98%
921
2 minutes
20
Diagnosis of ST-segment changes is challenging in patients with right ventricular pacing rhythm. Herein, we present a patient with a history of permanent His-bundle pacemaker implantation who developed chest pain and ST-segment changes on electrocardiography. An immediate diagnosis of acute myocardial infarction on the basis of the electrocardiographic abnormality and prompt management of coronary intervention resulted in a short door-to-balloon time of 80 minutes, even on a holiday morning, and a stable clinical course thereafter. This scenario underscores the potential benefit of electrocardiographic diagnosis in physiological pacing using a native conduction system, associating prompt treatment with a favorable prognosis.
Download full-text PDF |
Source |
---|---|
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC12046825 | PMC |
http://dx.doi.org/10.1016/j.jaccas.2024.103203 | DOI Listing |
Cureus
August 2025
Emergency Medicine, NMC Royal Hospital, Khalifa City, ARE.
In adults having chest pain, ST-segment elevation, both benign and pathologic, is a common finding seen on electrocardiograms (ECGs). Some degree of ST-segment elevation is common, especially in young men. Commonly referred to as benign early repolarization (BER), this elevation is seen in the precordial leads.
View Article and Find Full Text PDFCureus
August 2025
Emergency Medicine, Stockport NHS Foundation Trust, Stockport, GBR.
Kounis syndrome, also known as allergic myocardial infarction, is a rare but potentially life-threatening condition in which acute coronary events are triggered by an allergic reaction. The pathophysiology involves mast cell degranulation and the release of inflammatory mediators such as histamine, leukotrienes, and platelet-activating factor, leading to coronary vasospasm, myocardial ischemia, or infarction. We present the case of a female patient in her 80s with no prior history of coronary artery disease who developed anaphylaxis shortly after intravenous administration of co-amoxiclav in the emergency department.
View Article and Find Full Text PDFSci Prog
September 2025
Faculty of Medicine, Universitas Indonesia, Jakarta, Indonesia.
Single coronary ostium and intramural coronary artery variations in patients with transposition of the great arteries significantly increase the mortality and morbidity after arterial switch operation (ASO). In these patients, the classic coronary button implantation may cause kinking or twisting of the coronary artery which can cause coronary insufficiency. This case series presents two patients, a 15-month-old girl with transposition of the great arteries and a 10-month-old boy with a Taussig-Bing anomaly.
View Article and Find Full Text PDFMedicine (Baltimore)
August 2025
Kasralainy Faculty of Medicine, Cairo University, Cairo, Egypt.
Rationale: This case report highlights the complex clinical course and successful multidisciplinary management of a pediatric patient with multisystem inflammatory syndrome in children (MIS-C), who posed clinical dilemma at presentation. It underscores the ongoing clinical relevance of MIS-C as a post-Coronavirus disease 2019 sequelae and emphasizes the importance of maintaining a high index of suspicion for MIS-C in pediatric differential diagnoses, especially when symptoms overlap with other common conditions.
Patient Concerns: An 11-year-old previously healthy Saudi girl presented with gastrointestinal symptoms initially suggestive of acute appendicitis.
Int 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.
View Article and Find Full Text PDF