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Öğe 2017 St Yükselmeli Miyokart Enfarktüsü Kılavuzunda Yenilikler(2017) Şimşek, VedatBu derlemede ESC (European Society of Cardiology) 2017 ST segment yükselmeli miyokart enfarktüsü (STYME) kılavuzunda değişen ve yeni eklenen öneriler ele alınacaktır. Bu kılavuzda, ST segment yükselmeli miyokart enfarktüsü tanımı genişletilerek hasta kapsamı arttırılmıştır. Acil tedavide oksijen tedavisinin ve opioidlerin önemi azalırken, reperfüzyon süresinin kısaltılmasına yönelik ‘tanıdan tel geçişine’ kavramı geliştirilmiştir. Koroner anjiyografi süresi 2-24 saate indirilirken, 48 saatten sonra perkütan koroner girişim (PKG) iskemi yokluğunda önerilmemiştir. Radial girişim ve ilaç kaplı stent kullanımı ön plana çıkarken, rutin trombüs aspirasyonu artık önerilmemektedir. Komplet revaskülarizasyon artık hastaneden çıkmadan önerilmektedir. Stent trombozunu artırdığından bivalirudin endikasyonu azalırken, enoxaparin heparine alternatif olarak PKG de daha güçlü önerilmektedir. Potent P2Y12 inhibitörlerinin kullanımı klopidogrele üstün gözükmektedir. Kangrelor, oral alımı olmayanlarda intravenöz olarak ilk kez kullanıma girmiştir. Maksimum doz statine rağmen, 70 mg/dl LDL olanlarda ek ilaçların kullanımı önerilmektedir. İkili antiplatelet tedavi bir yıl süre ile önerilirken, 36 aya uzatılabileceğinden bahsedilmiştir. Kalite kontrolü değerlerinin standardizasyonu için kriterler belirlenmiştir.Öğe Aort darlığında anjiyotensin dönüştürücü enzim geni insersiyon/delesyon polimorfizminin fonksiyonel kapasite belirteçleri ve ekokardiyografik parametrelerle ilişkisi(2012) Tulmaç, Murat; Şimşek, Vedat; Şimşek, Fadime; Yazıcı, Hüseyin Uğur; Poyraz, Fatih; Turfan, Murat; Çengel, AtiyeAmaç: Fonksiyonel durumda bozulma aort darlığının doğal seyrinde kritik bir nokta olup kapak değişimi operasyonun en önemli endikasyonunu oluşturur. Bu çalışmada hafif ve orta dereceli aort darlığı (AD) olan hastalarda anjiyotensin dönüştürücü enzim (ADE) geni insersiyon/delesyon (I/D) polimorfizminin fonksiyonel kapasite belirteçleri ve ekokardiyografide sol ventrikül fenotipi ile ilişkisi araştırıldı. Gereç ve Yöntem: Ekokardiyografi ile doğrulanmış hafif-orta dereceli AD’si olan 22 asemptomatik hastanın ADE gen polimorfizmleri ile fonksiyonel kapasiteleri New York Kalp Cemiyeti sınıflaması, 6 dakika yürüme testi, plazma NT-proBNP ölçümleri yapılarak değerlendirildi. Bulgular: Yaş, hipertansiyon, dejeneratif darlık ve aort kapak kalsifikasyonu daha kötü fonksiyonel kapasiteyle ilişkili bulundu (p0.05). ADE gen polimorfizmi ile fonksiyonel kapasite arasında ilişki saptanmadı. DD genotipi normotansif hastalarda egzantrik şekillenmeyle ilişkili bulundu (p:0,03) Hipertansif hastalarda ve 40 yaş üzeri DD genotipli hastalarda daha belirgin sol ventrikül hipertrofisi saptandı (sırasıyla 190,122,2g/m2 vs 132,112,8g/m2; p:0,004 ve 181,929,6g/m2 vs 143,836,3g/m2; p:0,02) . Sonuç: Yaşlı, hipertansif, dejeneratif veya kalsifik hafif orta dereceli AD’si olan hastaların fonksiyonel kapasitenin bozulması açısından daha yakın takip edilmeleri uygun olabilir. DD genotipli hipertansif ve 40 yaş üstünde hafif-orta dereceli aort darlığı olan hastalarda sol ventrikül hipertrofisi daha belirgindir.Öğe Bilirubin Levels and the Burden of Coronary Atherosclerosis in Patients With STEMI(Sage Publications Inc, 2013) Şahin, Ömer; Akpek, Mahmut; Elçik, Deniz; Karadavut, Serhat; Şimşek, Vedat; Tulmaç, Murat; Kaya, Mehmet G.We investigated whether serum bilirubin level (a marker of heme oxygenase activity) is a predictor of high levels of SYNTAX score (SXscore) in patients with acute myocardial infarction. Patients (n = 281; male 77%; mean age 60 +/- 12) who were admitted with ST-elevation myocardial infarctions (STEMIs) were enrolled. Patients were divided into 2 groups. Group 1 was defined as SXscore <22 and group 2 was defined as SXscore >= 22. Total bilirubin levels were significantly higher in the high-SXscore group than in the low-SXscore group (0.86 +/- 0.42 vs 1.02 +/- 0.51, P = .005). A significant correlation was detected between total bilirubin and SXscore (r = .42; P = .001). At multivariate analysis, total bilirubin (odds ratio: 1.86, 95% confidence interval 1.04-3.35; P = .038) was an independent risk factor for high SXscore in patients with STEMI. In conclusion, serum bilirubin level is independently associated with SXscore in patients with STEMI.Öğe Coxiella burnetii seropositivity and coronary ectasia(Cardiology Academic Press, 2014) Doğru, Mehmet Tolga; Alpay, Yeşim; Şimşek, Vedat; Ünal, Nilgün; Askar, Şinasi; Ebinç, Haksun; Yıldırım, NesligülBacterial infections could contribute to atherosclerotic inflammation. We investigated the association of Coxiella Burnetii seropositivity with the atherosclerotic lesion types (obstructive and/or ectatic), serum lipid profile, nitric oxide (NO),total sulfhydryl (SH) groups and malonyldialdehyde (MDA) levels. A total of 150 participants (73 male, mean age: 56.6 ± 11.4 years; 77 female, mean age: 57.3 ± 13.0 years) were enrolled into the study. Coronary angiography was performed all the participants. We also performed serum lipid profile, NO, SH groups and MDA levels to determine the changes in chronic and acute Coxiella burnetii infections. The patients with obstructive and ectatic coronary artery lesions were of higher Coxiella phase I IgG titer (The marker of chronic Coxiella infection) than those of other coronary artery disease groups(One Way ANOVA, p=0.001). There were higher serum total cholesterol levels in the patients with chronic Coxiella infection than those of other patients. The chronic Coxiella Burnetii infection may be an important factor for the formation of coronary artery ectasia on basement of atherosclerotic coronary artery disease. Hyperlipidemia might also facilitate and augment this association.Öğe Depresyon Hastalarında Endotel Fonksiyonları, Ekokardiyografik Parametreler ve Damar Sertliğine Antidepresan Tedavinin Etkisi(Kırıkkale Üniversitesi, 2013) Tulmaç, Murat; Özdemir, Hatice; Şahin, Ömer; Poyraz, Fatih; Şimşek, Vedat; Canlı, DeryaIncreasing evidence reveals that depression is emerging as an independent cardiovascular disease (CVD) risk factor. We investigated whether treating depression with seratonin reuptake inhibitors (SSRI) would effect echocardiographic systolic and diastolic functions, in addition endothelial function and arterial stiffnes indexes which are known CVD risk factors Fourtyone patients who were prescribed SSRI therapy for the first time due to major depression without known CVD and between 16-65 years of age were included. At the beginning of the study and after 8 weeks of SSRI therapy patients were underwent echocardiographic analysis of systolic and diastolic parameters, myocardial performance index (MPI) and aortic strain (Ao strain). Also by finger plethysmography with the aid of an auto-analyser pulse wave analysis were done and pulse propagation time (PPT), stiffness index (SI) and reflection index (RI) were measured. Endothelial functions were estimated with flow mediated dilatation method. Nineteen patients (46.3%) came to control visit after 8 weeks of therapy and the final analysis was done with their results. Compared to beginning, 8 weeks of therapy with SSRI resulted in an increase in systolic ejection fraction (%64,83±4,54 vs %66,80±3,3, p=0,020) and fractional shortening (%35,39±3,53 vs %37,11±2,49, p=0,013) and decrease in MPI (0,60±0,21 vs 0,45±0,15, p=0,004). The other parameters including left ventricular diastolic functions, aortic strain, endothelial function and aortic stiffness parameters were not significantly effected. Our results imply that short term therapy with SSRI in patients with newly diagnosed depression might favorably effect the left ventricular systolic functions whereas left ventricular diastolic functions, endothelial functions and aortic stifness parameters remain unchanged.Öğe Differences in autonomic activity in individuals with optimal, normal, and high-normal blood pressure levels(Kare Publ, 2010) Dogru, M. Tolga; Şimşek, Vedat; Şahin, Ömer; Özer, NurtaçObjectives: We investigated differences in autonomic activity in normotensive individuals having optimal, normal and high-normal blood pressure (BP) levels according to the guidelines of the European Society of Hypertension and European Society of Cardiology (ESH/ESC). Study design: The study included 294 normotensive subjects (135 males, 159 females; age range 16 to 75 years) with similar clinical, morphometric, biochemical, electrocardiographic, and echocardiographic features. The subjects were classified into the following BP groups: group 1 (n=113) with optimal BP (<120/80 mmHg); group 2 (n=104) with normal BP (120-129/80-84 mmHg), and group 3 (n=77) with high-normal BP (130-139/85-89 mmHg). All the subjects underwent 24-hour Holter monitoring to obtain heart rate variability (HRV) parameters of 24-hour, daytime, and nighttime periods. Normalized low (LFn) and high (HFn) frequency powers, and logarithmic (Log) values of HRV parameters were also calculated. Results: On 24-hour Holter monitoring, heart rates were similar in three groups. Compared to group 1 and 2, group 3 exhibited significantly higher LF/HF (p<0.001) and LFn (p=0.001) values, and significantly lower HFn (p=0.001), pNN50 (p=0.001), and rMSSD (p=0.005) values. There were no significant differences between the groups with respect to daytime HRV parameters; however, nighttime LF/HF, LFn, and HFn values were significantly different between the groups. Log LF/HF values obtained during the 24-hour and nighttime periods showed significant differences between group 1 and group 3 (for 24 hours, p<0.001; for night, p=0.001) and between group 2 and group 3 (for 24 hours, p<0.001; for night, p=0.009), but group 1 and group 2 did not differ significantly in this respect (p>0.05). Conclusion: These findings suggest that subjects with high-normal BP have increased sympathetic activity and decreased parasympathetic activity, possibly making them more liable to hypertension.Öğe The effects of statin therapy on pulse wave velocity measurements(Cardiology Academic Press, 2014) Şimşek, Vedat; Doğru, Mehmet Tolga; Demir, V.; Şahin, Ö.; Tulmaç, Murat; Ebinç, Haksun; Yıldırım, NiyaziSeveral studies have shown that positive effects of statins on pulse wave velocity parameters. However, there is few study about the comparison of the effectivity of statins on pulse wave velocity parameters. In the present study, we aimed to show the difference about the effects of long term atorvastatin and rosuvastatin therapy on aortic stiffness in patients with hyperlipidemia. A total of 104 hyperlipidemic patients were enrolled into the study. There were 50 patients in Group 1 (The patients treated with Atorvastatin 20 mg/day) (23 male and 27 female, mean age: 55.8 ± 10.3 years;, mean age: 52.7 ± 9.4 years) and 54 patients in Group 2 (The patients treated with Rosuvastatin 10 mg/day) (23 male and 31 female, mean age: 52.7 ± 9.4 years). All patients followed up to 12 months about their lipid profile and pulse wave analysis data. After 12 months, we found that rosuvastatin was of higher positive effects on arterial stiffness and reflection index parameters (Student T test, p=0.049 and =0.041, respectively ) We considered that, rosuvastatin was of greater ameliorative effect on vascular stiffness than that of atorvastatin in the patients with hyperlipidemia.Öğe Fondaparinux used for severe heparin induced thrombocytopenia with subacute instent thrombosis(2008) Tulmaç, Murat; Ebinç, Haksun; Doğru, Mehmet Tolga; Özer, Murat; Çeneli, Özcan; Şimşek, VedatHeparin induced thrombocytopenia (HIT) is an immune mediated event that may result in life and limb threatening complications. We report a 52 year old diabetic woman with subacute instent thrombosis and severe heparin induced thrombocytopenia treated successfully with fondaparinux. Not only platelet count returned to normal but also thromboembolic or hemorrhagic events were prevented under treatment. The low rate of de novo antibody formation and the scarce cross-reactivity with HIT antibodies offer fondaparinux as a relatively safe alternative anticoagulant agent for use in patients with HIT. Fondaparinux should be kept in mind in severe HIT if direct thrombin inhibitors are unavailable.Öğe Massive Systemic Air Embolism During Aortic Root Angiography A Dire Complication(Lippincott Williams & Wilkins, 2012) Tulmaç, Murat; Şimşek, Vedat; Şahin, Ömer; Ebinç, Haksun…Öğe Monocyte count to high-density lipoprotein ratio predicts occlusion of the infarct-related artery in STEMI(2017) Zehir, Regayip; Sarak, Taner; Barutçu, Süleyman; Şimşek, Vedat; Karadeniz, Muhammed; Kandemir, HüseyinAmaç: ST segment yükselmeli miyokard enfarktüsü (STEMI) olan hastalarda, primer perkütan koroner girişim (pPKI) öncesi enfarktüs ilişkili arter acıklığı daha iyi klinik sonuçlar ile ilişkilidir. Bununla birlikte, STEMI ortamında pPKI öncesinde IRA açıklığının öngördürücüleri ile ilgili sınırlı veri vardır. STEMI'de monosit sayısı /yüksek yoğunluklu lipoprotein oranı (MHR) ile enfarktla ilişkili arterin acıklığı arasındaki ilişkiyi değerlendirmek istedik.Gereç ve Yöntemler: Toplam 726 hasta çalışmaya alındı. IRA açıklığı, miyokard enfarktüsünde tromboliz (TIMI) akım sınıflaması ile belirlendi. PKI öncesi IRA'da TIMI akım derecesine göre çalışma popülasyonu, TIMI 0,1 veya 2 grup (tıkalı IRA, n=624) ve TIMI 3 grubu (patent IRA, n=102) olmak üzere iki gruba ayrıldı. MHR hesaplamak için basvuruda kan örnekleri toplandı. Tüm hastaların 92'sinde (%20,4) IRA'da pre-pPKI TIMI 3 akımı vardı.Bulgular: MHR, tıkanan IRA grubunda anlamlı derecede yüksekti (22,4 ± 5,4'e karşılık 17,8 ± 6,9, P < ,001). Tıkalı IRA grubunda, glikoz, troponin İ ve trombosit/lenfosit oranı (PLR) düzeyleri de yüksekti (P < 0.05). Çok değişkenli regresyon analizinde, başvuru sırasındaki MHR değeri (odds oranı [1,391]; %95 güven aralığı [CI]: 1,116-1,272, P < 0,001) ve prasugrel veya tikagrelorun hastane öncesi kullanımı (OR: 7,045; CI:1,687-29,414, P = 0,007) IRA açıklığının bağımsız öngördürücüleri olarak bulundu.Sonuçlar: IRA açıklığı, pPKI öncesi hızlı etkili antitrombosit tedavi alan hastalarda daha sık görülmektedir ve daha düşük bir MHR değeri IRA açıklığını bağımsız bir şekilde tahmin eder.Öğe The relationship between the QT interval and autonomous and anthropometric features(2007) Doğru, Tolga; Günaydın, Sedar; Şimşek, Vedat; Tulmaç, Murat; Güneri, MahmutObjectives: We investigated the effect of anthropometric and autonomous factors on the QT interval in both sexes. Study design: The study included 237 individuals (114 males, 123 females) who were asymptomatic and had no abnormal laboratory or physical findings. The mean age was 47 years (range 20 to 79 years) for men, and 39 years (range 20 to 71 years) for women. All the participants were subjected to a careful history taking, physical examination, routine biochemical examinations, electrocardiographic recording, 24-hour Holter monitoring, and when necessary, color Doppler echocardiography and treadmill exercise test. Serum estrogen levels, serum free and total testosterone levels were also measured in males. Results: The minimum QT interval was significantly lower in males (p=0.043). The mean QT (p=0.022) and QTc (p<0.001) intervals in females, and QT dispersion in males (p=0.025) were significantly higher. In male participants, the maximum QT interval (p=0.049) and QT dispersion (p=0.043) were significantly different between age groups of 20-44 years and 45-69 years. Parasympathetic activity played a determinant role in the mean and maximum QT intervals. Anthropometric features were not correlated with the QT interval in females, whereas in males, waist-hip ratio was positively correlated with the mean QT and minimum QTc intervals (r=0.188, p=0.049 and r=0.236, p=0.013, respectively). Serum sex hormone levels were significantly effective on the QT interval in males. Conclusion: Concerning anthropometric and autonomic factors, the QT interval is significantly influenced by gender-related features.Öğe Serum orexin-a level and the severity of coronary artery disease: Original article(Cardiology Academic Press, 2014) Şimşek, Vedat; Doğru, Mehmet Tolga; Boyunağa, Hakan; Çağlayan, Osman; Yıldırım, Niyazi; Tulmaç, Murat; Ebinç, HaksunIn this study, we aimed to investigate the correlations of serum Orexin-A level (SOAL) and the severity of coronary artery disease (CAD). A total of 80 participants (mean age: 55.7±12.7 years) were enrolled into the study. SOAL, electrocardiography and transthoracic echocardiography and 24 Hour Holter monitoring (24HHM) and coronary angiography were performed in all participants. Autonomic functions were assessed using the data of Heart Rate Variability measurements. Patients were categorized into three groups according to their Gensini scores as: Group 1: The patients with normal coronary angiogram, Group 2: The patients with mild CAD (Gensini <20) and Group 3: The patients with severe CAD (Gensini ?20). A total of 28 patients were Group 1 (mean age 51.8±12.0 years), 25 patients were Group 2 (mean age 57.7±11.6 years) and 27 patients were Group 3 (mean age 57.6±13.6 years). There were statistically significant differences in SOAL (p=0.004) among the groups. We found that SOAL had statistically significant associations with Gensini score and LF/HF (Sympathetic activity) values. (F= 15.299; p=0.004 and F= 15.470; p=0.004, respectively). Serum Orexin-A levels are positively correlated with severity of CAD and sympathetic activity.Öğe Son Dönem Böbrek Yetmezliği Olan Olgularda B-Tipi Natriüretik Peptidin Sessiz Miyokard İskemisini Öngördürmedeki Rolü(Kırıkkale Üniversitesi, 2013) Poyraz, Fatih; Şimşek, Vedat; Turfan, Murat; Ayerden Ebinç, Fatma; Timurkaynak, TimurThe aim of this study was to evaluate the value of BNP for detecting silent myocardial ischemia in dialysis patients. 53 hemodialysis patients with no anginal symptoms were included. Ambulatory electrocardiographic monitorisation were done to all patients in order to determine silent myocardial ischemia. BNP assays were done to all patients before the second hemodialysis session of the week. The median age of the participants was 50 (60 % male). Male sex and hyperlipidemia were more frequent in the silent ischemia group. Other demographic and echocardiographic parameters were similar in both groups. The median BNP concentration was significantly higher in the silent ischemia group (682,7 pg/mL vs 503,2, p= 0,006). Left ventricular mass index (r=0,502, pÖğe The relationship between orthostatic differences in arterial blood pressure and autonomic tone: gender variability(Aves, 2007) Doğru, Tolga; Günaydın, Serdar; Şimşek, Vedat; Tulmaç, Murat; Tireli, EmineObjectives: The differences in orthostatic blood pressure result from dynamic changes in the sympathovagal balance. We studied sex-related variations in autonomic tone regulation. Study design: The study included 237 individuals (114 males, 123 females) who were asymptomatic and had no abnormal laboratory or physical findings. The mean age was 47 years (range 20 to 79 years) for men, and 39 years (range 20 to 71 years) for women. All the participants were subjected to a careful history taking, physical examination, routine biochemical examinations, electrocardiographic recording, 24-hour Holter monitoring, and orthostatic tests. Results: In heart rate variability analysis, parasympathetic tone parameters, in particular the high frequency (HF) component was significantly high in females, whereas sympathetic tone parameters, in particular the low frequency (LF)/HF ratio was significantly high in males (p< 0.001). The normalized LF component in males showed positive correlations with systolic (r= 0.308, p= 0.001) and diastolic (r= 0.301, p= 0.002) blood pressures during the rapid stand test; this correlation was not seen in females. Blood pressures obtained in the second minute of the rapid supine test following the stand test were in positive correlation with the LF/HF ratio in both sexes. In males, variations in systolic and diastolic blood pressures during rest, stand, and supine positions were primarily influenced by the LF component and HF component, respectively. In females, variations in systolic blood pressure during the three positions were not correlated with autonomic tone components, but variations in diastolic blood pressure were primarily affected by the LF/HF ratio. Conclusion: Autonomic system works through varying priorities in both sexes and this causes sex-related differences in orthostatic tolerance.Öğe The relationship between serum sex steroid levels and heart rate variability parameters in males and the effect of age(Aves, 2010) Doğru, M. Tolga; Başar, M. Murad; Yuvanç, Ercan; Şimşek, Vedat; Şahin, ÖmerObjectives: We evaluated the relationships between sex steroid levels and heart rate variability (HRV) parameters. Study design: The study included 114 male subjects (mean age 46.6 +/- 11.3 years) presenting to our department for cardiologic evaluation. Hormonal analysis included serum levels of luteinizing hormone, prolactin, total testosterone (TT), free testosterone, estradiol (E2), and dehydroepiandrosterone sulfate (DHEA-S). Parameters of HRV were derived from 24-hour Holter monitoring. The associations between serum sex steroid levels and HRV parameters were investigated in three age groups (20-39 years; 40-59 years; >60 years). Results: All the participants had normal biochemical results. The three age groups were similar in terms of anthropometric measurements. Among sex steroids analyzed, only serum DHEA-S level was significantly different among the groups (p=0.026), showing a decreasing trend with age. In the evaluation of HRV, all parasympathetic activities decreased (for HFn, pNN50, and rMSDD: p=0.001, p=0.000, and p=0.000, respectively), while only LF/HF among sympathetic activities increased (p=0.000) with age. Partial correlation analysis with control of age and waist circumference showed that TT and DHEA-S were positively correlated with HFn (parasympathetic parameter), and were in negative correlation with LF/HF24 hours and global sympathetic index (GSI) (sympathetic parameters). Serum E2 level was negatively correlated with the parasympathetic parameter of rMSSD, and positively correlated with LF/HF24 hours and GSI. Among serum sex steroids, DHEA-S was the most correlated parameter with autonomic functions. Conclusion: Our results showed positive correlations between androgens and parasympathetic activity and between estradiol and sympathetic activity in men, independent from anthropometric factors.Öğe The relationship between the QT interval and autonomous and anthropometric features(Aves, 2007) Dogru, Tolga; Günaydın, Serdar; Şimşek, Vedat; Tulmaç, Murat; Güneri, MahmutObjectives: We investigated the effect of anthropometric and autonomous factors on the QT interval in both sexes. Study design: The study included 237 individuals (114 males, 123 females) who were asymptomatic and had no abnormal laboratory or physical findings. The mean age was 47 years (range 20 to 79 years) for men, and 39 years (range 20 to 71 years) for women. All the participants were subjected to a careful history taking, physical examination, routine biochemical examinations, electrocardiographic recording, 24-hour Holter monitoring, and when necessary, color Doppler echocardiography and treadmill exercise test. Serum estrogen levels, serum free and total testosterone levels were also measured in males. Results: The minimum QT interval was significantly lower in males (p=0.043). The mean QT (p=0.022) and QTc (p< 0.001) intervals in females, and QT dispersion in males (p=0.025) were significantly higher. In male participants, the maximum QT interval (p=0.049) and QT dispersion (p=0.043) were significantly different between age groups of 20-44 years and 45-69 years. Parasympathetic activity played a determinant role in the mean and maximum QT intervals. Anthropometric features were not correlated with the QT interval in females, whereas in males, waist-hip ratio was positively correlated with the mean QT and minimum QTc intervals (r=0.188, p=0.049 and r=0.236, p=0.013, respectively). Serum sex hormone levels were significantly effective on the QT interval in males. Conclusion: Concerning anthropometric and autonomic factors, the QT interval is significantly influenced by gender-related features.Öğe Transient global amnesia after ventricular fibrillation during acute myocardial infarction(2013) Tulmaç, Murat; Şimşek, Vedat; Dağ, Ersel; Tireli, Emine; Eser, Özer; Ebinç, Haksun; Doğru, Mehmet TolgaBurada akut inferolateral miyokard infarktüsü seyrinde anında tedavi edilen ventrikül fibrilasyonu sonrası geçici global amnezi gelişen 48 yaşında bir erkek hastayı bildiriyoruz. Hekimler ventrikül fibrilasyonu ile komplike olan miyokard infarktüsü ile gelen hastalarda geçici global amnezi varlığını araştırmaya özellikle dikkat etmelidir.
