased inflammatory markers, and adverse cardiac events within one year. Overall, recognizing these clinical manifestations is crucial for timely diagnosis and management of STEMI to improve patient outcomes.
What are the cardiac manifestations of COVID-19?4 answersCardiac manifestations of COVID-19 include atrial arrhythmias such as atrial fibrillation or atrial flutter, sinus node dysfunction, atrioventricular conduction abnormalities, ventricular tachyarrhythmias, sudden cardiac arrest, and cardiovascular dysautonomias including the so-called long COVID syndrome. Studies have revealed persistent myocardial injury with late gadolinium enhancement and myocardial scar on cardiac magnetic resonance in a significant proportion of patients. COVID-19 is often found to be complicated with hypercoagulable state resulting in thrombotic events. Patients affected by COVID-19 are at increased risk of myocardial infarction, myocarditis, venous thromboembolism, arrhythmias, and exacerbation of heart failure. A proportion of patients recovered from COVID-19 have persistent cardiac symptoms and are at risk of cardiovascular disease.
How PET/CT radiomics can enhance the diagnosis of cardiac inflamation?3 answersPET/CT radiomics has the potential to enhance the diagnosis of cardiac inflammation. Radiomics is a form of medical image processing that aims to find quantitative image-derived biomarkers for lesion characterization and response prediction. By extracting numerous quantitative image-based features from PET/CT scans, radiomics can create large datasets that can be analyzed using machine learning techniques to find meaningful patterns and relationships in the data. Currently, 18F-fluorodeoxyglucose (FDG) is the standard radiotracer for detecting myocardial inflammation, but it lacks the ability to differentiate between glucose uptake in normal cardiomyocytes and inflammatory cells. Developing a PET radiotracer that can differentiate between these cell types and target specific subpopulations of immune cells involved in inflammation would be ideal. By incorporating radiomics into PET/CT imaging, it may be possible to identify specific radiotracer characteristics that can accurately diagnose and characterize cardiac inflammation in its early stages.
What are the cardiac manifestations of idiopathic inflammatory myopathy?4 answersCardiac manifestations of idiopathic inflammatory myopathy (IIM) include systolic and diastolic heart failure, coronary artery disease, myocarditis, pericarditis, valvular abnormalities, and arrhythmias. Cardiovascular involvement in IIM is a major cause of mortality. It is important to note that cardiac involvement in IIM is often subclinical, making early detection challenging. However, cardiac magnetic resonance imaging has shown to be sensitive in detecting subclinical cardiac involvement. Surveillance and prevention of cardiovascular risk factors are essential in managing cardiovascular complications in patients with IIM. The role of immunosuppressive therapy in managing cardiac disease in IIM is unclear, and there is limited evidence on the use of rituximab for cardiac manifestations.
What are the types of imaging available for MRA infarct?4 answersThere are several types of imaging available for MRA infarct. Conventional CT and MRI techniques, as well as lumen imaging sequences such as CT angiography (CTA) and MR angiography (MRA), are commonly used for evaluation and management of acute ischemic stroke. Non-enhanced CT or T2* MRI sequences are sufficient for deciding intravenous treatment eligibility within the first 4.5 hours after stroke onset. Vessel wall MRI provides high-resolution analysis of both extracranial and intracranial vasculature to identify previously occult lesions or characteristics of lesions that may have a worse natural history. Transcranial Doppler ultrasonography can be used to identify large vessel occlusions or monitor the response to stroke treatment. Four-dimensional CTA and MRA provide a less invasive alternative to digital subtraction angiography to determine the extent of clot burden and collateral blood flow in large vessel occlusions.
What are the risk factors for acute myocardial infarction?5 answersThe risk factors for acute myocardial infarction (AMI) include higher diastolic blood pressure, systolic blood pressure, triglyceride, total cholesterol, LDL-cholesterol, HDL-cholesterol, fasting glucose, smoking, hypertension (HTA), and diabetes. Young individuals with AMI have a unique risk profile with less traditional cardiovascular risk factors compared to older populations. Plaque rupture is still the most common cause of AMI, but other etiologies such as plaque erosion, coronary microvascular dysfunction, spontaneous coronary artery dissection, and coronary spasm related to drug use are more prevalent in this age group. Major risk factors for myocardial infarction (MI) include hypertension, diabetes, smoking, coronary artery disease, alcohol consumption, and obesity. In addition to chronic risk factors, certain circumstances and activities can act as immediate triggers of acute coronary syndromes, including acute myocardial infarction. Risk factors for myocardial infarction in young patients include obesity disorders, lipid metabolism disorders, and smoking.