1/5. Coronary aneurysms in a case of ehlers-danlos syndrome.An asymptomatic 48 year old man had transient T-wave inversion in the anterolateral leads after nonpenetrating chest trauma. Both the patient and his 6 year old son showed the typical skin hyperelasticity and joint hyperextensibility of the ehlers-danlos syndrome, suggesting autosomal dominant inheritance. The coexisting cardiac abnormalities of the patient included multiple coronary aneurysms, mitral valve prolapse with slight regurgitation, fusiform dilatation of the ascending aorta with moderate insufficiency and left anterior hemiblock. A routine noninvasive cardiovascular evaluation should be performed in all patients with ehlers-danlos syndrome in order to exclude valvular heart disease and dilatation of the aortic root or of other vessels, including the coronary arteries.- - - - - - - - - - ranking = 1keywords = vessel (Clic here for more details about this article) |
2/5. cerebral infarction: shortcomings of angiography in the evaluation of intracranial cerebrovascular disease in 25 cases.We studied the utility and limitations of conventional cerebral angiography in 25 patients with cerebral infarction unassociated with extracranial cerebrovascular disease during a 7-year period. In only one-third of cases was the angiogram diagnostic, and in a single case it altered the pre-angiogram diagnosis by revealing a previously unsuspected embolus. Among the cases clinically diagnosed as cerebral emboli, the 2 confirmatory angiograms were performed early (within 48 hours), and demonstrated medium-large or large vessel filling defects. Two-thirds of the negative angiograms in the embolic clinical category were delayed, but there was no statistically relevant predilection for specific vessel size involvement. The category, primary cerebral vasculopathy, comprised the largest group, 10 in all, and one-half had angiographic confirmation despite time delays. Angiographic recognition was dependent on a characteristic picture of vascular involvement, and not on timing or vessel size predilection. mitral valve prolapse figured prominently in the clinical cases of vasculopathy of uncertain etiology, which contained a total of 4 cases. The 3 cases with nondiagnostic angiograms were all delayed and demonstrated nonspecific radiographic changes. Clinically, these cases demonstrated signs or symptoms of autoimmune dysfunction, raising the specter of primary cerebral vasculopathy as a cause of cerebral infarction, in contrast to recurrent cerebral emboli.- - - - - - - - - - ranking = 3keywords = vessel (Clic here for more details about this article) |
3/5. Three main coronary arteries to pulmonary artery fistula.A case of a 19-year-old woman with coronary artery fistula was reported. She was asymptomatic throughout her life. physical examination revealed a continuous murmur along the left sternal border. Echocardiograms and left ventriculograms showed mitral valve prolapse. Selective coronary arteriograms disclosed arteriovenous fistula between branches of the right, the left anterior descending and the left circumflex coronary artery and the main pulmonary trunk. We believe that this is the first case report of an unusual form of anomalous coronary-pulmonary artery communication: three main coronary vessels participate in the fistula.- - - - - - - - - - ranking = 1keywords = vessel (Clic here for more details about this article) |
4/5. Coronary artery aneurysms. Report of seven cases and review of the pertinent literature.Coronary artery aneurysm was demonstrated in 7 patients, whose ages ranged from 38 to 66 years, by selective coronary angiography. Four patients had atypical chest pain probably not caused by cardiac ischemia, 1 patient had aortic stenosis and recurrent bouts of atrial fibrillation, and 2 were evaluated following myocardial infarction and found to have triple vessel atherosclerotic coronary disease. mitral valve prolapse and varicosities of the coronary venous tree found in one individual suggest that mucoid degeneration which replaces the normal fibrous tissue resulting in weakness of vessel wall may be responsible for the formation of coronary artery aneurysm and varicosities of the coronary venous system. The unsuspected presentation and benign course of these patients are emphasized and the pertinent literature is reviewed.- - - - - - - - - - ranking = 2keywords = vessel (Clic here for more details about this article) |
5/5. myocardial infarction and coronary ectasia in idiopathipc mitral valve prolapse syndrome.angina pectoris and myocardial infarction occurred in two patients with idiopathic mitral valve prolapse in the absence of atherosclerotic coronary artery disease. Instead, both patients showed the presence of coronary artery ectasia on cineangiography. The anatomic localization of ectasia corresponded with segmental derangement of left ventricular wall motion. Repeated thromboemboli from ectatic vessels and/or locally liberated platelet metabolites were considered the probable mechanism of these symptoms.- - - - - - - - - - ranking = 1keywords = vessel (Clic here for more details about this article) |