Small Septal Branch Artery Thrombus Inducing Ventricular Fibrillation: To Intervene or Not to Intervene

A 64-year-old woman presented for chest pain and was diagnosed with anteroseptal ST segment elevation myocardial infarction (STEMI). Emergent angiography showed 95% stenosis at the ostium of the second septal branch, consistent with thrombus, and no other significant lesions. The lesion was not amen...

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Detalles Bibliográficos
Autores principales: Agarwal, Vratika, Olson, Peter C, Mroue, Jad, Olkovsky, Yefim, Bekheit, Soad, Lafferty, James
Formato: Online Artículo Texto
Lenguaje:English
Publicado: SAGE Publications 2019
Materias:
Case Report
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6378485/
https://www.ncbi.nlm.nih.gov/pubmed/30799967
http://dx.doi.org/10.1177/1179547619828717
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author Agarwal, Vratika
Olson, Peter C
Mroue, Jad
Olkovsky, Yefim
Bekheit, Soad
Lafferty, James
author_facet Agarwal, Vratika
Olson, Peter C
Mroue, Jad
Olkovsky, Yefim
Bekheit, Soad
Lafferty, James
author_sort Agarwal, Vratika
collection PubMed
description A 64-year-old woman presented for chest pain and was diagnosed with anteroseptal ST segment elevation myocardial infarction (STEMI). Emergent angiography showed 95% stenosis at the ostium of the second septal branch, consistent with thrombus, and no other significant lesions. The lesion was not amenable to intervention due to small caliber. Post angiography, the patient’s electrical rhythm deteriorated into ventricular fibrillation. Following resuscitation, repeat angiography confirmed same findings. Electrophysiology study at 3 months was positive for inducing fibrillation. Due to patient risk factors, she had placement of a dual chamber defibrillator. A 5-month follow-up echocardiogram showed a small area of ventricular septal wall bowing, consistent with blood supply from septal territory.
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spelling pubmed-63784852019-02-22 Small Septal Branch Artery Thrombus Inducing Ventricular Fibrillation: To Intervene or Not to Intervene Agarwal, Vratika Olson, Peter C Mroue, Jad Olkovsky, Yefim Bekheit, Soad Lafferty, James Clin Med Insights Case Rep Case Report A 64-year-old woman presented for chest pain and was diagnosed with anteroseptal ST segment elevation myocardial infarction (STEMI). Emergent angiography showed 95% stenosis at the ostium of the second septal branch, consistent with thrombus, and no other significant lesions. The lesion was not amenable to intervention due to small caliber. Post angiography, the patient’s electrical rhythm deteriorated into ventricular fibrillation. Following resuscitation, repeat angiography confirmed same findings. Electrophysiology study at 3 months was positive for inducing fibrillation. Due to patient risk factors, she had placement of a dual chamber defibrillator. A 5-month follow-up echocardiogram showed a small area of ventricular septal wall bowing, consistent with blood supply from septal territory. SAGE Publications 2019-02-15 /pmc/articles/PMC6378485/ /pubmed/30799967 http://dx.doi.org/10.1177/1179547619828717 Text en © The Author(s) 2019 http://www.creativecommons.org/licenses/by-nc/4.0/ This article is distributed under the terms of the Creative Commons Attribution-NonCommercial 4.0 License (http://www.creativecommons.org/licenses/by-nc/4.0/) which permits non-commercial use, reproduction and distribution of the work without further permission provided the original work is attributed as specified on the SAGE and Open Access pages (https://us.sagepub.com/en-us/nam/open-access-at-sage).
spellingShingle Case Report
Agarwal, Vratika
Olson, Peter C
Mroue, Jad
Olkovsky, Yefim
Bekheit, Soad
Lafferty, James
Small Septal Branch Artery Thrombus Inducing Ventricular Fibrillation: To Intervene or Not to Intervene
title Small Septal Branch Artery Thrombus Inducing Ventricular Fibrillation: To Intervene or Not to Intervene
title_full Small Septal Branch Artery Thrombus Inducing Ventricular Fibrillation: To Intervene or Not to Intervene
title_fullStr Small Septal Branch Artery Thrombus Inducing Ventricular Fibrillation: To Intervene or Not to Intervene
title_full_unstemmed Small Septal Branch Artery Thrombus Inducing Ventricular Fibrillation: To Intervene or Not to Intervene
title_short Small Septal Branch Artery Thrombus Inducing Ventricular Fibrillation: To Intervene or Not to Intervene
title_sort small septal branch artery thrombus inducing ventricular fibrillation: to intervene or not to intervene
topic Case Report
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6378485/
https://www.ncbi.nlm.nih.gov/pubmed/30799967
http://dx.doi.org/10.1177/1179547619828717
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