1/5. Takayasu disease masquarading as interruption of the aortic arch in a 2-year-old child.Takayasu disease is a chronic, progressive inflammatory vasculitis of large and medium-sized vessels, which commonly presents in adulthood. This case report describes a 2 year old girl who presented with acute heart failure and complete occlusion of the aortic arch and was subsequently diagnosed with Takayasu disease. As far as we can determine, this is the first report of such an acute and atypical presentation of Takayasu disease at such a young age.- - - - - - - - - - ranking = 1keywords = vessel (Clic here for more details about this article) |
2/5. Transmural coronary inflammation triggers simultaneous multivessel rupture of unstable plaques.The authors describe a case of sudden cardiac death caused by the simultaneous multivessel rupture of unstable atherosclerotic plaques, triggered by a transmural inflammatory process (coronaritis). male subject, 44 years old, apparently in good health until 1 hour before death, when he complained of worsening dyspnea. At autopsy, it was found that the heart weighed 486 g. Evaluation of the coronary arteries revealed the presence of atherosclerotic plaques resulting in a lumen critical stenosis of the left anterior descending artery (LAD), right coronary artery (RCA) and left circumflex artery, and acute occlusive thrombosis of the LAD and RCA. Transverse sections of the ventricular mass highlighted the presence of eccentric hypertrophy of the left ventricle associated with myocardiosclerosis of the posterior interventricular septum and of the posterior wall of the left ventricle. histology revealed the presence of a coagulative myocytolysis ascribable to the free walls of the left ventricle, and a focus of lymphocytic-active myocarditis. All coronary arteries were sites of intima fibroatheromatous plaques complicated by rupture and thrombosis within the RCA and LAD and by a transmural infiltrate consisting of macrophages and t-lymphocytes associated with consensual medionecrosis and perineuritis. In conclusion, the present case report confirms the hypothesis that inflammation plays a key role in the onset of acute coronary syndromes as it promotes the formation of an unstable plaque as well as its rupture.- - - - - - - - - - ranking = 5keywords = vessel (Clic here for more details about this article) |
3/5. The concomitant intramyocardial bridging in the left coronary artery and anomalous origin of the right coronary artery--evaluation in ECG-gated multi-slice computed tomography (MSCT).The anomalous origin and course of coronary vessels are rare and in some cases may lead to the symptoms of heart ischaemia. The paper presents the case of a 63-year-old patient with angina pectoris evaluated in ECG-gated multi-slice CT and coronarography in whom the concomitant ectopic origin of the recessive right coronary artery from the left sinus of valsalva and intramyocardial bridging in the left anterior descendens artery were observed.- - - - - - - - - - ranking = 1keywords = vessel (Clic here for more details about this article) |
4/5. Reverse redistribution on dynamic exercise and dipyridamole stress technetium-99m-MIBI myocardial SPECT.Reverse redistribution on 201TI-chloride stress-redistribution myocardial scintigraphy has been associated with coronary artery stenosis. We report a patient whose two separate 99mTc-MIBI myocardial SPECT stress studies (dynamic exercise and dipyridamole) showed septal reverse redistribution and fixed inferior defect. Echocardiograms showed left ventricular (LV) hypertrophy and diffuse hypokinesis, especially in the inferior wall, and EKG showed LV hypertrophy and strain and inferior infarct. Coronary angiogram confirmed two-vessel disease involving 80%-90% stenosis of the proximal second diagonal branch of the left anterior descending artery and 75%-90% stenosis of the right coronary artery as well as global left ventricular dysfunction. Reverse redistribution on 99mTc-MIBI myocardial SPECT occurring on dynamic or dipyridamole stress may indicate damaged but viable myocardium.- - - - - - - - - - ranking = 1keywords = vessel (Clic here for more details about this article) |
5/5. Pseudohypertension in a child with williams syndrome.Pseudohypertension has often been reported in elderly subjects, but is an unusual phenomenon in children. We report the case of a 5-year-old child who presented with features of williams syndrome (characterized by elfin facies, supravalvar aortic stenosis, and peripheral pulmonary artery stenosis). Repeated blood pressure recordings made with appropriately sized blood pressure cuffs were very high, while simultaneous intraarterial blood pressure was normal, confirming the presence of pseudohypertension. This was shown to be caused by excessively thickened arterial vessels.- - - - - - - - - - ranking = 1keywords = vessel (Clic here for more details about this article) |