3c and d)) and his right coronary artery had no stenosis ( Fig. His left coronary arteriogram showed no fixed stenosis ( Fig. After more than 15 minutes' cardiac massage, his blood pressure gradually increased ( Fig. Wide QRS changes were observed on ECG during the shocks ( Fig. 2c, e and g), he did not recover from the cardiogenic shock, and the PEA arrest continued ( Fig. However, despite the administration of adrenaline/etilefrine as well as nitroglycerine ( Fig. e: Normal coronary arteriogram in the right coronary artery.Ĭardiac massage was promptly performed. d: No fixed stenosis was found after the insertion of a drug-eluting stent. c: Severe coronary artery spasm was relieved after 15 minutes’ cardiopulmonary support. b: Contrast medium was observed at the proximal left coronary artery. a: Total and subtotal spasm were observed at the proximal left anterior descending artery or proximal left circumflex artery. 2b and c) were observed after the insertion of a diagnostic catheter (5-Fr Terumo outlook™ JL 3.5, Terumo, Tokyo, Japan) into the ascending aorta.Ĭoronary arteriograms during cardiogenic shock. 1b) leads and a decreased blood pressure (60/40 mmHg) ( Fig. ST-segment elevation in the V1-6, I, II, and aVF ( Fig. His blood pressure was 140/80 mmHg, and his heart rate was 80/min ( Fig. His electrocardiogram (ECG) had no significant ST-T changes, and chest symptom were not recognized ( Fig. We used the same local anesthetic drug (xylocaine injection polyamp 1% AstraZeneca, Osaka, Japan) on the four previous occasions. We started coronary angiography at 9:00 AM without premedication. Cardiac thallium scintigraphy showed slight partial redistribution on the anterior lesion. He was medicated with antiplatelets (ticlopidine 200 mg), aspirin (100 mg), angiotensin-receptor blockers (telmisartan 20 mg), statins (atrovastatin 10 mg) and beta-blockers (carvedilol 2.5 mg). He had ventricular fibrillation treated with direct current possibly due to a catheter wedge in the right coronary artery during follow-up coronary angiography nine years earlier. He had not been using sublingual nitrates when he complained of atypical chest discomfort. He had no typical chest pain but some atypical chest discomfort at rest during daily life. He had quit smoking 10 years earlier and had hypertension, dyslipidemia and diabetes mellitus. He had undergone coronary angiography four times, including coronary intervention three times, before this admission. 2007 4(6):775–80.A 75-year-old man was admitted to our hospital for follow-up coronary angiography after the implantation of a drug-eluting stent (Ultimaster 3.0×38 mm & Xience Alpine 2.5×23 mm) into the left anterior descending artery approximately 1 year earlier. OptiVol fluid status monitoring with an implantable cardiac device: a heart failure management system. Yamokoski LM, Haas GJ, Gans B, Abraham WT. Utility of impedance cardiography for the identification of short-term risk of clinical decompensation in stable patients with chronic heart failure. Packer M, Abraham WT, Mehra MR, Yancy CW, Lawless CE, Mitchell JE, Smart FW, Bijou R, O’Connor CM, Massie BM, Pina IL. 2017 AHA/ACC/HRS guideline for management of patients with ventricular arrhythmias and the prevention of sudden cardiac death: a report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines and the Heart Rhythm Society. Al-Khatib SM, Stevenson WG, Ackerman MJ, Bryant WJ, Callans DJ, Curtis AB, Deal BJ, et al.
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