Multimodality cardiac imaging of a patient with syncope
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A 60-year-old man was admitted to the hospital following an episode of syncope lasting for a few minutes while brushing his teeth. He denied chest pain, palpitation, or an aura prior to falling unconscious. He had history of hypertension, diabetes mellitus, dyslipidemia, coronary artery disease, transient ischemic attacks, smoking, and heavy alcohol abuse. He suffered from a myocardial infarction several years ago, which was treated with percutaneous coronary intervention. His electrocardiogram showed precordial Q waves with 1-mm ST-segment elevation (Figure 1A). Chest x-ray revealed a faint curvilinear opacity in the cardiac apical region, suspicious for a calcified apical aneurysm (Figure 1B). Echocardiogram (Figure 2; Video 1) showed left ventricular ejection fraction (LVEF) of 35% and dyskinesia of the distal anteroseptal and apical myocardium. He ruled out for an acute myocardial infarction, but was noticed to have frequent episodes of non-sustained ventricular arrhythmias....
KeywordsLeft Ventricular Ejection Fraction Leave Anterior Descend Dacron Patch Aneurysm Resection Obtuse Marginal Branch
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.
Conflict of interest
The authors have indicated that they have no financial conflict of interest.
Video 1: Echocardiogram in long axis view showing an apical aneurysm and severely impaired global left ventricular ejection fraction. (AVI 542 kb)
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- 3.O’Gara PT, Kushner FG, Ascheim DD, Casey DE Jr, Chung MK, de Lemos JA, et al. 2013 ACCF/AHA guideline for the management of ST-elevation myocardial infarction: A report of the American College of Cardiology Foundation/American Heart Association Task Force on Practice Guidelines. J Am Coll Cardiol 2013;61:e78-140.PubMedCrossRefGoogle Scholar
© American Society of Nuclear Cardiology 2014