ST elevation myocardial infarction causes: Difference between revisions

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Revision as of 17:17, 8 May 2014

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]

Overview

The most common proximate cause of ST elevation myocardial infarction is plaque rupture. There are risk factors for plaque rupture and triggers of plaque rupture. A full discussion regarding the chronic risk factors and acute triggers of ST elevation MI can be found in other chapters.

Causes

A rare cause of STEMI is adrenal myocarditis, where elevated levels of catecholamines due to pheochromocytoma cause myocarditis and STEMI.^[1]^[2]^[3]

References

↑ Roghi A, Pedrotti P, Milazzo A, Bonacina E, Bucciarelli-Ducci C (2011). "Adrenergic myocarditis in pheochromocytoma". J Cardiovasc Magn Reson. 13: 4. doi:10.1186/1532-429X-13-4. PMC 3025878. PMID 21223554.
↑ Navarro I, Molina M, Civera M, Ascaso JF, Real JT, Carmena R (2011). "[Catecholamine-induced cardiomyopathy triggered by pheochromocytoma]". Endocrinol Nutr. 58 (4): 204–6. doi:10.1016/j.endonu.2010.11.005. PMID 21393076.
↑ Subramanyam S, Kreisberg RA (2012). "Pheochromocytoma: a cause of ST-segment elevation myocardial infarction, transient left ventricular dysfunction, and takotsubo cardiomyopathy". Endocr Pract. 18 (4): e77–80. doi:10.4158/EP11346.CR. PMID 22441003.

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[pmid21223554-1] Roghi A, Pedrotti P, Milazzo A, Bonacina E, Bucciarelli-Ducci C (2011). "Adrenergic myocarditis in pheochromocytoma". J Cardiovasc Magn Reson. 13: 4. doi:10.1186/1532-429X-13-4. PMC 3025878. PMID 21223554.

[pmid21393076-2] Navarro I, Molina M, Civera M, Ascaso JF, Real JT, Carmena R (2011). "[Catecholamine-induced cardiomyopathy triggered by pheochromocytoma]". Endocrinol Nutr. 58 (4): 204–6. doi:10.1016/j.endonu.2010.11.005. PMID 21393076.

[pmid22441003-3] Subramanyam S, Kreisberg RA (2012). "Pheochromocytoma: a cause of ST-segment elevation myocardial infarction, transient left ventricular dysfunction, and takotsubo cardiomyopathy". Endocr Pract. 18 (4): e77–80. doi:10.4158/EP11346.CR. PMID 22441003.

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@@ Line 4: / Line 4: @@
 ==Overview==
-ST elevation myocardial infarction can be physiologically induced via exertional strain. A discussion regarding the [[ST elevation myocardial infarction risk factors|risk factors]] and [[ST elevation myocardial infarction triggers|triggers]] can be found in other chapters.
+The most common proximate cause of ST elevation myocardial infarction is plaque rupture.  There are risk factors for plaque rupture and triggers of plaque rupture. A full discussion regarding the [[ST elevation myocardial infarction risk factors|chronic risk factors]] and [[ST elevation myocardial infarction triggers|acute triggers]] of ST elevation MI can be found in other chapters.
 ==Causes==
-Heart attack rates are higher in association with intense exertion, be it [[stress (psychology)|psychological stress]] or [[Human body|physical]] exertion, especially if the exertion is more intense than the individual usually performs.<ref name="Framingham1998">{{cite journal | author=Wilson PW, D'Agostino RB, Levy D, Belanger AM, Silbershatz H, Kannel WB. | title=Prediction of coronary heart disease using risk factor categories | journal=Circulation | year=1998 | volume=97 | issue=18 | pages=1837–47 | format=PDF | url=http://circ.ahajournals.org/cgi/reprint/97/18/1837.pdf | pmid=9603539 | doi=10.1161/01.CIR.97.18.1837}}</ref> The period of intense exercise and subsequent recovery is associated with about a 6-fold higher myocardial infarction rate (compared with other more relaxed time frames) for people who are physically very fit.<ref name="Framingham1998"/> For those in poor physical condition, the rate differential is over 35-fold higher.<ref name="Framingham1998"/> One observed mechanism for this phenomenon is the increased arterial pulse pressure stretching and relaxation of arteries with each heart beat, which, as has been observed with [[intravascular ultrasound]], increases mechanical "shear stress" on [[atheroma]]s and the likelihood of plaque rupture.<ref name="Framingham1998"/>
-Acute severe infection, such as [[pneumonia]], can trigger myocardial infarction. A more controversial link is that between ''[[Chlamydophila pneumoniae]]'' infection and [[atherosclerosis]].<ref name="Saikku-1992">{{cite journal | author=Saikku P, Leinonen M, Tenkanen L, Linnanmaki E, Ekman MR, Manninen V, Manttari M, Frick MH, Huttunen JK. | title=Chronic Chlamydia pneumoniae infection as a risk factor for coronary heart disease in the Helsinki Heart Study | journal=Ann Intern Med | year=1992 | volume=116 | issue=4 | pages=273–8 | pmid=1733381}}</ref> While this intracellular organism has been demonstrated in atherosclerotic plaques, evidence is inconclusive as to whether it can be considered a causative factor.<ref name="Saikku-1992"/> Treatment with antibiotics in patients with proven atherosclerosis has not demonstrated a decreased risk of heart attacks or other coronary vascular diseases.<ref name="Andraws-2005">{{cite journal | author=Andraws R, Berger JS, Brown DL. | title=Effects of antibiotic therapy on outcomes of patients with coronary artery disease: a meta-analysis of randomized controlled trials | journal=JAMA | year=2005 | volume=293 | issue=21 | pages=2641–7 | pmid=15928286 | doi = 10.1001/jama.293.21.2641}}</ref>
-There is an association of an increased incidence of a heart attack in the morning hours, more specifically around 9 a.m.<ref name="pmid2865677">{{cite journal |author=Muller JE, Stone PH, Turi ZG, ''et al.'' |title=Circadian variation in the frequency of onset of acute myocardial infarction |journal=[[N. Engl. J. Med.]] |volume=313 |issue=21 |pages=1315–22 |year=1985 |pmid=2865677 |doi=10.1056/NEJM198511213132103}}</ref><ref name="pmid3673917">{{cite journal |author=Beamer AD, Lee TH, Cook EF, ''et al.'' |title=Diagnostic implications for myocardial ischemia of the circadian variation of the onset of chest pain |journal=[[Am. J. Cardiol.]] |volume=60 |issue=13 |pages=998–1002 |year=1987 |pmid=3673917 |doi=10.1016/0002-9149(87)90340-7}}</ref><ref name="pmid9036740">{{cite journal |author=Cannon CP, McCabe CH, Stone PH, ''et al.'' |title=Circadian variation in the onset of unstable angina and non-Q-wave acute myocardial infarction (the TIMI III Registry and TIMI IIIB) |journal=[[Am. J. Cardiol.]] |volume=79 |issue=3 |pages=253–8 |year=1997 |pmid=9036740 |doi= 10.1016/S0002-9149(97)00743-1|url=http://linkinghub.elsevier.com/retrieve/pii/S0002914997007431 |last2=McCabe |last3=Stone |last4=Schactman |last5=Thompson |last6=Theroux |last7=Gibson |last8=Feldman |last9=Kleiman}}</ref> Some investigators have noticed that the ability of platelets to aggregate varies according to a circadian rhythm, although they have not proven causation.<ref name="pmid3587281">{{cite journal |author=Tofler GH, Brezinski D, Schafer AI, ''et al.'' |title=Concurrent morning increase in platelet aggregability and the risk of myocardial infarction and sudden cardiac death |journal=[[N. Engl. J. Med.]] |volume=316 |issue=24 |pages=1514–8 |year=1987 |pmid=3587281 |doi=10.1056/NEJM198706113162405}}</ref>
 A rare cause of STEMI is [[adrenal myocarditis]], where elevated levels of [[catecholamine]]s due to [[pheochromocytoma]] cause [[myocarditis]] and STEMI.<ref name="pmid21223554">{{cite journal| author=Roghi A, Pedrotti P, Milazzo A, Bonacina E, Bucciarelli-Ducci C| title=Adrenergic myocarditis in pheochromocytoma. | journal=J Cardiovasc Magn Reson | year= 2011 | volume= 13 | issue=  | pages= 4 | pmid=21223554 | doi=10.1186/1532-429X-13-4 | pmc=PMC3025878 | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=21223554  }} </ref><ref name="pmid21393076">{{cite journal| author=Navarro I, Molina M, Civera M, Ascaso JF, Real JT, Carmena R| title=[Catecholamine-induced cardiomyopathy triggered by pheochromocytoma]. | journal=Endocrinol Nutr | year= 2011 | volume= 58 | issue= 4 | pages= 204-6 | pmid=21393076 | doi=10.1016/j.endonu.2010.11.005 | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=21393076  }} </ref><ref name="pmid22441003">{{cite journal| author=Subramanyam S, Kreisberg RA| title=Pheochromocytoma: a cause of ST-segment elevation myocardial infarction, transient left ventricular dysfunction, and takotsubo cardiomyopathy. | journal=Endocr Pract | year= 2012 | volume= 18 | issue= 4 | pages= e77-80 | pmid=22441003 | doi=10.4158/EP11346.CR | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=22441003  }} </ref>

ST elevation myocardial infarction causes: Difference between revisions

Revision as of 17:17, 8 May 2014

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