Clinical presentation and prognosis of left main coronary artery disease in the 1980s

Atié, Jacob; Brugada, Pedro; Brugada, J.; Smeets, J. L. R. M.; Cruz, Fernando E.S.; Roukens, M. R.; Gorgels, A.P.M.; Wellens, Hein J.J.

doi:10.1007/978-94-011-4110-9_47

Cited by 5 publications

(11 citation statements)

References 19 publications

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“…These findings are consistent with prior angiographic and autopsy studies of patients with LMCA disease, which found that 90% or more of patients have significant disease in another epicardial artery [7,8,[15][16][17][18][19]. We identified one patient with isolated disease of the LMCA ostium.…”

Section: Discussionsupporting

confidence: 90%

“…Since a significant percentage of young patients do not have diabetes, hypertension, or abnormal cholesterol levels but do have severe, diffuse CAD, this population may represent a useful group in which to identify genetic and environmental factors that contribute to advanced atherosclerosis. [15] 1974 28 82 39 a 39 Demots et al [18] 1975 58 10 20 a 20 Iskandrian et al [19] 1976 94 40 36 a 5 Conti et al [7] 1979 66 17 35 a 20 Atie et al [8] 1991 127 65 57 25 This report 2000 100 78 37 27 *MI, myocardial infarction; ECG, electrocardiogram. a Percentage of patients with pathologic Q waves.…”

Section: Discussionmentioning

confidence: 99%

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Left main coronary artery disease in adults younger than 50 years: A comparison with older patients

Stouffer

Mott

Brizolara

et al. 2000

Cathet. Cardiovasc. Intervent.

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Left main coronary artery (LMCA) disease is a potentially lethal disease that can be effectively treated if it is recognized expeditiously. To determine whether clinical signs and symptoms vary with age, we examined data from 100 patients with angiographically significant LMCA disease (> or =50% stenosis). The majority of patients had myocardial infarction (32%) or Braunwald class I unstable angina (46%). There were no differences in initial symptoms, electrocardiographic findings (normal or only nonspecific changes in 52% of patients), or left ventricular function (normal or only mildly impaired in 76% of patients) between younger patients (< 50 yr; n = 29) and older patients (n = 71). Severe atherosclerosis was common in both groups. Risk factor profiles were different, however, in that diabetes mellitus (10% vs. 34%; P = 0.028) and hypertension (38% vs. 73%; P = 0.002) were less common and tobacco use was more common (79% vs. 39%; P <0.001) in younger patients. In summary, age influenced the risk factors associated with but not the clinical signs and symptoms of LMCAD.

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Section: Discussionsupporting

confidence: 90%

Section: Discussionmentioning

confidence: 99%

Left main coronary artery disease in adults younger than 50 years: A comparison with older patients

Stouffer

Mott

Brizolara

et al. 2000

Cathet. Cardiovasc. Intervent.

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“…3A-C). 40,44,45 Current ACC/ AHA and ESC STEMI guidelines accept this pattern as a predictor of left main coronary artery subocclusion or multivessel disease, particularly if the patient presents with hemodynamic compromise and otherwise unremarkable ECG.…”

Section: The Ecg In Patients With Ongoing Typical Symptomsmentioning

confidence: 99%

“…3A and C). 40,44 This issue is especially relevant for patients with NSTE-ACS. Many of these patients present after symptoms have resolved and the presenting ECG is therefore, relatively unremarkable.…”

Section: The Ecg In Patients After Resolution Of Symptomsmentioning

confidence: 99%

The Role of the ECG in Diagnosis, Risk Estimation, and Catheterization Laboratory Activation in Patients with Acute Coronary Syndromes: A Consensus Document

Birnbaum

Nikus

Kligfield

et al. 2014

Noninvasive Electrocardiol

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The electrocardiogram (ECG) is the most widely used imaging tool helping in diagnosis and initial management of patients presenting with symptoms compatible with acute coronary syndrome. Acute ischemia affects the configuration of the QRS complexes, the ST segments and the T waves. The ECG should be read along with the clinical assessment of the patient. ST segment elevation (and ST depression in leads V 1 -V 3 ) in patients with active symptoms usually indicates acute occlusion of an epicardial artery with ongoing transmural ischemia. These patients should be triaged for emergent reperfusion therapy per current guidelines. However, many patients have ST segment elevation secondary to nonischemic causes. ST depression in leads other than V 1 -V 3 usually are indicative of subendocardial ischemia secondary to subocclusion of the epicardial artery, distal embolization to small arteries or spasm supply/demand mismatch. ST depression may also be secondary to nonischemic etiologies, such as left ventricular hypertrophy, cardiomyopathies, etc. Knowing the clinical scenario, comparison to previous ECG and subsequent ECGs (in cases that there are changes in the quality or severity of symptoms) may add in the diagnosis and interpretation in difficult cases. This review addresses the different ECG patterns, typically seen in patients with active symptoms, after resolution of symptoms and the significance of such changes when seen in asymptomatic patients. Ann Noninvasive Electrocardiol 2014;19(5):412-425noninvasive techniques-electrocardiography; Acute coronary syndrome; ischemia; ST elevation; ST depression; myocardial infarctionThe electrical activity of the heart, as depicted by the surface electrocardiogram (ECG) is affected by ischemia, reperfusion and presence of necrosis or scar. Therefore, the ECG has remained the most widely utilized ancillary tool, along with focused history taking and physical examination,

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“…Atie et al 2 studied 127 consecutive patients with angiographically proven LMCA disease. Atie et al 2 studied 127 consecutive patients with angiographically proven LMCA disease.…”

mentioning

confidence: 99%

LMCA Disease and T‐Wave Positivity in Lead aVR

Tefik

Bitigen

2014

Noninvasive Electrocardiol

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Clinical presentation and prognosis of left main coronary artery disease in the 1980s

Cited by 5 publications

References 19 publications

Left main coronary artery disease in adults younger than 50 years: A comparison with older patients

Left main coronary artery disease in adults younger than 50 years: A comparison with older patients

The Role of the ECG in Diagnosis, Risk Estimation, and Catheterization Laboratory Activation in Patients with Acute Coronary Syndromes: A Consensus Document

LMCA Disease and T‐Wave Positivity in Lead aVR

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