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dc.contributor.authorGue, Ying X.
dc.contributor.authorAnwar, Majid
dc.contributor.authorGorog, Diana A.
dc.date.accessioned2019-11-08T01:21:35Z
dc.date.available2019-11-08T01:21:35Z
dc.date.issued2018-03-01
dc.identifier.citationGue , Y X , Anwar , M & Gorog , D A 2018 , ' A rare cause of myocardial infarction with non-obstructive coronary arteries-case report of ST-segment elevation myocardial infarction caused by a mediastinal mass ' , European Heart Journal - Case Reports , vol. 2 , no. 1 , yty008 , pp. 1-7 . https://doi.org/10.1093/ehjcr/yty008
dc.identifier.issn2514-2119
dc.identifier.otherPURE: 17666545
dc.identifier.otherPURE UUID: 5bc8b2e7-1122-47c7-aaef-0dd252aa83b5
dc.identifier.otherScopus: 85073547294
dc.identifier.urihttp://hdl.handle.net/2299/21874
dc.description© The Author(s) 2018. Published by Oxford University Press on behalf of the European Society of Cardiology. This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0/), which permits non-commercial re-use, distribution, and reproduction in any medium, provided the original work is properly cited.
dc.description.abstractIntroduction ST-segment elevation myocardial infarction (STEMI) is attributable to an occluded coronary artery in almost 90% of patients. Accordingly, restoration of coronary perfusion as early as possible, preferably with primary percutaneous coronary intervention, is the recommended treatment by the European Society of Cardiology, to maximise myocardial salvage. However, not all cases of STEMI are because of coronary artery occlusion. ST-segment elevation myocardial infarction that occurs in the absence of obstructive coronary artery disease on angiography has been termed myocardial infarction with non-obstructive coronary arteries (MINOCA). Case A 44-year-old man was admitted with retrosternal chest pain radiating to the left arm and jaw, and electrocardiogpresentation raphy showed extensive anterior ST-segment elevation. Emergency coronary angiography showed all three coronary arteries were patent with Thrombolysis in Myocardial Infarction-3 flow and no evidence of dissection or thrombus. The ST-elevation and pain resolved spontaneously. Troponin-T level rose from <3 ng/L on arrival to 549 ng/L at 12 h. Subsequent cardiac magnetic resonance imaging (MRI) showed a structurally normal heart (without late gadolinium enhancement) but detected an incidental large, lobulated (90 * 31 * 71 mm) mediastinal mass containing multiple cysts in the anterior mediastinum with inflammation and oedema of the parietal pericardium. Tissue biopsy confirmed Hodgkin's lymphoma and the patient was initiated on chemotherapy. Discussion Some 3% of ST-segment myocardial infarctions occur in the absence of obstructive coronary disease (MINOCA), is more frequent in younger patients. Cardiac MRI is a useful tool to both identify some of the potential causes of MINOCA and also to confirm the diagnosis of infarction. Some 26% of MINOCA patients have significant biochemical evidence of myocardial injury but have a normal cardiac MRI. This case illustrates a very rare cause of myocardial infarction in a young patient with unobstructed coronary arteries, and highlights the need in such cases for further detailed imaging of the myocardium and thorax to establish the diagnosis and initiate appropriate treatment.en
dc.format.extent7
dc.language.isoeng
dc.relation.ispartofEuropean Heart Journal - Case Reports
dc.rightsOpen
dc.subjectCase report
dc.subjectLymphoma
dc.subjectMediastinum
dc.subjectMINOCA
dc.subjectMyocardial infarction
dc.subjectST-elevation
dc.subjectCardiology and Cardiovascular Medicine
dc.titleA rare cause of myocardial infarction with non-obstructive coronary arteries-case report of ST-segment elevation myocardial infarction caused by a mediastinal massen
dc.contributor.institutionDepartment of Clinical and Pharmaceutical Sciences
dc.contributor.institutionBasic and Clinical Science Unit
dc.contributor.institutionCentre for Health Services and Clinical Research
dc.contributor.institutionSchool of Life and Medical Sciences
dc.contributor.institutionDepartment of Pharmacy, Pharmacology and Postgraduate Medicine
dc.description.statusPeer reviewed
dc.identifier.urlhttp://www.scopus.com/inward/record.url?scp=85073547294&partnerID=8YFLogxK
dc.relation.schoolSchool of Life and Medical Sciences
dc.description.versiontypeFinal Published version
dcterms.dateAccepted2018-03-01
rioxxterms.versionVoR
rioxxterms.versionofrecordhttps://doi.org/10.1093/ehjcr/yty008
rioxxterms.licenseref.urihttp://creativecommons.org/licenses/by/4.0/
rioxxterms.typeJournal Article/Review
herts.preservation.rarelyaccessedtrue
herts.rights.accesstypeOpen


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