Document Detail


High incidence of focal left ventricular wall motion abnormalities and normal coronary arteries in patients with myocardial infarctions presenting to a community hospital.
MedLine Citation:
PMID:  16877787     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Myocardial infarction with normal coronary arteries (MINCA) is a well-documented syndrome often associated with global left ventricular wall motion abnormalities (LVWMAs). Recent literature has emphasized the occurrence of Takotsubo cardiomyopathy associated with MINCA. What has not been reported is the incidence of MINCA in the general population and the relative frequency of other types of associated LVWMAs. METHODS AND RESULTS: Data were retrospectively collected on 165 consecutive patients with ST-elevation myocardial infarction (STEMI) and 244 patients with non-ST-elevation myocardial infarction (NSTEMI) who underwent cardiac catheterization at a single institution in Marin County, California. Thirty-two of the 409 (7.8%) patients had MINCA. Of the patients presenting with STEMI, 10.3% had MINCA, and 6.1% of the patients presenting with NSTEMI had MINCA. Females were more likely to present with MINCA than males, both for STEMI (21.6% vs. 5.3%; p < 0.001) and NSTEMI (12.1% vs. 2.6%; p < 0.001). Of the 32 patients who presented with MINCA, 7 (21.9%) females had Takotsubo cardiomyopathy, while 10 (31.3%) patients (9 females, 1 male) had other previously undescribed focal anterior and inferior LVWMAs. A recent stressful event was noted in 50% (47.8% of females, 55.6% of males) of the patients with MINCA. CONCLUSIONS: An unexpectedly high incidence of MINCA with newly-described focal anterior and inferior LVWMAs as well as Takotsubo cardiomyopathy was observed in our community hospital. This syndrome occurred predominantly in females and was often associated with a recent stressful event. As these results were from a community, rather than a referral hospital, this finding challenges the current thought about the incidence of this syndrome in the general population.
Authors:
Brian Strunk; Richard E Shaw; Sally Bull; James Adams; Margaret Baer; Kent Gershengorn; Ann Kao; Brian Keeffe; Joel Sklar; David Sperling; Robert Sperling; Mark Wexman; Jerald Young
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  The Journal of invasive cardiology     Volume:  18     ISSN:  1557-2501     ISO Abbreviation:  J Invasive Cardiol     Publication Date:  2006 Aug 
Date Detail:
Created Date:  2006-07-31     Completed Date:  2006-09-08     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8917477     Medline TA:  J Invasive Cardiol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  376-81     Citation Subset:  IM    
Affiliation:
Marin General Hospital, Marin County, California, USA.
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MeSH Terms
Descriptor/Qualifier:
Adult
Aged
Aged, 80 and over
Biological Markers / blood
Coronary Angiography*
Echocardiography
Electrocardiography
Female
Follow-Up Studies
Hospitals, Community
Humans
Incidence
Male
Middle Aged
Myocardial Infarction / blood,  complications*,  diagnosis
Retrospective Studies
Ventricular Dysfunction, Left / blood,  complications*,  diagnosis,  epidemiology*
Chemical
Reg. No./Substance:
0/Biological Markers

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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