RESUMEN
Anterior ischemic optic neuropathy is caused by microvascular occlusion of the prelaminar or laminar portion of the optic nerve head. The main types are arteritic, non-arteritic, and autoimmune. Few cases were reported following coronary artery bypass surgery. A 63-year-old man, who is both diabetic and hypertensive, underwent coronary artery bypass graft complicated postoperatively by sudden visual loss in his right eye. The diagnosis was non-arteritic anterior ischemic optic neuropathy. Possible predisposing factors were crowded disc and internal carotid artery stenosis.
Asunto(s)
Puente de Arteria Coronaria/efectos adversos , Enfermedad Coronaria/cirugía , Neuropatía Óptica Isquémica/etiología , Trastornos de la Visión/etiología , Estenosis Carotídea/complicaciones , Causalidad , Enfermedad Coronaria/complicaciones , Diabetes Mellitus Tipo 2/complicaciones , Angiografía con Fluoresceína , Humanos , Hipertensión/complicaciones , Masculino , Persona de Mediana Edad , Neuropatía Óptica Isquémica/diagnóstico , Trastornos de la Visión/diagnóstico , Campos VisualesRESUMEN
The use of reperfusion therapy in patients with ST elevation acute coronary syndromes had been established. However, reperfusion therapy is usually considered contra-indicated in those with ST depression, despite the knowledge that regional posterior infarction is typically indicated by ST depression maximal in leads V1 to V3 and nonregional subendocardial infarction is typically indicated by marked ST depression maximal in other leads. This study of patients with non-ST-elevation acute coronary syndromes investigates the quantitative relationship between presenting ST depression and final QRS changes in both of these subgroups. The final QRS score was significantly higher (2.44 points) than that of a control group with not ST depression, (1.55 points) in the group with maximal ST depression in V1 to V3 (P = 0.04). However, in the entire population, there was a highly significant correlation (P = .003) between the sum of the presenting ST depression and the final QRS score. Trials of reperfusion therapy will be required to determine if such evolution to electrocardiogram documented acute myocardial infarction can be prevented in patient with marked ST depression acute coronary syndromes.
Asunto(s)
Electrocardiografía , Infarto del Miocardio/fisiopatología , Estudios de Casos y Controles , Humanos , Síndrome , Disfunción Ventricular/fisiopatologíaRESUMEN
Anterior ischemic optic neuropathy is caused by microvascular occlusion of the prelaminar or laminar portion of the optic nerve head. The main types are arteritic, non-arteritic, and autoimmune. Few cases were reported following coronary artery bypass surgery. A 63-year-old man, who is both diabetic and hypertensive, underwent coronary artery bypass graft complicated postoperatively by sudden visual loss in his right eye. The diagnosis was non-arteritic anterior ischemic optic neuropathy. Possible predisposing factors were crowded disc and internal carotid artery stenosis.
