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We report a case of a patient double-seropositive for anti-glomerular basement membrane (anti-GBM) and anti-neutrophil cytoplasmic antibodies (ANCA) who reported retrosternal chest pain during a regular hemodialysis session associated with ST-segment depression in electrocardiogram and an increase of serum high-sensitivity troponin T. Urgent coronary angiography excluded obstructive coronary artery disease, suggesting the diagnosis of ischemia with non-obstructive coronary arteries. This case illustrates an unusual presentation of cardiovascular involvement in a patient with double-positive ANCA/anti-GBM disease, emphasizing the possible relevance of coronary microvascular dysfunction and the need for close cardiovascular follow-up in this patient population.
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http://dx.doi.org/10.3389/fcvm.2022.893742 | DOI Listing |
J Electrocardiol
August 2025
Department of Cardiology, Kırşehir Ahi Evran Training and Research Hospital, Kırşehir, Turkey. Electronic address:
Background: Ischemia with non-obstructive coronary arteries (INOCA) represents a diagnostic and therapeutic challenge, often related to coronary microvascular dysfunction (CMD). Identifying non-invasive electrocardiographic markers that predict ischemia in this population remains a clinical priority. P-wave peak time (PWPT), reflecting atrial conduction delay, has been linked to ischemic pathophysiology.
View Article and Find Full Text PDFEur Heart J Case Rep
September 2025
Department of Cardiovascular Sciences, Fondazione Policlinico Universitario A. Gemelli IRCCS, L.go A. Gemelli 1, Rome 00168, Italy.
Background: Chest pain is a common reason for emergency department (ED) visits, yet not all cases are attributable to coronary artery disease (CAD). The 2024 European Society of Cardiology (ESC) guidelines emphasize the importance of invasive coronary function testing in patients with angina and non-obstructive coronary arteries. Understanding alternative causes of chest pain is crucial for appropriate diagnosis and management.
View Article and Find Full Text PDFEur Heart J
September 2025
Department of Cardiovascular and Pulmonary Sciences, Catholic University of the Sacred Heart, Rome, Italy.
J Electrocardiol
August 2025
Cardiology, Government TD Medical College Alappuzha, Kerala, India.
We report an elderly woman who presented with cardiac arrest due to complete heart block. She developed progressive T-wave inversions in leads V3-V6 due to pacinginduced cardiac memory, accompanied by marked QTc prolongation. These repolarization abnormalities occurred despite normal electrolytes and non-obstructive coronary angiography and culminated in polymorphic ventricular tachycardia.
View Article and Find Full Text PDFInt J Cardiovasc Imaging
September 2025
Department of Cardiology, Zealand University Hospital, Roskilde, Denmark.
Purpose: In patients with non-ST-segment elevation acute coronary syndrome (NSTEACS), coronary pathology ranges from normal vessels to severe obstructive disease. In NSTEACS patients where invasive coronary angiography (ICA) is recommended, it is unknown whether a non-invasive coronary computed tomography angiography (CCTA) may be used for patient triage. The Very Early Computerized Tomography to Organize Revascularization in patients with NSTEACS (VECTOR) study was a pilot study that assessed whether CCTA can be used to safely discharge NSTEACS patients without obstructive coronary artery disease.
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