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 40
- Downloads 0
Iodine content and consumption pattern of salt in households of Mehrauli, Delhi
Background Iodine deficiency disorders are a common public health issue in India as well as in various developing countries which can be easily prevented by universalisation of iodated salt ingestion. Salt consumption pa...
Intracerebral Hemorrhage: Current Concepts
Spontaneous intracerebral hemorrhage (ICH) is a devastating condition. The most common cause of ICH is hypertension. Aggressive blood pressure management and surgical management in selected cases improves outcome. In thi...
A case of Vasmol Poisoning: Monitoring and treatment
We report a case of suicidal ingestion of hair dye that presented with cervicofascialoedema and later developed rhabdomyolysis and liver cell injury. Our patient improved with symptomatic management
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...
Do we need breast pumps in India?
Use of breastpump for milk expression was the norm especially in mothers of babies in the neonatal intensive care unit, however the use has become common even in the normal healthy baby. Breast pumps are easily available...