1/13. Coronary artery spasm and ventricular fibrillation after off-pump coronary surgery.Native coronary artery or bypass graft spasm is a rare cause of acute myocardial infarction after coronary artery bypass grafting. This report presents angiographic documentation of native coronary artery spasm following successful multivessel off-pump coronary revascularization, which caused myocardial ischemia leading to inferior wall myocardial infarction and ventricular fibrillatory arrest.- - - - - - - - - - ranking = 1keywords = vessel (Clic here for more details about this article) |
2/13. Cardiac arrest in a soccer player: a unique case of anomalous coronary origin detected by 16-row multislice computed tomography coronary angiography.Anomalous origin of the coronary arteries may be present in otherwise normal subjects without clinical significance, but can also be the cause of myocardial ischemia and sudden death in both adults and teenagers. In particular, the origin of the left main coronary artery or left anterior descending artery from the right sinus of valsalva or right coronary artery may result in compression of the vessel during or immediately after exercise. We present a unique case of coronary anomaly with four separate coronary ostia originating from the right coronary sinus in a soccer player with sudden cardiac arrest. Multislice contrast-enhanced computed tomography has emerged as a valid noninvasive method for the diagnosis of coronary artery anomaly.- - - - - - - - - - ranking = 1keywords = vessel (Clic here for more details about this article) |
3/13. Apical hypertrophic cardiomyopathy: a case of slow flow in lad and malign ventricular arrhythmia.The coronary slow flow phenomenon is an angiographic finding characterized by delayed distal vessel opacification in the absence of epicardial coronary artery disease. patients often present with acute coronary syndrome. Histopathologic studies have revealed the existence of fibromuscular hyperplasia and myofibrilar hypertrophy. Apical hypertrophic cardiomyopathy is a benign progressive form of hypertrophic cardiomyopathy, that is rarely observed in western communities. It remains commonly asymptomatic until advanced ages. syncope, arrhythmia or sudden death may be the first symptom. We report a case of slow coronary arterial flow in a 71-year-old male patient with apical hypertrophic cardiomyopathy who experienced chest pain and sudden cardiac arrest due to ventricular arrhythmia.- - - - - - - - - - ranking = 1keywords = vessel (Clic here for more details about this article) |
4/13. survival after spontaneous coronary artery dissection presenting with ventricular fibrillation arrest.Spontaneous coronary artery dissection (SCAD) is a rarely documented etiology of myocardial infarction and sudden cardiac death (SCD). We present a case of a 37-year-old non-pregnant female who presented with a left anterior descending artery (LAD) dissection complicated by ventricular fibrillation arrest. After early diagnostic catheterization and medical management, our patient experienced a complete recovery, returning to her pre-SCD status without limitation. This case is unique in that the SCAD did not occur in the context of previously described associations. Also, this is only the second reported case of a patient with SCAD who survived documented SCD. Our case suggests that medical management is a reasonable option in patients with single-vessel non-left main/proximal LAD artery SCAD.- - - - - - - - - - ranking = 1keywords = vessel (Clic here for more details about this article) |
5/13. Successful management of air embolism-induced ventricular fibrillation in orthotopic liver transplantation.ventricular fibrillation (VF) although less common during noncardiac surgery often brings about severe complication as an aftermath. We report a case of VF which was highly suspected to be induced by air embolism at the moment when the surgeon was dissecting the collateral vessels of portal vein in liver transplantation surgery. The outcome of this patient was excellent due to aggressive resuscitative measures including open-chest cardiac massage. Transesophageal echocardiogram (TEE) was not applied in this patient in fear of increased risk of esophageal varicose bleeding in a liver cirrhotic patient. However, some reports described the use of TEE in cirrhotic patients without obvious complications. In this case, venous air embolism (VAE) happened during the dissection of collateral vessels of the portal vein, which to our knowledge was ever been reported in liver transplantation surgery. The related literature has been reviewed and the success of the resuscitation is also herein discussed.- - - - - - - - - - ranking = 2keywords = vessel (Clic here for more details about this article) |
6/13. Suppression of incessant polymorphic ventricular tachycardia by selective intracoronary ethanol infusion.Two weeks after an extensive anterior myocardial infarction, a 68-year-old man developed incessant polymorphic ventricular tachycardia (PMVT), unresponsive to all conventional treatment modalities. After requiring greater than 40 direct current cardioversions in less than 3 hours, he underwent attempted intracoronary chemical ablation of his arrhythmia as a treatment of last resort. An infusion catheter was positioned selectively in the subtotally occluded left anterior descending (LAD) coronary artery, the putative "tachycardia-related vessel." Fifty percent ethanol was delivered to the anterior wall through this catheter by slow, constant infusion. Following selective intracoronary ethanol infusion, spontaneous, unprovoked episodes of PMVT ceased, despite discontinuation of all antiarrhythmic drugs. The LAD remained patent. Several days later, the patient underwent coronary artery bypass surgery and implantation of an implantable defibrillator, succumbing in the early postoperative period from recrudescent intractable ventricular fibrillation and cardiogenic shock. Slow intracoronary infusion of 50% ethanol does not cause abrupt vessel occlusion such as occurs after rapid injection of higher concentrations of ethanol. Selective intracoronary infusion of 50% ethanol may provide temporary lifesaving suppression of otherwise intractable polymorphic ventricular tachycardia.- - - - - - - - - - ranking = 2keywords = vessel (Clic here for more details about this article) |
7/13. Painless myocardial ischaemia and ventricular fibrillation during treadmill stress test.Painless myocardial ischaemia is a frequent occurrence, but its clinical importance has not been realised. We report a case who developed ventricular tachycardia and fibrillation following painless ischaemia during treadmill stress test. Significant left main severe triple vessel coronary artery disease and normal left ventricular functions were found. Symptoms improved following coronary bypass surgery. Thus, painless ischaemia is a potentially lethal phenomenon, and needs careful assessment and treatment.- - - - - - - - - - ranking = 1keywords = vessel (Clic here for more details about this article) |
8/13. Immediate balloon inflation during ventricular fibrillation complicating coronary angioplasty--an alternative technique to angioplasty system withdrawal: case reports and review.Two patients are presented in whom ventricular fibrillation occurred during otherwise uncomplicated percutaneous transluminal coronary angioplasty. Rather than withdrawing the angioplasty dilatation system in place in the coronary vessel before instituting resuscitation procedures, immediate balloon inflation was performed while a defibrillator was charged. During balloon inflation, both patients were countershocked, and they recovered stable cardiac rhythm. Postresuscitation hemodynamic and angiographic analysis revealed successful angioplasty results. This report describes an alternative technique to immediate removal of the balloon dilatation system for cardiac arrest complicating coronary angioplasty. Theoretical advantages and potential disadvantages of this technique are discussed.- - - - - - - - - - ranking = 1keywords = vessel (Clic here for more details about this article) |
9/13. verapamil for refractory ventricular fibrillation during cardiac operations in patients with cardiac hypertrophy.calcium-entry blockers prevent ventricular fibrillation during acute myocardial ischemia in laboratory animals. They may be useful as an adjunct to cold cardioplegia by preserving the myocardium during cardiopulmonary bypass. Their use may limit myocardial infarct size. However, the clinical application of calcium-entry blockers for ventricular dysrhythmias associated with myocardial ischemia has been little explored, as yet. We describe four patients, all of whom had significant cardiac hypertrophy (two had idiopathic hypertrophic subaortic stenosis; one had transposition of great vessels; and one had aortic stenosis) and in whom ventricular fibrillation developed after rewarming or shortly after the termination of bypass. The dysrhythmias were refractory to multiple attempts at defibrillation and conventional pharmacologic interventions. However, in each case, defibrillation was successful after administration of verapamil.- - - - - - - - - - ranking = 1keywords = vessel (Clic here for more details about this article) |
10/13. Action of intracoronary nitroglycerin in refractory coronary artery spasm.Coronary artery spasm usually responds to sublingual nitroglycerin. This report describes four patients with variant angina and one patient with rest angina who had coronary spasm that was refractory to sublingual or i.v. nitroglycerin. In four patients, spasm occurred spontaneous and in one patient after 0.05 mg of ergonovine. In each case, 25-100 micrograms of intracoronary nitroglycerin promptly (30-45 seconds) resulted in reopacification of the vessel involved in spasm and resolution of evidence for ischemia. Thus, intracoronary nitroglycerin can reverse coronary artery spasm that does not respond to systemic nitroglycerin administration.- - - - - - - - - - ranking = 1keywords = vessel (Clic here for more details about this article) |
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