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...
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| Format: | Article |
| Language: | English |
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Столичная издательская компания
2025-04-01
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| Series: | Рациональная фармакотерапия в кардиологии |
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| Online Access: | https://www.rpcardio.online/jour/article/view/3126 |
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| 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 |
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