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Both olmesartan and losartan are effective and safe in the treatment of Chinese patients with mild-to-moderate essential hypertension. Olmesartan 20mg once daily is more potent and has a more rapid antihypertensive effect than losartan 50mg once daily in the treatment of mild-to-moderate hypertension in Chinese patients.

SUMMARYThe case of a 43-year-old Taiwanese man who presented with spinal epidural hematoma following intravenous administration of recombinant tissue plasminogen activator (rTPA) and heparin therapy for acute myocardial infarction (AMI) is reported. Upper back pain and progressive neurological dysfunction ensued, secondary to spinal epidural hematoma with spinal cord compression. The patient did not recover neurologic function postsurgically, possibly because the operation was delayed. In conclusion, cardiologists should be alert to this rare, severe complication of rTPA and should perform early laminectomy (in ≤36 hours for those with complete deficit and in ≤48 hours for those with incomplete deficit) if possible. (Jpn Heart J 2002; 43: 417-421) Key words: Spinal epidural hematoma, Recombinant tissue plasminogen activator, Acute myocardial infarction THROMBOLYTIC therapy, in combination with heparin and aspirin, reestablishes coronary blood flow, reduces infarct size, improves left ventricular function, and reduces mortality following acute myocardial infarction (AMI). However, its use is limited by bleeding complications, especially intracranial hemorrhage. Spinal epidural hematoma associated with recombinant tissue plasminogen activator (rTPA) is very rare. We report here a case of spontaneous spinal epidural hematoma after combined rTPA and heparin therapy for AMI. CASE REPORTA 43-year-old Taiwanese man was admitted with acute inferior myocardial infarction. His coronary artery disease risk factors were smoking and uncontrolled hypertension. We administered thrombolytic therapy with recombinant From the

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SUMMARYA case of acute aortic dissection complicating acute inferior myocardial infarction diagnosed by accidentally inserting the catheters into the false lumen during the emergency cardiac catheterization is reported. Although the incidence of acute aortic dissection developing acute myocardial infarction is not very rare, an aortogram and coronary angiogram via the false lumen has never been seen before. This case also illustrates how myocardial infarction can mask aortic dissection. Cardiologists should pay more attention to this severe complication of acute aortic dissection and Perform transthoracic echocardiography prior to catheterization or fibrinolysis. (Jpn Heart J 2003; 44: 583-585) Key words: Acute aortic dissection, Acute myocardial infarction, Cardiac catheterization MANY conditions such as acute aortic dissection, pericarditis, and myocarditis may mimic acute myocardial infarction. As a complication of acute aortic dissection, acute myocardial infarction is relatively rare, with an incidence of 1-2%. 1-2)Clinicians should be alert to patients with this condition because such patients can be saved by early diagnosis and treatment. We report here a case of acute aortic dissection developing acute inferior myocardial infarction accidentally diagnosed during catheterization. CASE REPORTA 70-year-old Taiwanese woman who had a history of hypertension without regular treatment suddenly developed chest discomfort and then lost consciousness. She was dead on arrival and pulseless ventricular tachycardia was noted.From