Distant inferior myocardial infarction with pathological Q-wave: a clinical case

A clinical case of Q-myocardial infarction (MI) of the lower wall of the left ventricle in a 71-year-old patient with a history of MI in the presence of chronic occlusions of the right and circumflex coronary arteries (CA), extended narrowing of the intermediate branch in the upper and middle segmen...

Full description

Saved in:
Bibliographic Details
Main Authors: K. G. Pereverzeva, S. S. Yakushin, S. A. Biryukov, N. N. Peregudova, Yu. O. Cherkasova
Format: Article
Language:English
Published: Столичная издательская компания 2025-04-01
Series:Рациональная фармакотерапия в кардиологии
Subjects:
Online Access:https://www.rpcardio.online/jour/article/view/3126
Tags: Add Tag
No Tags, Be the first to tag this record!
_version_ 1849227501072547840
author K. G. Pereverzeva
S. S. Yakushin
S. A. Biryukov
N. N. Peregudova
Yu. O. Cherkasova
author_facet K. G. Pereverzeva
S. S. Yakushin
S. A. Biryukov
N. N. Peregudova
Yu. O. Cherkasova
author_sort K. G. Pereverzeva
collection DOAJ
description A clinical case of Q-myocardial infarction (MI) of the lower wall of the left ventricle in a 71-year-old patient with a history of MI in the presence of chronic occlusions of the right and circumflex coronary arteries (CA), extended narrowing of the intermediate branch in the upper and middle segments from 50 % to 80 % and stenosis of the anterior interventricular artery in the upper the 99% segment is described. Upon admission to the hospital, the patient’s ECG revealed a completely right bundle branch block and ST-segment elevation of up to 0.5 mm in lead III against the background of sinus rhythm. The diagnosis of myocardial infarction was confirmed by a diagnostically significant high-sensitivity troponin I level. The refusal of attempts to stent chronic occlusions of the right and circumflex CA and stenting of the proximal anterior interventricular artery led to relief of pain, stabilization of the patient’s condition and subsequent discharge from the hospital. Echocardiography at discharge revealed akinesia and mild bulging of the upper half of the left ventricular (LV) inferior wall, severe hypokinesia of the upper and middle thirds of the LV posterior wall, and hypokinesia of the upper third of the LV inferoseptal wall. The LV ejection fraction (Simpson’s method) was 44-45 %. The clinical case presented in the article demonstrates the importance of the correct management tactics for patients with distant MI, when the correct choice of infarct- related CA and its stenting led to a favorable outcome in an elderly patient with severe multivessel CA lesion and developed recurrent Q-lower distant MI.
format Article
id doaj-art-65b05dbca4524653a03c9ee5268ffc6f
institution Kabale University
issn 1819-6446
2225-3653
language English
publishDate 2025-04-01
publisher Столичная издательская компания
record_format Article
series Рациональная фармакотерапия в кардиологии
spelling doaj-art-65b05dbca4524653a03c9ee5268ffc6f2025-08-23T10:00:37ZengСтоличная издательская компанияРациональная фармакотерапия в кардиологии1819-64462225-36532025-04-01211828810.20996/1819-6446-2025-31262264Distant inferior myocardial infarction with pathological Q-wave: a clinical caseK. G. Pereverzeva0S. S. Yakushin1S. A. Biryukov2N. N. Peregudova3Yu. O. Cherkasova4Pavlov Ryazan State Medical UniversityPavlov Ryazan State Medical UniversityPavlov Ryazan State Medical UniversityPavlov Ryazan State Medical UniversityPavlov Ryazan State Medical UniversityA clinical case of Q-myocardial infarction (MI) of the lower wall of the left ventricle in a 71-year-old patient with a history of MI in the presence of chronic occlusions of the right and circumflex coronary arteries (CA), extended narrowing of the intermediate branch in the upper and middle segments from 50 % to 80 % and stenosis of the anterior interventricular artery in the upper the 99% segment is described. Upon admission to the hospital, the patient’s ECG revealed a completely right bundle branch block and ST-segment elevation of up to 0.5 mm in lead III against the background of sinus rhythm. The diagnosis of myocardial infarction was confirmed by a diagnostically significant high-sensitivity troponin I level. The refusal of attempts to stent chronic occlusions of the right and circumflex CA and stenting of the proximal anterior interventricular artery led to relief of pain, stabilization of the patient’s condition and subsequent discharge from the hospital. Echocardiography at discharge revealed akinesia and mild bulging of the upper half of the left ventricular (LV) inferior wall, severe hypokinesia of the upper and middle thirds of the LV posterior wall, and hypokinesia of the upper third of the LV inferoseptal wall. The LV ejection fraction (Simpson’s method) was 44-45 %. The clinical case presented in the article demonstrates the importance of the correct management tactics for patients with distant MI, when the correct choice of infarct- related CA and its stenting led to a favorable outcome in an elderly patient with severe multivessel CA lesion and developed recurrent Q-lower distant MI.https://www.rpcardio.online/jour/article/view/3126distant myocardial infarctionstentingcoronary artery chronic occlusiondonor arterymyocardial revascularization, infarction- associated coronary arterymultivessel diseaseanterior interventricular arteryright coronary arterycircumflex artery
spellingShingle K. G. Pereverzeva
S. S. Yakushin
S. A. Biryukov
N. N. Peregudova
Yu. O. Cherkasova
Distant inferior myocardial infarction with pathological Q-wave: a clinical case
Рациональная фармакотерапия в кардиологии
distant myocardial infarction
stenting
coronary artery chronic occlusion
donor artery
myocardial revascularization, infarction- associated coronary artery
multivessel disease
anterior interventricular artery
right coronary artery
circumflex artery
title Distant inferior myocardial infarction with pathological Q-wave: a clinical case
title_full Distant inferior myocardial infarction with pathological Q-wave: a clinical case
title_fullStr Distant inferior myocardial infarction with pathological Q-wave: a clinical case
title_full_unstemmed Distant inferior myocardial infarction with pathological Q-wave: a clinical case
title_short Distant inferior myocardial infarction with pathological Q-wave: a clinical case
title_sort distant inferior myocardial infarction with pathological q wave a clinical case
topic distant myocardial infarction
stenting
coronary artery chronic occlusion
donor artery
myocardial revascularization, infarction- associated coronary artery
multivessel disease
anterior interventricular artery
right coronary artery
circumflex artery
url https://www.rpcardio.online/jour/article/view/3126
work_keys_str_mv AT kgpereverzeva distantinferiormyocardialinfarctionwithpathologicalqwaveaclinicalcase
AT ssyakushin distantinferiormyocardialinfarctionwithpathologicalqwaveaclinicalcase
AT sabiryukov distantinferiormyocardialinfarctionwithpathologicalqwaveaclinicalcase
AT nnperegudova distantinferiormyocardialinfarctionwithpathologicalqwaveaclinicalcase
AT yuocherkasova distantinferiormyocardialinfarctionwithpathologicalqwaveaclinicalcase