Polycythaemia Vera Presenting as ST-Elevation Myocardial Infarction

Polycythemia Vera Presenting as Left Ventricular Pseudoaneurysm: The Role of Multimodality Imaging

“…In a study on 149 patients diagnosed with PV who were followed for ten years, Rossi et al [9] found that 11.4% had MI. Despite the association of PV with coronary artery disease, its presentation as acute MI is rare [10][11][12]. Nevertheless, patients with PV have never presented with a rare complication such as LVPA.…”

Caution Is Necessary When Dexmedetomidine Is Used Off-Label, Especially When Combined with Other Sedatives

“…4 Moreover, this was the second case in our institution during which dexmetomidine appeared to contribute to cardiogenic shock. Talke and Maze implicating the profound and potent sympatholytic effects of dexmetomidine.…”

“…4 Additionally, we're not aware of any report linking dexmedetomidine to ST segment elevations or ventricular fibrillation. Rupture of a coronary plaque as a consequence of arterial hypertension (epinephrine during CPR) and heparin reversal with protamine or microvascular sludging in the setting of polycythemia vera and extreme hypotension are much more plausible causes.…”

“…[2][3][4] The editorial 5 accompanying the case report advises against using DEX in patients with known sinus or atrioventricular conduction problems, in procedures where stress-induced sympathetic stimulation is absent and in patients with insufficient cardiovascular reserve. Of those, 8 deaths were preceded by hypotension during DEX use, and occurred in patients with severe coronary artery disease and serious medical problems, including renal impairment (Available at: http://www.fda.gov/cder/foi/nda/ 99/21-038_Precedex_medr_P1.pdf.…”

Polycythemia vera presenting as acute myocardial infarction: An unusual presentation

“…The authors found some reports [10][11][12][13][14][15][16][17][18] documenting PV presenting as AMI. Not all papers were available for review but the majority of cases were young males with minimal coronary occlusion.…”