Fibrinolysis in STEMI - A Second thought
Journal Title: The Indian Practitioner - Year 2016, Vol 69, Issue 8
Abstract
Cardiac sarcoidosis (CS) is an infrequent element of systemic sarcoidosis, manifesting in upto 2% cases of sarcoidosis, but found in upto 25% of these on autopsy. Despite a plethora of tools such as ECG, echocardiography, cardiac MRI, PET scan, endomyocardial biopsy (EMB), accurate antemortem diagnosis of CS remains a challenge. Pathological hallmark of CS is a noncaseating epitheloid granuloma, either microscopic or macroscopic. It causes conduction defects manifesting on ECG as a variety of arrhythmias or non-specific ST-T segment changes. Uncommon amongst these is an ST segment elevation mimicking myocardial infarction (MI). This triggers an urge for fibrinolysis if a proper history and other confirmatory biochemical markers are not sought. We report a previously healthy male presenting with chest discomfort and progressive breathlessness, and with ECG suggestive of ST segment elevation myocardial infarction (STEMI). Fibrinolytic therapy was spared owing to a high index of suspicion for CS against a background of detailed history and incoherent biochemistry. CS was confirmed by cardiac MRI and endomyocardial biopsy. Partial remission of symptoms was observed after steroid therapy alongwith anti-arrhythmics
Authors and Affiliations
S A Adukia, A G Diwan, C, Chavan, N Jagade
Keywords
Related Articles
- EP ID EP574911
- DOI -
- Views 64
- Downloads 0
A Study on the Effects of Vitamin C (Ascorbic Acid) on Reaction time in Healthy Young Adults
Background: Ascorbate (vitamin C) is a vital antioxidant molecule in the brain. Ascorbate is proposed as a neuromodulator of glutamatergic, dopaminergic, cholinergic and GABAergic transmission and related behaviours. Rea...
Indeterminate Pulmonary Nodule: An assessment from a Surgeon’s perspective
Background: Finding of pulmonary nodule in chest X-ray or CT scan during routine investigations or during surveillance for metastasis, in known case of malignancy is not an uncommon occurrence. Even after all routine eva...
Scar endometriosis-report of seven cases
Background: Endometriosis is the aberrant presence of uterine mucosa in locations outside the uterus. It may be pelvic or extra pelvic. Case: Retrospective analysis of seven cases of scar endometriosis from the file reco...
Emphysematous Cystitis associated with E. coli
We report a case of a middle-aged, poorly controlled, 71 year old diabetic female who presented with dysuria, fever, vomiting and hematuria and was found to have Escherichia coli emphysematous cystitis that resolved with...
A Study of The Clinical Profile and Pattern of Acute Febrile Illness in a Teaching Hospital in Central Mumbai
AIMS AND OBJECTIVES : Fever remains the commonest cause of OPD and indoor admissions, in underdeveloped and developing countries including India. The present study was undertaken to study the fever profile, compare the a...