Acute myocardial infarction with isolated conus branch occlusion

Umemura, Masanari; Ho, David W.; Nozawa, Naoki; Balginnyam, Erdene; Iwatsubo, Kousaku; Saito, T.; Endo, Tsutomu; Ishikawa, Yoshihiro; Umemura, Satoshi; Kimura, Kazuo

doi:10.1016/j.jelectrocard.2011.11.006

Cited by 7 publications

(6 citation statements)

References 5 publications

(7 reference statements)

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“…In our case, in addition to the main culprit lesion at segment 7 in the LAD, a 75% stenotic lesion in the LMT might also have played a critical role in the genesis of the ECG changes, since the specific features as described by Hirano et al almost matched our case. On the other hand, recent reports have provided evidence that ischemia of the conus branch may induce Brugada-type ECG changes in patients with coronary artery disease (19)(20)(21)(22). In our case, the Brugada-like ECG pattern may have been caused by a LMT lesion leading to possible conus branch ischemia.…”

Section: Discussionmentioning

confidence: 46%

Acute Myocardial Infarction with a Left Main Trunk Lesion and Documented Lambda-like J Waves

et al. 2012

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We herein describe a case of a myocardial infarction, in which Lambda-like J waves were documented. The patient was referred to our hospital due to ventricular fibrillation. The twelve-lead electrocardiogram (ECG) on admission showed prominent J waves in the lateral and precordial leads. Coronary angiography revealed 99% stenosis with a delay in the left anterior descending artery, 75% stenosis in the left main trunk, and possible ischemia in the conus branch. Our report addresses the possibility that ischemic J waves can be used as an important marker for lethal arrhythmias in patients with acute myocardial infarction.

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Section: Discussionmentioning

confidence: 46%

Acute Myocardial Infarction with a Left Main Trunk Lesion and Documented Lambda-like J Waves

et al. 2012

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“…A conus branch artery is considered as the substrate of Brugada syndrome. After conus branch occlusion during angioplasty, anterior ST segment elevation was detected in the previous reports [1][2][3][4][5] . However, some of these electrocardiogram (ECG) changes were not typical type of Brugada syndrome.…”

Section: Introductionmentioning

confidence: 76%

The electrocardiogram change of conus branch occlusion during right coronary artery angioplasty

Kuno

Fujisawa

Numasawa

et al. 2015

CRIM

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There are few reports of electrocardiogram (ECG) changes of conus branch occlusion. A conus branch artery supply to the outflow tract of right ventricle. A conus branch artery is considered as the substrate of Brugada syndrome. We report a case of conus branch occlusion during angioplasty with ST segment elevation in V 1-3 like Brugada syndrome ECG. We need to bear in mind that this ECG change may cause lethal arrhythmia.

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“…Spontaneous atherothrombotic conus branch occlusion can be the cause of acute myocardial infarction. There are a few reported cases of spontaneous acute myocardial infarction due to occlusion of the conus artery and can present with ST elevation in precordial leads [17]. Isolated RV infarction is seen in approximately 3% of all patients with myocardial infarction [9].…”

Section: Discussionmentioning

confidence: 99%

“…Isolated RV infarction is seen in approximately 3% of all patients with myocardial infarction [9]. In spite of this, there are cases in which RV infarction leads to ST-segment elevation in precordial leads, mimicking anteroseptal or anterior infarction [10][11][12]17].…”

Section: Discussionmentioning

confidence: 99%

Malignant Arrhythmia in Acute Conus Artery Occlusion

Câlmâc¹,

Horodinschi²

2021

J Clin Stud Rev Rep

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We present the case of a 74 y.o. woman with multiple cardiovascular risk factors, admitted for worsening angina over the past three weeks. On admission she had no significant electrocardiographic and echocardiographic changes and a negative Troponin test. Coronary angiography revealed single vessel disease: severe stenosis of the right coronary artery (RCA) ostium (difficult to assess visually), 50% mid-vessel and 60% distal segment. The left anterior descending artery and circumflex artery had non-significant stenoses. Fractional flow reserve technique (FFR) was used to evaluate the RCA ostial lesion which proved to be significant, therefore angioplasty with three drug-eluting stents was performed for all three lesions of the right coronary artery, starting from the ostium. Due to its location, minimal aortic protrusion of the first stent occluded a small ostial branch which proved to be the conus artery and the patient developed mild transient angina during the procedure, but with good outcome regarding the intracoronary flow. After the angioplasty the patient presented anterior leads ST-elevation and developed mild chest pain with an increase in cardiac enzymes (CK-MB peak 39 U/L). Later on, she had two episodes of ventricular fibrillation with rapid defibrillation to sinus rhythm, with no further events or echocardiographic changes and no recurrent angina. The patient was started on amiodarone to prevent ventricular arrhythmias and continued double antiplatelet therapy with aspirin and clopidogrel. She was discharged six days later. In conclusion, although the conus branch is a small artery, its acute occlusion can have significant life-threatening complications.

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Acute myocardial infarction with isolated conus branch occlusion

Cited by 7 publications

References 5 publications

Acute Myocardial Infarction with a Left Main Trunk Lesion and Documented Lambda-like J Waves

Acute Myocardial Infarction with a Left Main Trunk Lesion and Documented Lambda-like J Waves

The electrocardiogram change of conus branch occlusion during right coronary artery angioplasty

Malignant Arrhythmia in Acute Conus Artery Occlusion

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