11/169. myocardial infarction due to coronary abnormalities in pulmonary atresia with intact ventricular septum.We describe the clinical course, angiography, and histopathology of a newborn male with pulmonary atresia and intact ventricular septum who succumbed to a myocardial infarction. Angiography demonstrated right ventricular-dependent coronary circulation and focal areas of coronary narrowing. His clinical course was characterized by attacks of sudden irritability, consistent with ischemia. histology demonstrated significant coronary artery narrowing secondary to fibromuscular dysplasia as well as evidence of new and old infarction. This case illustrates the severity of coronary lesions in pulmonary atresia and the potential for progression of coronary obstruction and insufficiency, and it provides correlation between angiography, ischemic symptoms, and pathology.- - - - - - - - - - ranking = 1keywords = area (Clic here for more details about this article) |
12/169. Local pulmonary malformation caused by bilateral coronary artery and bronchial artery fistulae to the left pulmonary artery in a patient with coronary artery disease.At 10 years of age and again at 25, our patient had been treated for pulmonary tuberculosis due to the presence of a localized pulmonary shadow. coronary angiography at age 59 revealed 3 fistulous communications: from the right and circumflex coronary arteries and from the left bronchial artery. All 3 emptied into the same recipient artery, the distal part of a left pulmonary artery branch, which produced substantial left-to-right shunt. On computed tomography, cystic formations could be seen in the pulmonic area. The pulmonary tuberculosis for which this patient had been treated in his youth was in the same part of the lung where the shunt was discovered. Our conclusion is that the initial diagnosis was in error.- - - - - - - - - - ranking = 1keywords = area (Clic here for more details about this article) |
13/169. Single coronary artery with probable origin of the anomalous right coronary artery from a left atrial recurrent branch.A 62-year-old woman presented for evaluation of chest pain. She ruled out for myocardial infarction, and subsequent non-invasive studies were diagnostic for ischemia. On coronary angiography, she was found to have a previously undescribed variant of single coronary artery, in which the anomalous right coronary artery probably arose from a left atrial recurrent branch. In this patient, the congenital anomaly was an incidental finding, since her clinical presentation was felt to be due to moderate obstructive disease of the left anterior descending artery, in the setting of poorly controlled systemic hypertension.- - - - - - - - - - ranking = 8537.395329634keywords = chest pain, chest, pain (Clic here for more details about this article) |
14/169. Left ventricular function before and after repair of an anomalous left coronary artery arising from the pulmonary trunk.We report an infant with an abnormal left coronary artery arising from the pulmonary trunk in whom, subsequent to surgical repair, sequential improvements in regional left and right systolic and diastolic myocardial function were quantified by the new ultrasound-based method of regional strain and strain rate imaging. The regional radial and longitudinal myocardial function of the left ventricle was homogeneously reduced prior to repair, while the time course of their recovery differed subsequent to repair. We discuss the concepts and advantages behind this quantitative approach to monitoring regional myocardial function in children.- - - - - - - - - - ranking = 4721.4274012419keywords = behind (Clic here for more details about this article) |
15/169. A case of coronary artery fistula draining into the pericardium causing hematoma.A 28-yr old female patient admitted to our clinic because of dyspnea and chest pain. Her transesophageal echocardiography demonstrated a huge mass on the anterolateral wall of the left ventricle causing dysfunction of the myocardium. coronary angiography demonstrated left anterior descending artery fistula draining into the pericardial cystic mass. Hydatic cyst was suspected and ELISA and hemagglutinin tests were both negative for echinococcus granulosus. Magnetic resonance image of the heart showed a mass thought to be a hematoma inside the cyst. She underwent surgery. The cystic lesion with a pure hematoma inside, was excised, and the fistula between left anterior descending artery and the mass was ligated without any complications. To our knowledge, this is the first case of a pericardial hematoma due to a coronary artery fistula, in the English literature.- - - - - - - - - - ranking = 8537.395329634keywords = chest pain, chest, pain (Clic here for more details about this article) |
16/169. Emergency angioplasty and stent deployment for acute occlusion of an anomalous single coronary artery (all three coronary arteries from one ostium in the right sinus of valsalva).A single coronary ostium is traditionally considered to be of little clinical significance. We report a case of a single ostium in the right sinus of valsalva, giving rise to the right coronary artery, from which the left main coronary artery originated. Sudden death occurred seven days after acute gastrointestinal bleeding and subsequent interruption of aspirin therapy. Acute coronary angiography following successful resuscitation revealed an ascending thrombus in the right coronary artery. The patient underwent a complex percutaneous coronary angioplasty with stent deployment. We conclude that coronary artery disease may lead to severe ischemia with a large area at risk and major complications in patients with coronary anomalies. patients with acute stent implantation might benefit from platelet aggregation even in cases of recent intestinal bleeding.- - - - - - - - - - ranking = 1keywords = area (Clic here for more details about this article) |
17/169. Cardiac imaging in a patient with anomalous origin of the left coronary artery from the pulmonary artery--a case report.Anomalous origin of the left coronary artery from the pulmonary artery (ALCAPA) is an uncommon congenital heart disease and has a high mortality rate in infancy. However, myocardial ischemia does not develop until adolescence or adulthood in about 10% of patients. Moreover, the diagnosis of ALCAPA is often difficult in cases without heart murmur or cardiac symptoms. The authors report the case of a 31-year-old man with ALCAPA. He was admitted to the hospital for evaluation of mild shortness of breath at exercise, but he had no typical chest symptoms due to myocardial ischemia or heart failure until age 31 and he had no heart murmur. Moreover, electrocardiogram did not show an old myocardial infarction or myocardial ischemia. Therefore, the authors did not suspect ALCAPA until they performed transthoracic echocardiography and exercise-stress single photon emission computed tomography (SPECT) with Tc-99m-tetrofosmin. The final diagnosis was established from the results of coronary arteriography. In the present case, a transthoracic echocardiogram showed abnormal coronary circulation, and exercise-stress SPECT revealed reversible myocardial ischemia. Transthoracic echocardiography and myocardial SPECT imaging could be a useful noninvasive tools for diagnosing the ALCAPA.- - - - - - - - - - ranking = 152.8207491082keywords = chest (Clic here for more details about this article) |
18/169. Anomalous left coronary artery from the pulmonary artery: creating an autogenous arterial conduit for aortic implantation.Anomalous origin of the left coronary artery from the pulmonary artery requires surgical correction. A surgical technique is presented. Two infants underwent re-implantation of their anomalous left coronary arteries by creating a tunnel using autogenous aortic and pulmonary arterial walls. The advantage of this technique is that the new left coronary artery lies in the horizontal plane and in an anatomically correct axis running in the groove behind the pulmonary artery. It also provides a tension free endothelialized autogenous arterial walls with normal growth anticipated.- - - - - - - - - - ranking = 4721.4274012419keywords = behind (Clic here for more details about this article) |
19/169. Hypoplasia of the coronary sinus with coronary venous drainage into the left ventricle by way of the Thebesian system.A 60-year-old woman with recent onset of exertional chest pain, left anterior hemiblock and negative stress electrocardiogram was found to have hypoplasia of the coronary sinus with drainage of the major coronary venous blood by way of the Thebesian system into the left ventricle. This abnormality appeared to be of no great functional significance.- - - - - - - - - - ranking = 8537.395329634keywords = chest pain, chest, pain (Clic here for more details about this article) |
20/169. myocardial ischemia induced by anomalous aortic origin of the right coronary artery in a patient with atrial septal defect.A 27-year-old woman with atrial septal defect (ASD) and a sensation of squeezing in the anterior chest by effort was admitted to our hospital. In addition to the ASD, the coronary angiogram showed an abnormal anomalous position of the right coronary artery. exercise thallium (Tl)-201 cardiac scintigram with an electrocardiogram clearly detected myocardial ischemia in the inferior area. In the operative findings, the orifice of the right coronary artery was positioned high above the commissure between the right and left sinuses of Valsalva, and it ran between the aorta and pulmonary trunk. Considering myocardial ischemia possibly caused by the anomalous origin of the right coronary artery, a coronary artery bypass graft (CABG) was simultaneously performed to the right coronary artery with direct closure of ASD. The myocardial ischemic finding in the inferior area disappeared after the operation, and she was also relieved from the chest pain. In view of these findings, we suggest that an active combination treatment such as CABG and ASD closure is highly successful in a patient with a threatening coronary anomaly and congenital heart disease.- - - - - - - - - - ranking = 8692.2160787422keywords = chest pain, chest, pain, area (Clic here for more details about this article) |
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