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Enrica Perugini,
Giuseppe Di Pasquale, Lara Di Diodoro,
Paolo Ortolani,
Gianni Casella,
Nevio Taglieri,
M Letizia Bacchi Reggiani,
Antonio Marzocchi,
Massimiliano Lorenzini,
Angelo Branzi,
Claudio Rapezzi
International journal of cardiology 11/2011; 154(3):356-8. · 7.08 Impact Factor
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ABSTRACT: More than a century after it was invented, standard ECG is enjoying a renaissance of sorts. With regard to acute ischemic heart disease, this phenomenon is due mainly to the availability of large databases that in an ordered and predefined manner collect patient ECG patterns along side their clinical and coronary angiography details as well as outcome data. The present review critically analyses the diagnostic role of standard ECG in acute coronary syndromes with or without ST-segment elevation (STEMI and NSTEMI, respectively) and focuses on interpretation pitfalls and patterns that can contribute to therapeutic decision-making. In front of a patient with a clinical presentation suggestive of acute myocardial infarction the ECG can help answer many questions. In case a STEMI is suspected: are we sure we can exclude an infarction? (the problem of false negatives); are we sure it is a real infarction and not a false positive? Which is the obstructed coronary artery and at what level? Has there been reperfusion? In case an NSTEMI is suspected: are we sure it is a real myocardial infarction, rather than a pulmonary embolism or an aortic dissection? Are we sure it is NSTEMI rather than a "masked" dorsal STEMI? Which coronary substrate and what ischemia extension can we hypothesize in this patient? In particular, is the substrate of such high risk suggesting an emergency invasive approach?
Giornale italiano di cardiologia (2006) 09/2010; 11(9):630-44.
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Luca Ragni,
Elena Biagini,
Fernando M Picchio,
Daniela Prandstraller,
Ornella Leone,
Alessandra Berardini,
Antonella Perolo,
Francesco Grigioni, Lara di Diodoro,
Gaetano Gargiulo,
Eloisa Arbustini,
Claudio Rapezzi
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ABSTRACT: Whereas it is well known that idiopathic HCM can present in newborns and infants, little information is available on HT in this very young age group. We report a series of 17 infants with idiopathic HCM, including two neonates with rapidly progressive severe HF for whom HT was necessary. When HF manifests in a newborn/infant with idiopathic HCM and extreme cavity size reduction, the possibility of a rapidly progressive clinical course should be anticipated and HT may become the only available therapeutic solution.
Pediatric Transplantation 10/2008; 13(5):650-3. · 1.48 Impact Factor
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Journal of Cardiovascular Medicine 12/2007; 8(11):967-8. · 1.51 Impact Factor
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Elena Biagini,
Carla Lofiego,
Marinella Ferlito,
Rossella Fattori,
Guido Rocchi,
Maddalena Graziosi,
Luigi Lovato, Lara di Diodoro,
Robin M T Cooke,
Elisabetta Petracci,
Letizia Bacchi-Reggiani,
Romano Zannoli,
Angelo Branzi,
Claudio Rapezzi
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ABSTRACT: We investigated frequency/characteristics of acute coronary syndrome-like (ACS-like) electrocardiographic (ECG) profiles among patients with a final diagnosis of acute aortic syndrome (AAS), and explored pathophysiologic determinants and prognostic relevance within each Stanford subtype. We blindly reviewed presentation electrocardiograms of 233 consecutive patients with final diagnosis of AAS (164 Stanford type A) at a regional treatment center. Prevalence of ACS-like ECG findings was 27% (type A, 26%, type B, 29%); most were non-ST-elevation myocardial infarction-like. Patients with ACS-like ECG findings more often had coronary ostia involvement (p=0.002), pleural effusion (p=0.02), significant aortic regurgitation (p=0.01), and troponin positivity (p=0.001). ACS-like ECG profile in type A disease was independently associated with coronary ostia involvement (odds ratio [OR] 5.27, 95% confidence interval [CI] 1.75 to 15.88). ACS-like ECG profile predicted in-hospital mortality (OR 2.90, 95% CI 1.24 to 6.12), as did age (each incremental 10-year: OR 1.59, 95% CI 1.14 to 2.22), and syncope at presentation (OR 2.90, 95% CI 1.16 to 7.24). In conclusion, about 25% of our AAS patients (in either Stanford subtype) presented ACS-like ECG patterns-often with non-ST-elevation myocardial infarction characteristics-which could cause misdiagnosis. ACS-like ECG profile was associated with more complicated disease, and in type A disease was a strong independent predictor of in-hospital mortality.
The American Journal of Cardiology 10/2007; 100(6):1013-9. · 3.37 Impact Factor