Cases reported "Atherosclerosis"

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1/7. Penetrating atherosclerotic ulcer in the juxtarenal abdominal aorta and coronary artery disease: emergency one-stage repair with off-pump coronary surgery.

    An 82 year-old woman suddenly developed severe back pain. Enhanced computed tomography and aortography revealed penetrating atherosclerotic ulcer (PAU), that was a localized contrast-filled outpouching in the juxtarenal abdominal aorta and intramural hematoma within the aortic wall. coronary angiography revealed significant stenosis in the left anterior descending artery and right coronary artery. Urgent aortic repair was required; therefore we performed the combined operations of coronary artery bypass grafting and aortic repair. PAUs typically occur in elderly patients with a history of hypertension, and are frequently complicated by coronary artery disease. However, few cases have been reported in the literature, such as cases involving combined operations. In this study, we report on a successful case of emergency repair involving concomitant juxtarenal abdominal aortic replacement for PAU and off-pump coronary artery bypass grafting.
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ranking = 1
keywords = back pain, back
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2/7. Giant aneurysms of coronary arteries and saphenous vein grafts: angiographic findings and histopathological correlates.

    INTRODUCTION: Giant aneurysms that develop in native coronary arteries or saphenous vein grafts are morphologically defined as abnormally expanded outpouching vascular structures >4 cm in diameter. The location, morphology, and content of giant aneurysms account for adverse cardiovascular effects. methods: Two cases of giant aneurysms were studied comprehensively by noninvasive and invasive cardiac methods and subsequent histopathology. The first patient had a giant aneurysm that developed over a course of several years in a saphenous vein graft whereas the second patient had a giant aneurysm occurring within a native coronary artery. Accompanying clinical and angiographic findings are described. RESULTS: atherosclerosis and thrombosis were among the prominent histopathological findings. CONCLUSIONS: atherosclerosis and associated thrombosis within giant aneurysms result in obstruction of flow, distal embolization, and development of acute coronary syndromes including recurrent ischemic chest pain, unstable angina, and acute myocardial infarction. The options for clinical management of giant coronary or vein graft aneurysms include surgical excision, percutaneous coil occlusion and stent deployment, or medical approach.
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ranking = 0.019878403659442
keywords = chest
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3/7. stroke attributable to a calcific embolus from the brachiocephalic trunk.

    BACKGROUND AND PURPOSE: Calcific brain embolization is a rare event that is usually secondary to cardiac valve calcification. We present a case of stroke caused by embolization of calcific material from the brachiocephalic trunk, probably induced by radiotherapy. SUMMARY OF CASE: A 56-year-old right-handed female developed left-sided hemiparesis, hemihypesthesia, and sensory inattention. She had a history of right breast carcinoma that was excised 8 years previously followed by radiotherapy. She had no other history of note. Computed tomography of the head and magnetic resonance imaging confirmed a calcific embolus in right middle cerebral artery and an acute infarction in the corresponding territory. Plain chest radiography, carotid ultrasonography, transthoracic and transoesophageal echocardiography failed to demonstrate the source of calcific embolism. Computed tomography of the thorax revealed heavy calcification of the brachiocephalic trunk and the origin of the right common carotid artery. CONCLUSIONS: Undertaking a vigilant systematic search for the source in cases of calcific embolization is necessary. The aorta and its main branches are possible, yet unusual, sources of calcific emboli that merit investigation.
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ranking = 0.019878403659442
keywords = chest
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4/7. Homograft replacement of the calcified aortic root in familial hypercholesterolemia.

    A 39-year-old woman with a known history of homozygous familial hypercholesterolemia was admitted with chest discomfort. Preoperative echocardiography and coronary angiography showed a heavily stenotic aortic valve as well as a calcific hypoplastic aortic root. Aortic root replacement using an aortic homograft was done.
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ranking = 0.019878403659442
keywords = chest
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5/7. Potential interest of intra-aorta ultrasound imaging for the diagnosis of aortic penetrating atherosclerotic ulcer.

    A 72-year-old man was admitted to our hospital for acute back pain. Transesophageal echocardiography (TEE), computed tomography (CT) and magnetic resonance imaging (MRI) all showed the presence of intramural hematoma (IMH) located in the descending aorta, with bilateral pleural effusions. The patient was initially referred for medical therapy and 'watchful waiting'. However, he continued to have back pain, so we decided to perform invasive aortography examination and intra-aortic ultrasound (IAU) imaging. No penetrating aortic ulcer (PAU) was found on multiple angiographic views, but intra-aorta ultrasound imaging clearly showed a PAU measuring 3x1 mm(2) in connection with the intramural hematoma. Even retrospective analysis of CT images failed to reveal this PAU. Therefore, we think that IAU imaging may be a useful tool in the diagnosis of PAU.
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ranking = 2
keywords = back pain, back
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6/7. retroperitoneal fibrosis presenting as acute renal failure.

    BACKGROUND: A 60-year-old man with a history of atherosclerotic disease of the carotid and coronary vasculature presented with lower back pain and acute renal failure. Imaging studies revealed bilateral ureteral obstruction by a large retroperitoneal mass. INVESTIGATIONS: physical examination, urine and blood analysis, catheterization, radiography of the chest, abdominal and pelvic CT, magnetic resonance angiography, renal ultrasound and biopsy of mass. diagnosis: retroperitoneal fibrosis. MANAGEMENT: Ureteral stenting, laparoscopic ureterolysis, and immunosuppressive therapy with prednisone and mycophenolate mofetil.
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ranking = 1.0198784036594
keywords = back pain, back, chest
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7/7. Is every chronic low back pain benign? Case report.

    BACKGROUND: There is a well-recognized association between chronic back pain and the existence of an AAA. In literature, there are few reported AAA cases that describe patients with extensive pressure erosion of the vertebral body. CASE DESCRIPTION: The authors present the case of a 38-year-old woman with chronic low back pain for the last 2 years in whom an AAA was formed during the follow-up period. The patient presented with an episode of low back pain following hard work 2 years ago. MR imaging of the lumbar spine was reported as disc degeneration at the L4-5 and L5-S1 levels. She was given medical treatment and was doing well with occasional back pain for a year. One year later, she suffered another disabling pain attack, and MR imaging revealed an additional focal disc protrusion at the L4-5 level. She was again medically treated. In August 2004, she presented with severe low back pain, and this time, MR imaging showed edema and erosion at the anterior part of L3 vertebra body. MR imaging studies (2- and 3-dimensional) depicted AAA as the cause. She was operated on, and the aneurysm was resected with graft repair of the site. She was pain-free in the postoperative period. CONCLUSIONS: The evaluation of a patient with chronic back pain needs a thorough clinical and radiological workup. Limited evaluation of the bony and nervous structures of the spinal canal radiologically is insufficient. Pre- and paravertebral structures as well as vertebral body should carefully be evaluated to diagnose other causes of pain.
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ranking = 9.0520068953776
keywords = back pain, back
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