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PP-016 Anteroseptal Myocardial Infarction due to Myocardial Bridging in a Young Long Distance Runner
MARCH 26e29, 2015
Figure. Serial ECGs recorded at few and several hours and also several days after the index event, anteroseptal MI, and the angiographic image of a long segment of intramyocardial course-myocardial bridging at the middle segment of LAD artery.
Figure. Presentation of aneurysms of coronary artery, aorta, and pulmonary artery from different echocaridographic views and multisliced computed tomograhic angiography.
P O S T E R A B S T R A C T S
Conclusion: Although the young subjects with aneurysm of central or coronary arteries have favorably a stable and asymptomatic period of life several types of sports activities such as isometric or strenuous types of exercises including straining and valsalva maneuver, weight lifting could lead not only progressively enlargement of great arteries but also acute dissection or rupture of them and consequence with sudden cardiac death. Transthroracic echocardiography is best way of screening the aneurysm of central arteries especially their proximal segments and also coronary ostiums which could be imaged with a high resolution devices.
- PP-016 Anteroseptal Myocardial Infarction due to Myocardial Bridging in a Young Long Distance Runner. Mustafa Aparci1, Cengiz Ozturk2, Sercan Okutucu3, Sevket Balta4, Zafer Isilak5, Murat Yalcin5. 1Dept. of Cardiology Kasimpasa Military Hospital, Istanbul, Turkey; 2 Dept. of Cardiology, Gulhane Military Medical Academy, Ankara, Turkey; 3Dept. of Cardiology, Memorial Hospital, Ankara, Turkey; 4Eskis¸ehir Military Hospital, Dept. of Cardiology and Aviation Medicine; 5Dept. of Cardiology, Haydarpas¸a Training Hospital, Istanbul, Turkey. Aim: Young and young adults may suffer acute cardiovascular events due to various pathologies related with coronary artery. Those events may vary from syncope to potentially lethal infarct and ventricular arrhythmia. We presented 36 years old male was professional cross trainer. He had been admitted to cardiology service for a routine check up just after his daily training. There were ST/T wave changes that indicated acute Anteroseptal myocardial infarction on ECG. He was duty on professional sports team of army forces. He trains various types of instruments and programs as routine daily training. On that day, he had been run a distance of 12 kilometers which was prolonged more than his ordinary training activity. Then he applied for the periodical examination to Cardiology service of Etimesgut Military Hospital. Material-Method: First ECG (Figure 1) revealed prominent ST segment elevation indicating acute anteroseptal myocardial infarction. He had mild hypokinesia at apical segment of left ventricle. He was
transferred to coronary care unit and was performed coronary angiography. He had intramyocardial course after the D2 branch with slight ectasia at its proximal on the LAD artery and a noncritical plaque at mid of RCA. Results: It was observed that dynamic ST elevations on precordial derivations were recovered on following ECGs (Figure 2-3). His cardiac markers slightly elevated meeting the criteria of myocardial infarction (cardiac Troponin 0.17 and 0.21 ng/mL > 0.06ng/ml). Conclusion: Non critical coronary lesions e.g. myocardial bridging or atherosclerotic plaques with <%25 luminal narrowing may act as a critical lesion in patients who participate into professional sports training. Mismatch of oxygen demand-blood supply due to extreme levels or prolonged duration of exercise may be resulted with myocardial ischemia or even infarct. Anatomically restriction of the coronary flow due to myocardial bridging on LAD artery and also reduced diastolic period due to tachycardia were accounted for the anteroseptal myocardial infarction of a sportsman during the extremely prolonged exercise. Myocardial bridging of coronary arteries should be sought and reported during the assessment of MSCT angiography or invasive coronary angiography. Antiagregant therapy, betablocking therapy and statin therapy was prescribed as secondary prevention. He was prohibited from the prolonged durations of exercises.
- PP-017 Clinical Results of Short-Term and Long Term Follow Up Period and Antihypertensive Drug Treatment of Patients with Aortic Aneurysm. Mustafa Aparci1, Cengiz Ozturk2, Sevket Balta3, Zafer Isilak4, Turgay Celik2, Murat Yalcin4, Ejder Kardesoglu4, Mehmet Uzun4, Bekir Sitki Cebeci4. 1Dept. of Cardiology Kasimpasa Military Hospital, Istanbul, Turkey; 2 Dept. of Cardiology, Gulhane Military Medical Academy, Ankara, Turkey; 3Eskis¸ehir Military Hospital, Dept. of Cardiology and Aviation Medicine; 4Dept. of Cardiology, Haydarpasa Training Hospital, Istanbul, Turkey. Aim: Patients with aortic aneurysm (AA) may potentially progress into larger dimensions and may be at high risk for lethal complications such as aortic dissection unless they are treated with antihypertensive drugs and restricted from straining and isometric type exercises. Thus earlier detection of aortic aneurysms and treatment of co-morbidities gained importance worldwide. We evaluated the antihypertensive drug preferences in the management of patients with aortic aneurysm and their clinical progress and also the diameter changes from the short term and long term medical recordings. Material-Method: We retrospectively evaluated medical recordings of 30 patients whose aortic diameters had been measured at short term (2.40.6, 2-4 months) and long term (7.31.7, 5-11 months) follow up
S102 The American Journal of Cardiologyâ MARCH 26e29, 2015 11th INTERNATIONAL CONGRESS OF UPDATE IN CARDIOLOGY AND CARDIOVASCULAR SURGERY ABSTRACTS / Poster
Figure. Serial ECGs recorded at few and several hours and also several days after the index event, anteroseptal MI, and the angiographic image of a long segment of intramyocardial course-myocardial bridging at the middle segment of LAD artery.
Figure. Presentation of aneurysms of coronary artery, aorta, and pulmonary artery from different echocaridographic views and multisliced computed tomograhic angiography.
P O S T E R A B S T R A C T S
Conclusion: Although the young subjects with aneurysm of central or coronary arteries have favorably a stable and asymptomatic period of life several types of sports activities such as isometric or strenuous types of exercises including straining and valsalva maneuver, weight lifting could lead not only progressively enlargement of great arteries but also acute dissection or rupture of them and consequence with sudden cardiac death. Transthroracic echocardiography is best way of screening the aneurysm of central arteries especially their proximal segments and also coronary ostiums which could be imaged with a high resolution devices.
- PP-016 Anteroseptal Myocardial Infarction due to Myocardial Bridging in a Young Long Distance Runner. Mustafa Aparci1, Cengiz Ozturk2, Sercan Okutucu3, Sevket Balta4, Zafer Isilak5, Murat Yalcin5. 1Dept. of Cardiology Kasimpasa Military Hospital, Istanbul, Turkey; 2 Dept. of Cardiology, Gulhane Military Medical Academy, Ankara, Turkey; 3Dept. of Cardiology, Memorial Hospital, Ankara, Turkey; 4Eskis¸ehir Military Hospital, Dept. of Cardiology and Aviation Medicine; 5Dept. of Cardiology, Haydarpas¸a Training Hospital, Istanbul, Turkey. Aim: Young and young adults may suffer acute cardiovascular events due to various pathologies related with coronary artery. Those events may vary from syncope to potentially lethal infarct and ventricular arrhythmia. We presented 36 years old male was professional cross trainer. He had been admitted to cardiology service for a routine check up just after his daily training. There were ST/T wave changes that indicated acute Anteroseptal myocardial infarction on ECG. He was duty on professional sports team of army forces. He trains various types of instruments and programs as routine daily training. On that day, he had been run a distance of 12 kilometers which was prolonged more than his ordinary training activity. Then he applied for the periodical examination to Cardiology service of Etimesgut Military Hospital. Material-Method: First ECG (Figure 1) revealed prominent ST segment elevation indicating acute anteroseptal myocardial infarction. He had mild hypokinesia at apical segment of left ventricle. He was
transferred to coronary care unit and was performed coronary angiography. He had intramyocardial course after the D2 branch with slight ectasia at its proximal on the LAD artery and a noncritical plaque at mid of RCA. Results: It was observed that dynamic ST elevations on precordial derivations were recovered on following ECGs (Figure 2-3). His cardiac markers slightly elevated meeting the criteria of myocardial infarction (cardiac Troponin 0.17 and 0.21 ng/mL > 0.06ng/ml). Conclusion: Non critical coronary lesions e.g. myocardial bridging or atherosclerotic plaques with <%25 luminal narrowing may act as a critical lesion in patients who participate into professional sports training. Mismatch of oxygen demand-blood supply due to extreme levels or prolonged duration of exercise may be resulted with myocardial ischemia or even infarct. Anatomically restriction of the coronary flow due to myocardial bridging on LAD artery and also reduced diastolic period due to tachycardia were accounted for the anteroseptal myocardial infarction of a sportsman during the extremely prolonged exercise. Myocardial bridging of coronary arteries should be sought and reported during the assessment of MSCT angiography or invasive coronary angiography. Antiagregant therapy, betablocking therapy and statin therapy was prescribed as secondary prevention. He was prohibited from the prolonged durations of exercises.
- PP-017 Clinical Results of Short-Term and Long Term Follow Up Period and Antihypertensive Drug Treatment of Patients with Aortic Aneurysm. Mustafa Aparci1, Cengiz Ozturk2, Sevket Balta3, Zafer Isilak4, Turgay Celik2, Murat Yalcin4, Ejder Kardesoglu4, Mehmet Uzun4, Bekir Sitki Cebeci4. 1Dept. of Cardiology Kasimpasa Military Hospital, Istanbul, Turkey; 2 Dept. of Cardiology, Gulhane Military Medical Academy, Ankara, Turkey; 3Eskis¸ehir Military Hospital, Dept. of Cardiology and Aviation Medicine; 4Dept. of Cardiology, Haydarpasa Training Hospital, Istanbul, Turkey. Aim: Patients with aortic aneurysm (AA) may potentially progress into larger dimensions and may be at high risk for lethal complications such as aortic dissection unless they are treated with antihypertensive drugs and restricted from straining and isometric type exercises. Thus earlier detection of aortic aneurysms and treatment of co-morbidities gained importance worldwide. We evaluated the antihypertensive drug preferences in the management of patients with aortic aneurysm and their clinical progress and also the diameter changes from the short term and long term medical recordings. Material-Method: We retrospectively evaluated medical recordings of 30 patients whose aortic diameters had been measured at short term (2.40.6, 2-4 months) and long term (7.31.7, 5-11 months) follow up
S102 The American Journal of Cardiologyâ MARCH 26e29, 2015 11th INTERNATIONAL CONGRESS OF UPDATE IN CARDIOLOGY AND CARDIOVASCULAR SURGERY ABSTRACTS / Poster