• The Korean Journal of Emergency Medical Services
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• v.25 no.1
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• pp.235-241
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• 2021

Cardiogenic syncope occurs due to arrhythmia (bradycardia and tachycardia) or decreased cardiac output, and if proper treatment is not provided, it can lead to acute sudden death. A detailed medical history and physical examinations are required to determine the cause of syncope, and clinical approaches, including 12-lead ECG, are important. The 12-lead ECG does not have a chest lead in the posterior wall of the left ventricle; therefore, ECG of the isolated posterior wall myocardial infarction caused by left circumflex artery occlusion is not observed with ST elevation. Therefore, the significantly higher appearance of ST depression and R waves than S waves from V1 to V3 of the chest lead must be interpreted meaningfully. Isolated posterior wall myocardial infarction is small in the area of myocardial necrosis, and tension is increased in the necrotic area due to the contraction of the normal myocardial muscle, which can cause ventricular wall rupture. Therefore, it is necessary to additionally check Beck's triad, such as jugular venous distension and decreased heart sound, in patients with low blood pressure with an isolated posterior wall myocardial infarction on 12-lead ECG in patients with syncope.

• Journal of Chest Surgery
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• v.47 no.4
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• pp.402-405
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• 2014

Myocardial infarction (MI) secondary to coronary artery fistula and the subsequent occlusion of the distal right coronary artery (RCA) after blunt chest trauma is a rare entity. Here, we describe a case of coronary artery fistula and occlusion with an inferior MI that occurred following blunt chest trauma. At the initial visit to the emergency room after a car accident, this patient had been undiagnosed with acute myocardial infarction, readmitted five months after ischemic insult, and revealed to have experienced MI due to RCA-right atrial fistula and occlusion of the distal RCA. He underwent coronary surgery and recovered without complications.

• Physical Therapy Korea
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• v.1 no.1
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• pp.83-87
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• 1994

The purpose of this paper is to provide an overview of the clinical physical therapy program used at the University of Yonsei Rehabilitation Hospital, for the practicing university trained physical therapists who may be unfamiliar with patients who have suffered a myocardial infarction. The four primary phases of the cardiac physical therapy graded exercise program are: 1) coronary care unit program (phase I), 2) general ward program (phase II), 3) convalescence program (phase III), 4) maintenance program (phase IV). The exercise prescription defines the exercise intensity, duration, frequency, and mode of exercise a after pre- discharge low level graded exercise test(LL-GXT) or symptom limited maximum graded exercise test. A typical exercise routine consists of preparation warm-up exercise, therapeutic exercise, cool-down exercise. Physical therapy is involved in the acute care and rehabilitation of the patient after a myocardial infarction. Therefore, the physical therapist must throughly comprehened the cardiac anatomy, cycle, performance, conduction system, pathogenesis, risk factors, and exercise benefits.

• Journal of Digital Convergence
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• v.10 no.1
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• pp.413-422
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• 2012

In this study, we developed the severity-adjusted length of stay (LOS) model for acute myocardial infarction patients using data from the hospital discharge survey and proposed management of medical quality and development of policy. The dataset was taken from 2,309 database of the hospital discharge survey from 2004 to 2006. The severity-adjusted LOS model for the acute myocardial infarction (AMI) patients was developed by data mining analysis. From decision making tree model, the main reasons for LOS of AMI patients were CABG and comorbidity. The difference between severity-adjusted LOS from the ensemble model and real LOS was compared and it was confirmed that insurance type and location of hospital were statistically associated with LOS. And to conclude, hospitals should develop the severity-adjusted LOS model for frequent diseases to manage LOS variations efficiently and apply it into the medical information system.

• Journal of Medicine and Life Science
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• v.15 no.2
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• pp.108-111
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• 2018

Extra-corporeal membrane oxygenation (ECMO) has the potential to rescue patients in cardiac arrest or respiratory failure. ECMO has two systems such as veno-arterial and veno-venous circulation. In cardiac arrest resulting from acute myocardial infarction, veno-arterial ECMO is mandatory for systemic circulation and oxygenation. A 75-year old female patient underwent primary coronary intervention for acute myocardial infarction. Despite successful revascularization, recurrent ventricular tachycardia and heart failure were progressing. We performed a veno-arterial ECMO through the femoral artery and vein, then the patient seemed to be stable clinically. However, laboratory studies, echocardiography, and vital signs indicated multi-organ failure and decreasing cardiac function. We found out an error that we performed veno-venous ECMO instead of veno-arterial ECMO. We added a femoral artery cannula and exchange the circuit system to veno-arterial ECMO. While the systemic circulation seemed to be recovered, the left ventricular function was decreased persistently. A hypovolemia resulting from pulmonary hemorrhage was occurred, which lead to ECMO failure. The patient died of cardiac arrest and multi-organ failure 23 hours after ECMO. Because the color of arterial and venous circuits represent the position and efficacy of ECMO, if unexpected or abnormal circuit colors are detected, prompt and aggressive evaluation for ECMO function is mandatory.

• Journal of Chest Surgery
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• v.40 no.3 s.272
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• pp.228-231
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• 2007

Chest trauma can lead to various cardiac complications ranging from arrythmia to myocardial rupture. Coronary artery injury in patients with blunt chest trauma is rare, and traumatic aneurysm of the left coronary artery is even more unusual than right coronary artery. Injury to the coronary arteries, including intimal aneurysm, dissection, laceration, arteriovenous fistula and thrombosis, are sequelae that rarely occur after a blunt trauma. Occlusion of the coronary artery results is a serious complication for the patient via acute myocardial infarction, We report here on a case of acute myocardial infarction with coronary artery aneurysm that arose from blunt chest trauma in a 33-year-old male, and he was successfully managed by a coronary bypass graft without performing cardiopulmonary bypass.

• The Journal of the Korean life insurance medical association
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• v.31 no.1
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• pp.10-14
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• 2012

The importance of the diseases which are differentiated with acute myocardial infarction (AMI) cannot be overemphasized in insurance medicine. Although there are lots of diseases similar with AMI, in this paper, 5 diseases were described; Myocardial bridging, cocaine toxicity, myocarditis, cardiac syndrome X, and Takotsubo syndrome. Costs of the interventions like coronary angiography or echocardiography are relatively low in Korea compared to western countries. Therefore, detection of those diseases has been increased recently and illegal drug addiction also has been increased probably due to globalization. In conclusion, the knowledge of those diseases dealt with this article could be helpful for the person who is related to insurance medicine.

• Journal of the Korea Society of Computer and Information
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• v.17 no.10
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• pp.145-154
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• 2012

Recently, the cardiovascular disease has increased by causes such as westernization dietary life, smoking, and obesity. In particular, the acute myocardial infarction (AMI) occupies 50% death rate in cardiovascular disease. Following this trend, the AMI has been carried out a research for discovery of risk factors based on national data. However, there is a lack of diagnosis minor suitable for Korean. The objective of this paper is to develop a classifier for short-term relapse mortality prediction of cardiovascular disease patient based on prognosis data which is supported by KAMIR(Korea Acute Myocardial Infarction). Through this study, we came to a conclusion that ANN is the most suitable method for predicting the short-term relapse mortality of patients who have ST-segment elevation myocardial infarction. Also, data set obtained by logistic regression analysis performed highly efficient performance than existing data set. So, it is expect to contribute to prognosis estimation through proper classification of high-risk patients.

• The Korean Journal of Emergency Medical Services
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• v.17 no.1
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• pp.21-39
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• 2013

Purpose : The purpose of this study is to provide the basic data to improve pre-hospital phase emergency care for acute myocardial infarction (AMI) patients by analyzing AMI patients' clinical characteristics and emergency care situations. Methods : Data were collected through medical records of 385 AMI patients including ambulance records of 107 AMI patients transferred to the emergency medical center for three and a half years. Results : Regarding emergency care for AMI patients in pre-hospital phase, 47% of the care revealed moderate level or higher, and appropriateness of pre-hospital phase emergency care for cardiopulmonary complaints practiced by paramedics showed statistically significant improvement in recent years (p<.001). The time from onset of symptom to ballooning intervention by 119 emergency services was shorter than that in other cases. However, emergency care by paramedic was mainly basic life support. Conclusion : Since prognosis of AMI shows vast differences depending on prompt detection and medical intervention, cooperation between pre-hospital and in-hospital phase is highly required. 119 paramedics should be trained focusing on the accurate assessment and emergency care, and medical direction should be activated. In addition, regulation on 12-lead EKG, cardiac enzyme analysis, use of analgesics and thrombolytic agents should be legally implemented.

• Journal of Information Processing Systems
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• v.12 no.1
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• pp.129-148
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• 2016

Acute myocardial infarction (AMI) is one of the three emergency diseases that require urgent diagnosis and treatment in the golden hour. It is important to identify the status of the coronary artery in AMI due to the nature of disease. Therefore, multi-modal medical images, which can effectively show the status of the coronary artery, have been widely used to diagnose AMI. However, the legacy system has provided multi-modal medical images with flat and unstructured data. It has a lack of semantic information between multi-modal images, which are distributed and stored individually. If we can see the status of the coronary artery all at once by integrating the core information extracted from multi-modal medical images, the time for diagnosis and treatment will be reduced. In this paper, we analyze semantic relations between multi-modal medical images based on coronary anatomy for AMI. First, we selected a coronary arteriogram, coronary angiography, and echocardiography as the representative medical images for AMI and extracted semantic features from them, respectively. We then analyzed the semantic relations between them and defined the convergence data model for AMI. As a result, we show that the data model can present core information from multi-modal medical images and enable to diagnose through the united view of AMI intuitively.