Imaging in cardiology M.J.M. Cramer and W. Jaarsma, editors
Figure 1. Electrocardiogram on admission.
Acute myocardlal Infarction due to left main occlusion A 39-year-old previously fit and healthy white male presented with chest pain of one hour's duration at one of our referring hospitals. Electrocardiogram (figure 1) showed sinus rhythm, left axis deviation and an ST-T segment pattern compatible with anterior myocardial infarction. There were signs of haemodynamic compromise and the patient needed defibrillation. Following transfer to our hospital, coronary angiography was performed 135 minutes after the onset of symptoms and showed total left main stem occlusion (figure 2). Primary coronary angioplasty was performed with stent implantation (figure 3). The
Netherlands Heart Journal, Volume 9, Number 8, November 2001
patient was treated with inotropics and intra-aortic balloon counterpulsation for four days. He recovered well and on discharge, ten days later, the ejection fraction of the left ventricle was 41%. Although the patient was asymptomatic, we performed elective In this section a remarkable 'image' is presented and a short comment is given. We invite you to send in images (in triplicate) with a short comment (one to two pages at the most) to Mediselect bv, Editorial Office Netherlands Heart Journal, PO Box 63, 3830 AB Leusden, the Netherlands.
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Imaging in cardiology
Figure 2. Coronary angiography revealing a total occlusion of the left main coronary artery.
cardiac catheterisation after three months, which revealed three-vessel coronary artery disease and a reduced left ventricular ejection fraction. Radionuclide exercise testing showed a resting left ventricular ejection fraction of 39% with a reduction to 27% during exercise. The patient underwent coronary artery bypass grafting with anastomoses ofthe left internal mammary artery on the diagonal branch and the left anterior descending artery of the right internal mammary artery 350
Figure 3. Coronary angiography after coronary angioplasty and stenting.
on an obtuse marginal branch and of the gastroepiploical artery on the posterior descending artery. He made an uneventful recovery and has currently resumed all his former activities. Z
J.P.S. Henriques.
F. Zilstra. Department of Cardiology, Isala Clinics, De Weezenlanden Hospital, Zwolle.
Netherlands Heart Journal, Volume 9, Number 8, November 2001
Figure 1. Electrocardiogram on admission.
Acute myocardlal Infarction due to left main occlusion A 39-year-old previously fit and healthy white male presented with chest pain of one hour's duration at one of our referring hospitals. Electrocardiogram (figure 1) showed sinus rhythm, left axis deviation and an ST-T segment pattern compatible with anterior myocardial infarction. There were signs of haemodynamic compromise and the patient needed defibrillation. Following transfer to our hospital, coronary angiography was performed 135 minutes after the onset of symptoms and showed total left main stem occlusion (figure 2). Primary coronary angioplasty was performed with stent implantation (figure 3). The
Netherlands Heart Journal, Volume 9, Number 8, November 2001
patient was treated with inotropics and intra-aortic balloon counterpulsation for four days. He recovered well and on discharge, ten days later, the ejection fraction of the left ventricle was 41%. Although the patient was asymptomatic, we performed elective In this section a remarkable 'image' is presented and a short comment is given. We invite you to send in images (in triplicate) with a short comment (one to two pages at the most) to Mediselect bv, Editorial Office Netherlands Heart Journal, PO Box 63, 3830 AB Leusden, the Netherlands.
349
Imaging in cardiology
Figure 2. Coronary angiography revealing a total occlusion of the left main coronary artery.
cardiac catheterisation after three months, which revealed three-vessel coronary artery disease and a reduced left ventricular ejection fraction. Radionuclide exercise testing showed a resting left ventricular ejection fraction of 39% with a reduction to 27% during exercise. The patient underwent coronary artery bypass grafting with anastomoses ofthe left internal mammary artery on the diagonal branch and the left anterior descending artery of the right internal mammary artery 350
Figure 3. Coronary angiography after coronary angioplasty and stenting.
on an obtuse marginal branch and of the gastroepiploical artery on the posterior descending artery. He made an uneventful recovery and has currently resumed all his former activities. Z
J.P.S. Henriques.
F. Zilstra. Department of Cardiology, Isala Clinics, De Weezenlanden Hospital, Zwolle.
Netherlands Heart Journal, Volume 9, Number 8, November 2001
