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normal coronary angiograms

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https://www.readbyqxmd.com/read/27915215/cha2ds2-vasc-hsf-score-new-predictor-of-severity-of-coronary-artery-disease-in-2976-patients
#1
Ranjan Modi, S V Patted, P C Halkati, Sanjay Porwal, Sameer Ambar, Prasad Mr, Vijay Metgudmath, Ameet Sattur
BACKGROUND: CHADS2 and CHA2DS2-VASc scores have been used for assessing prognostic risk of thromboembolism in non valvular atrial fibrillation patients. They include similar risk factors for the development of CAD To increase the likelihood of determining CAD severity, the CHA2DS2-VASc-HS and CHA2DS2-VASc-HSF score comprising of hyperlipidemia, smoking and family history respectively in addition to the components of the CHA2DS2-VASc score and male instead of female gender. The aim was to investigate whether these risk scores can be used to predict CAD severity...
October 29, 2016: International Journal of Cardiology
https://www.readbyqxmd.com/read/27842619/congenital-coronary-artery-anomalies-in-adults-review-of-111-cases-from-a-single-centre-experience
#2
Yiğit Çanga, Tolga S Güvenç, Mehmet B Karataş, Ali N Çalık, Tolga Onuk, Veysel O Tanık, Barış Güngör, Osman Bolca
BACKGROUND: Coronary artery anomalies are a heterogeneous group of congenital disorders presenting with a wide spectrum of symptoms, ranging from vague chest pain to sudden cardiac death. Despite available data, there is no consensus about the classification, nomenclature, and outcomes of coronary anomalies in the normally connected heart. In this study, we aimed to investigate clinical and angiographic characteristics of coronary arterial anomalies, as well as the frequency of atherosclerotic involvement in anomalous coronaries, diagnosed at a tertiary referral centre...
November 15, 2016: Cardiology in the Young
https://www.readbyqxmd.com/read/27803018/possible-complication-of-bee-stings-and-a-review-of-the-cardiac-effects-of-bee-stings
#3
Prabha Nini Gupta, B Krishna Kumar, Praveen Velappan, M D Sudheer
We report the case of a patient who, ∼3 weeks after multiple bee stings, developed a prolonged heart block, syncope and cardiac arrest. This required a temporary pacemaker to be implanted, which was later replaced with a permanent pacemaker. An ECG taken following surgery for a fractured humerus 6 years earlier was reportedly normal. The patient had been a rubber tapper who walked ∼1.5 km/day, but after the bee attack he was no longer able to walk or get up from the bed without experiencing syncope...
November 1, 2016: BMJ Case Reports
https://www.readbyqxmd.com/read/27759750/pheochromocytoma-presenting-as-a-mimic-of-acute-coronary-syndrome
#4
Yasmin Hakim, Anna Forbes, Momina Khan, Benjamin C Whitelaw
Chest pain with elevated serum troponin is a common clinical presentation and is normally managed as suspected myocardial infarction or acute coronary syndrome (ACS). We report a 49 year old man who presented with central chest pain sweating and breathlessness. He had a significantly elevated serum troponin I level and a subsequent angiogram showed near normal coronary arteries. He was subsequently investigated for fever and found to have a 3cm right sided adrenal mass consistent with a pheochromocytoma. After confirmation and appropriate blockade laparoscopic adrenalectomy was performed...
2016: Acute Medicine
https://www.readbyqxmd.com/read/27751309/paraganglioma-masquerading-as-acute-myocardial-infarction-and-cardiogenic-shock
#5
Tanveer Ahmad, Shankaragouda Patil, Ashwini Kumar Pasarad, Nandakumar Neralakere Maheshwarappa, Kolkebaile Sadanand Kishore
Paragangliomas, extra-adrenal pheochromocytomas, are rare catecholamine-secreting tumor. A 34-year-old lady admitted with diagnosis of ST elevation acute myocardial infarction with cardiogenic shock. Left ventricular function, severely depressed, returned to normal after initial stabilization. Coronary angiogram was normal. A para-aortic paraganglioma was diagnosed during the patient's work-up with biochemical studies, computed tomography of abdomen and functional radioisotopes imaging and was eventually surgically resected...
September 2016: Indian Heart Journal
https://www.readbyqxmd.com/read/27742420/acute-myocarditis-and-st-segment-elevation
#6
Muhammad Shahid, Edward Hoey, Sandeep Basavarajaiah
We report a case of focal myocarditis in a young boy mimicking acute ST-segment elevation MI. He presented with chest pain and the EKG changes were consistent with infero-laeral ST-segment elevation MI. Coronary angiogram revealed smooth arteries with no obstruction. Troponin was significantly elevated and the echocardiogram exhibited mildly impaired LV function with hypokinetic inferior and lateral walls. Subsequently performed cardiac magnetic resonance imaging confirmed the diagnosis of myocarditis by exhibiting classic features of delayed gadolinium enhancement in the epi and mid-myocardial regions of the lateral wall sparing the sub-endocardial region...
August 24, 2016: American Journal of Cardiology
https://www.readbyqxmd.com/read/27671984/acute-coronary-syndrome-like-presentation-with-prolonged-qt-interval-an-unusual-case-of-pheochromocytoma
#7
Nil Ozyuncu, Sevinc Akturk, Turkan Seda Tan Kurklu, Cetin Erol
Pheochromocytoma is a rare adrenal gland tumour, usually alerting the physician by causing hypertensive tachycardic attacks. Patients with pheochromocytoma can rarely present with clinical signs similar to acute coronary syndrome. QT interval prolongation and ST segment changes due to pheochromocytoma have also been reported in the literature in a few case reports. We report a patient who had been admitted to the emergency department with chest pain, ischaemic ECG changes and marked QT prolongation. Despite a normal coronary angiogram, we observed that the QT interval and ST segment morphologies had changed during the hospitalisation period...
September 26, 2016: BMJ Case Reports
https://www.readbyqxmd.com/read/27644405/left-ventricular-torsion-and-circumferential-strain-responses-to-exercise-in-patients-with-ischemic-coronary-artery-disease
#8
Jesus Peteiro, Alberto Bouzas-Mosquera, Javier Broullon, Gabriel Sanchez-Fernandez, Cayetana Barbeito, Lucia Perez-Cebey, Dolores Martinez, Jose M Vazquez-Rodriguez
LV torsion during exercise in patients with coronary artery disease (CAD) is not well known. Circumferential strain (CS) and left ventricular (LV) torsion (Tor) have not been evaluated during ischemia in these patients. We aimed to assess the effect of ischemia during exercise echocardiography (ExE) on CS and Tor. We studied a group of 73 patients with true positive ExE results (Ischemic group: ischemia plus an abnormal coronary angiogram) and a matched control group of 66 patients with negative ExE and either normal coronary angiography or low post-test probability of CAD...
September 19, 2016: International Journal of Cardiovascular Imaging
https://www.readbyqxmd.com/read/27639736/a-computational-atlas-of-normal-coronary-artery-anatomy
#9
Pau Medrano-Gracia, John Ormiston, Mark Webster, Susann Beier, Alistair Young, Chris Ellis, Chunliang Wang, Örjan Smedby, Brett Cowan
AIMS: The aim of this study was to define the shape variations, including diameters and angles, of the major coronary artery bifurcations. METHODS AND RESULTS: Computed tomographic angiograms from 300 adults with a zero calcium score and no stenoses were segmented for centreline and luminal models. A computational atlas was constructed enabling automatic quantification of 3D angles, diameters and lengths of the coronary tree. The diameter (mean±SD) of the left main coronary was 3...
September 18, 2016: EuroIntervention
https://www.readbyqxmd.com/read/27635184/unusual-survival-of-anomalous-left-coronary-artery-from-the-pulmonary-artery-with-severe-rheumatic-mitral-stenosis-in-septuagenarian-women-foes-becoming-friends
#10
Santosh Kumar Sinha, Dibbendhu Khanra, Mukesh Jitendra Jha, Karandeep Singh, Mahamdulla Razi, Amit Goel, Vikas Mishra, Mohammad Asif, Mohit Sachan, Nasar Afdaali, Ashutosh Kumar, Ramesh Thakur, Vinay Krishna, Umeshwar Pandey, Chandra Mohan Varma
ALCAPA syndrome (anomalous origin of the left coronary artery from the pulmonary artery) is a rare disease but lethal with clinical expression from myocardial infarction, congestive heart failure to death during early infancy and unusual survival to adulthood. We report a 73-year-old woman with ALCAPA who presented with exertional dyspnea (NYHA functional class II) over past 2 years. Physical examination revealed soft S, long mid diastolic rumbling murmur and apical pan-systolic murmur. Electrocardiography displayed biatrial enlargement and poor R progression and normal sinus rhythm...
October 2016: Journal of Clinical Medicine Research
https://www.readbyqxmd.com/read/27614851/cardiac-structural-changes-and-long-term-survival-in-patients-with-prominent-thebesian-veins
#11
David Snipelisky, Yogesh N V Reddy, Ryan J Lennon, Daniel J Crusan, Charanjit S Rihal, Andre C Lapeyre
Although rare, numerous case reports suggest that Thebesian veins confer increased morbidity and mortality. No study has evaluated their effects on cardiac structure or long-term patient outcomes. Patients undergoing coronary angiogram at the study institution from October 2002 and January 2015 were assessed for a diagnosis of prominent Thebesian veins. A matched control group was created and comparisons between clinical, echocardiographic, and survival measures were made. Of 50,116 total patients, 31 (0.06%) were found to have prominent Thebesian veins on angiography and were compared with a matched control group of 596 patients...
October 15, 2016: American Journal of Cardiology
https://www.readbyqxmd.com/read/27600369/a-rare-presentation-of-cardiac-amyloid-deposits-isolated-to-intramural-vessels
#12
Tor S Clemmensen, Henning Mølgaard, Niels F Andersen, Steen Baerentzen, Jens Soerensen, Steen H Poulsen
The present case illustrates the diagnostic challenges in symptomatic patients with heart failure of unknown etiology. The patients were previously diagnosed with κ-light chain amyloidosis without cardiac involvement. Echocardiography showed heart failure with mildly reduced ejection fraction but no signs of amyloidosis. Coronary angiogram showed normal arteries and 11C-PIB positron emission tomography was negative for amyloid deposits. Exercise testing revealed severe heart failure and reduced coronary flow velocity reserve...
November 2016: Echocardiography
https://www.readbyqxmd.com/read/27596482/high-risk-plaque-in-patients-with-near-normal-coronary-angiograms
#13
Michael C Turner
The increased use of cardiac computed tomography angiography in the emergency room to triage patients who present with chest pain syndrome has led to the identification of individuals with coronary plaques with high-risk characteristics in the absence of significant stenoses. Anecdotal observations have suggested that the presence of coronary high-risk plaque results in an increased risk of acute coronary syndrome over time. This case presentation represents an example of this subgroup of patients. Intuitively, it would seem that high-dose statin therapy would be the treatment of choice, with percutaneous intervention reserved for the development of flow-limiting lesions; however, a prospective trial to determine outcomes to our knowledge has not been performed...
November 2016: Echocardiography
https://www.readbyqxmd.com/read/27574609/coronary-artery-occlusion-after-arterial-switch-operation-in-an-asymptomatic-15-year-old-boy
#14
Ashish P Saini, Stephen E Cyran, Steven M Ettinger, Linda B Pauliks
A 15-year-old boy with transposition of the great arteries (TGA) and neonatal arterial switch operation (ASO) presented with complete occlusion of the left main coronary artery (LMCA). Intra-operatively, an intramural left coronary artery was identified. Therefore, since age 7 years he had a series of screening exercise stress tests. At 13 years old, he had 3 to 4 mm ST segment depression in the infero-lateral leads without symptoms. This progressed to 4.2 mm inferior ST segment depression at 15 years old with normal stress echocardiogram...
August 16, 2016: World Journal of Clinical Cases
https://www.readbyqxmd.com/read/27438591/effect-of-dexmedetomidine-on-normal-coronary-vessel-diameter
#15
Tanveer Singh Kundra, Parminder Kaur
Dexmedetomidine is a selective alpha2 agonist, which is widely used for conscious sedation in ICU patients. It is being increasingly used to provide conscious sedation in out-of-theatre procedures like CT scan, MRI, endoscopies and catheterization (cath) procedures. There is limited data till date regarding the effect of dexmedetomidine on coronary vessel diameter. The aim of this prospective observational study was to observe the effect of dexmedetomidine on normal coronary vessel diameter. Fifty patients who had come for elective coronary angiography in the cath lab were enrolled in the study...
2016: Pharmacology
https://www.readbyqxmd.com/read/27437324/normal-proximal-coronary-artery-diameters-in-adults-from-india-as-assessed-by-computed-tomography-angiography
#16
Manjappa Mahadevappa, Madhav Hegde, Ravi Math
INTRODUCTION: The normative data of coronary artery size among Indians are sparse. It is often essential to know the coronary dimensions especially during interventions such as stenting to choose the appropriate size of the stent and to decide the very need for stenting. In current practice it is the luminal angiography which is most widely employed to assess the coronary artery size. However, luminal angiography is not very accurate in estimating the epicardial coronary artery size as it does not take into account the mural thickness of the arterial wall...
May 2016: Journal of Clinical and Diagnostic Research: JCDR
https://www.readbyqxmd.com/read/27393032/is-ffr-ct-a%C3%A2-game-changer-in-the-diagnostic-management-of-stable-coronary-artery-disease
#17
W A Leber
The introduction of fractional flow reserve computed tomography (FFR-CT) that is performed from static coronary CT angiography datasets may open new horizons in the diagnostic management of patients with suspected coronary artery disease. FFR-CT has a high sensitivity and moderate specificity in identifying ischemia in intermediate coronary stenoses. It has been demonstrated that this technology has the potential to significantly reduce the number of invasive coronary angiograms and the rate of normal coronary angiograms that are not followed by an intervention...
August 2016: Herz
https://www.readbyqxmd.com/read/27343424/opium-addiction-as-an-independent-risk-factor-for-coronary-microvascular-dysfunction-a-case-control-study-of-250-consecutive-patients-with-slow-flow-angina
#18
Ali Esmaeili Nadimi, Farah Pour Amiri, Mahmood Sheikh Fathollahi, Gholamhossien Hassanshahi, Zahra Ahmadi, Ahmad Reza Sayadi
BACKGROUND: Approximately 20% to 30% of patients who undergo coronary angiography for assessment of typical cardiac chest pain display microvascular coronary dysfunction (MCD). This study aimed to determine potential relationships between baseline clinical characteristics and likelihood of MCD diagnosis in a large group of patients with stable angina symptoms, positive exercise test and angiographic ally normal epicardial coronary arteries. MATERIAL AND METHODS: This cross-sectional study included 250 Iranian with documented evidence of cardiac ischemia on exercise testing, class I or II indication for coronary angiography, and either: (1) angiographically normal coronary arteries and diagnosis of MCD with slow-flow phenomenon, or (2) normal angiogram and no evidence of MCD...
September 15, 2016: International Journal of Cardiology
https://www.readbyqxmd.com/read/27333905/59-year-old-female-with-breathlessness
#19
Alessandra Scatteia, Estefania De Garate, Chiara Bucciarelli-Ducci
CLINICAL INTRODUCTION: A 59-year-old female underwent an electrocardiogram (ECG) and echocardiographic screening. Her brother died at quite a young age of kidney failure. Resting ECG showed borderline voltage criteria for left ventricular hypertrophy (LVH), with marked widespread T-wave inversion. Echocardiogram was normal, but in consideration of exertional breathlessness and abnormal baseline ECG, she underwent a coronary angiogram, which showed unobstructed coronaries. She was then referred to have a cardiac MR (CMR) for further characterisation...
October 15, 2016: Heart: Official Journal of the British Cardiac Society
https://www.readbyqxmd.com/read/27316487/epicardial-fat-thickness-a-surrogate-marker-of-coronary-artery-disease-assessment-by-echocardiography
#20
K Meenakshi, M Rajendran, S Srikumar, Sundar Chidambaram
OBJECTIVE: Epicardial fat is considered as indicator of cardiovascular risk. Several studies have tested the association between epicardial fat thickness (EFT) and coronary artery disease. The aim of our study is to test the hypothesis that echocardiographic EFT is a marker of coronary artery disease. METHODS: One hundred and ten patients (70 males and 40 females with mean age of 51.5±10.6 and 52.6±9.6, respectively) admitted for coronary angiogram underwent assessment of epicardial fat thickness by echocardiography...
May 2016: Indian Heart Journal
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