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Thread: real life case

  1. #1
    preetin is offline Member 510 points
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    real life case

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    HI guys i just wanted to know if someone has a M.I occlusion of LAD and ejection fraction --50%. what is the prognosis.
    Last edited by preetin; 03-15-2007 at 03:32 PM.

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    anencephalic's Avatar
    anencephalic is offline Brainless Member 510 points
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    Quote Originally Posted by preetin View Post
    HI guys i just wanted to know if someone has a M.I occlusion of LAD and ejection fraction --50%. what is the prognosis. what should be some things to beware of.
    sometimes when u have a family memeber being affected you just blank out.
    any inputs?
    This really isn't the place to be asking for medical advice...ask your family member's cardiologist/internist, as they are the individuals who have all of the pertinent history/exam findings/labs/ancillary studies available to them necessary to give an accurate prognosis.

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    MDiva's Avatar
    MDiva is offline Member 511 points
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    Ooh, you got a path residency, congrats to you, anencephalic!!!!
    I used to pray and pray for a bike and never got one. Later I learned that God doesn't work that way... so I went out and stole a bike and asked God for forgiveness.

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    IMG SURVIVOR's Avatar
    IMG SURVIVOR is offline Moderator 536 points
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    Well for the boards an life lower than 50%, not good, not good
    Moderator: USMLE AND Residency Forums.

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    why even bother with the obvious. Just know where you are need it and where you can help the most.

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    teratos's Avatar
    teratos is offline Jedi Moderator 658 points
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    Depends on what other disease there is on cath. I assume if the MI occurred in the LAD and the EF is still 50%, the disease was in the distal LAD and not much myocardium was knocked out. If the rest of the coronarys are clean, that is much better than having diffuse disease. Keep in mind, the lesions that cause acute MI and death are often the 30% guys that rupture and cause acute blockage of the vessel The arteries that close slowly allow for collaterals to form, and are often better tolerated. Unfortunately, with the information provided an assessment cannot be made.
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    IMG SURVIVOR's Avatar
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    Hey so those that forms collaterals because the process is slowly are the ones that are at risk for the steel coroary syndrome?

    Thanks teratos
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    why even bother with the obvious. Just know where you are need it and where you can help the most.

  7. #7
    teratos's Avatar
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    If you have a gradual blockage, then collateral circulation will form around the blocked artery. It isn't unusual to see a 100% occlusion, but no apparent damage to the heart muscle in terms of function. You may see some ischemia with stress, depends on how well collateralized the blockage is. If you go from 30% stenosis, have a plaque rupture, and suddenly go to 100% there are no collateral vessels, so any muscle fed by that artery is hosed.

    Coronary steal is a slightly different story. The best example of this is how persantine works when you do a persantine thallium stress test. Persantine is a vasodilator, kinda like nitroglycerine. The healthy vessels open up nicely, the diseased vessels stay partially blocked. The blood preferentially goes to the path of least resistance and the muscle distal to the stenosis doesn't get as much blood. So the healthy vessels "steal" from the diseased vessels in this case. G
    AUC Class of '99
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    stephew is offline Moderator Guru 512 points
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    i understand that you must be anxious to get information but this is not the place to seek medical advice etc. thanks.
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