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normal coronary angiograms

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https://www.readbyqxmd.com/read/29738542/microvascular-retinopathy-and-angiographically-demonstrated-coronary-artery-disease-a-cross-sectional-observational-study
#1
Lisa Cheng, Peter Barlis, Joel Gibson, Deb Colville, Anastasia Hutchinson, Geoff Gleeson, Ecosse Lamoureux, William VanGaal, Judy Savige
Epidemiological studies suggest retinal microvascular abnormalities predict cardiac events. This study examined microvascular features associated with coronary artery abnormalities. This was a single-centre, cross-sectional, observational study of 144 consecutive subjects undergoing coronary angiography for clinical indications. Their angiograms were deidentified and graded for disease (Leaman score, LAD stenosis ≥ 70%, number of vessels stenosed ≥ 70%), and Thrombolysis in Myocardial Infarction (TIMI) blush score...
2018: PloS One
https://www.readbyqxmd.com/read/29716697/incidence-predictors-clinical-profile-management-and-outcome-of-patients-with-isolated-left-main-coronary-artery-ostial-disease
#2
Sunil Kumar Srinivas, Bharathi Sunil, Prabhavathi Bhat, Cholenahally Nanjappa Manjunath
OBJECTIVES: Isolated left main coronary artery (LMCA) ostial disease is a rare variant of LMCA disease. Earlier studies on this disease are limited by small number of patients enrolled. The aim of the present study was to analyze the incidence, risk factors, clinical profile and long term outcome of patients with isolated LMCA ostial disease. METHODS: 15,553 patients who underwent coronary angiogram in a single tertiary care cardiac hospital were analyzed for LMCA disease...
March 2018: Indian Heart Journal
https://www.readbyqxmd.com/read/29696430/subtraction-ct-angiography-improves-evaluation-of-significant-coronary-artery-disease-in-patients-with-severe-calcifications-or-stents-the-c-sub-320-multicenter-trial
#3
Andreas Fuchs, J Tobias Kühl, Marcus Y Chen, David Viladés Medel, Xavier Alomar, Sujata M Shanbhag, Steffen Helqvist, Klaus F Kofoed
OBJECTIVES: Diagnostic accuracy of conventional coronary CT angiography (CCTAconv ) may be compromised by blooming artifacts from calcifications or stents. Blooming artifacts may be reduced by subtraction coronary CT angiography (CCTAsub ) in which non-contrast and contrast CT data sets are subtracted digitally. We tested whether CCTAsub in patients with severe coronary calcification or stents reduces the number of false-positive stenosis evaluations compared with CCTAconv . METHODS: In this study, 180 symptomatic patients scheduled for invasive coronary angiography (ICA) were prospectively enrolled and CT scanned (2013-2016) at three international centers...
April 25, 2018: European Radiology
https://www.readbyqxmd.com/read/29691271/unusual-congenital-coronary-artery-anomaly-in-a-young-adult-presenting-as-sudden-cardiac-arrest
#4
Manuel Cortes, Carlos A Roldan, Stacey Clegg
A previously asymptomatic young female with no previous medical or cardiac history collapsed during indoor exercise. A portable automatic external defibrillator showed a shockable rhythm. She received multiple electrical shocks with return to normal sinus rhythm without ischaemic ECG changes. Her troponin level was mildly elevated. A transthoracic echocardiogram revealed moderately reduced left ventricular ejection fraction with global hypokinesis. During emergent coronary angiography, the left main coronary artery could not be found...
April 24, 2018: BMJ Case Reports
https://www.readbyqxmd.com/read/29658201/enhancement-of-standard-ecgs-by-a-new-method-for-multi-cycle-superimposition-and-summation
#5
Aharon Frimerman, Simcha Meisel, Avraham Shotan, David S Blondheim
BACKGROUND: Since the introduction of the electrocardiogram (ECG) in 1902, the fundamentals of ECG data acquisition, display, and interpretation in the clinical arena have not changed much. OBJECTIVES: To present a new method to enhance and improve acquisition, analysis, and display of the standard ECG. METHODS: We performed ECG enhancement by superimposition and summation of multiple standard ECG cycles of each lead, by temporal alignment to peak R wave and voltage alignment to an improved baseline, at the T-P segment...
January 2018: Israel Medical Association Journal: IMAJ
https://www.readbyqxmd.com/read/29655952/population-level-incidence-and-outcomes-of-myocardial-infarction-with-non-obstructive-coronary-arteries-minoca-insights-from-the-alberta-contemporary-acute-coronary-syndrome-patients-invasive-treatment-strategies-coapt-study
#6
Kevin R Bainey, Robert C Welsh, Wendimagegn Alemayehu, Cynthia M Westerhout, Dean Traboulsi, Todd Anderson, Neil Brass, Paul W Armstrong, Padma Kaul
BACKGROUND: Myocardial infarction with non-obstructive coronary arteries (MINOCA) is a known clinical conundrum with limited investigation. Using a large population-based cohort, we examined the incidence, demographic profile, use of evidence-based medicines (EBM) and clinical outcomes of MINOCA patients. METHODS: Patients hospitalized with a primary diagnosis of MI who underwent coronary angiography between 01/04/2002 and 31/03/2014 in Alberta, Canada, were included in the study...
April 4, 2018: International Journal of Cardiology
https://www.readbyqxmd.com/read/29648692/multimodality-imaging-for-evaluation-of-chest-pain-using-strain-analysis-at-rest-and-peak-exercise
#7
Mohamad Jihad Mansour, Wael AlJaroudi, Omar Hamoui, Sarah Chaaban, Elie Chammas
BACKGROUND: Exercise stress echocardiography (SE) is commonly used for diagnosing coronary artery disease (CAD). The use of quantitative echocardiographic measures such as strain imaging is expected to improve the sensitivity of conventional SE which relies on the visual diagnosis of wall-motion abnormalities (WMAs). This study is set to demonstrate the added value of resting and exercise strain analysis to detect underlying microangiopathy and inducible myocardial ischemia during a resting and SE in comparison with the results of coronary computed tomographic angiogram (CCTA)...
April 12, 2018: Echocardiography
https://www.readbyqxmd.com/read/29620544/elevated-fasting-blood-glucose-but-not-obesity-is-associated-with-coronary-artery-disease-in-patients-undergoing-elective-coronary-angiography-in-a-referral-hospital-in-jordan
#8
Abdel-Ellah Al-Shudifat, Mohammed Azab, Asgeir Johannessen, Amjad Al-Shdaifat, Lana M Agraib, Reema F Tayyem
BACKGROUND: Obesity and its metabolic complications are endemic in the Middle East, but the cardiovascular consequences are not well defined in local studies. OBJECTIVE: To assess the association between fasting blood glucose (FBG), obesity and coronary artery disease (CAD) in Jordan. DESIGN: A cross-sectional, hospital-based study. SETTING: A referral hospital in Amman, Jordan. PATIENTS AND METHODS: Patients with complete anthropomorphic data who were referred for elective coronary angiography were included in the analysis...
March 2018: Annals of Saudi Medicine
https://www.readbyqxmd.com/read/29601265/coronary-artery-fistulas-pathophysiology-imaging-findings-and-management
#9
Gabin Yun, Tae Hyun Nam, Eun Ju Chun
Coronary artery fistulas (CAFs) are abnormal communications of coronary arteries whereby venous circuits bypass the normal capillaries within the myocardium. CAFs are rare, and most affected patients are asymptomatic. However, these fistulas are the most common coronary artery anomalies that can alter coronary hemodynamic parameters. Although most CAFs are asymptomatic in young patients, symptoms and complications become more frequent with increasing age. CAFs are characterized by variable clinical manifestations that are based on the size, origin, and drainage site of the fistula...
March 27, 2018: Radiographics: a Review Publication of the Radiological Society of North America, Inc
https://www.readbyqxmd.com/read/29467150/high-sensitivity-troponin-i-levels-and-coronary-artery-disease-severity-progression-and-long-term-outcomes
#10
Ayman Samman Tahhan, Pratik Sandesara, Salim S Hayek, Muhammad Hammadah, Ayman Alkhoder, Heval M Kelli, Matthew Topel, Wesley T O'Neal, Nima Ghasemzadeh, Yi-An Ko, Mohamad Mazen Gafeer, Naser Abdelhadi, Fahad Choudhary, Keyur Patel, Agim Beshiri, Gillian Murtagh, Jonathan Kim, Peter Wilson, Leslee Shaw, Viola Vaccarino, Stephen E Epstein, Laurence Sperling, Arshed A Quyyumi
BACKGROUND: The associations between high-sensitivity troponin I (hsTnI) levels and coronary artery disease (CAD) severity and progression remain unclear. We investigated whether there is an association between hsTnI and angiographic severity and progression of CAD and whether the predictive value of hsTnI level for incident cardiovascular outcomes is independent of CAD severity. METHODS AND RESULTS: In 3087 patients (aged 63±12 years, 64% men) undergoing cardiac catheterization without evidence of acute myocardial infarction, the severity of CAD was calculated by the number of major coronary arteries with ≥50% stenosis and the Gensini score...
February 21, 2018: Journal of the American Heart Association
https://www.readbyqxmd.com/read/29463579/characteristics-and-prognosis-in-women-and-men-with-type-1-diabetes-undergoing-coronary-angiography-a-nationwide-registry-report
#11
Viveca Ritsinger, Christel Hero, Ann-Marie Svensson, Nawzad Saleh, Bo Lagerqvist, Katarina Eeg-Olofsson, Anna Norhammar
OBJECTIVE: To describe sex aspects on extent of coronary artery disease (CAD) and prognosis in a contemporary population with type 1 diabetes. RESEARCH DESIGN AND METHODS: All patients undergoing coronary angiography, 2001-2013, included in the Swedish Coronary Angiography and Angioplasty Registry and the Swedish National Diabetes Register as type 1 diabetes were followed for mortality until 31 December 2013. The coronary angiogram was classified into normal, one-vessel disease, two-vessel disease, three-vessel disease, and left main stem disease...
April 2018: Diabetes Care
https://www.readbyqxmd.com/read/29460660/early-repolarization-pattern-in-the-coronary-slow-flow-phenomenon
#12
Murat Sucu, Berzal Ucaman, Gökhan Altunbas
BACKGROUND: The coronary slow flow phenomenon (CSFP) is well-documented, and the early repolarization pattern (ERP) has recently been shown to be a risk factor for the development of malignant ventricular arrhythmias. METHODS: Those with true CSFP were included as cases and those with normal angiograms were included as controls. We assessed J-point elevation on surface electrocardiograms (ECGs) and defined ERP as notching or slurring of the terminal portion of the QRS takeoff...
February 20, 2018: Scandinavian Cardiovascular Journal: SCJ
https://www.readbyqxmd.com/read/29437817/atherothrombotic-out-of-hospital-cardiac-arrest-watch-out-for-a-second-train
#13
Laura Petruescu, Fabien Picard, Alain Cariou, Olivier Varenne
A 63-year-old man presented with an out-of-hospital cardiac arrest. The coronary angiogram with intravascular imaging was performed and showed a mid-left anterior descending artery atherosclerotic cap rupture with thrombus burden treated with drug-eluting stent (DES) implantation. During the hospitalisation in the intensive care unit, the patient experienced recurrent ventricular fibrillations and asystole with transient ST-segment elevation in the inferior leads with normal coronary angiography. A methylergonovine provocative test was therefore performed and showed an occlusive right coronary artery (RCA) spasm...
February 8, 2018: BMJ Case Reports
https://www.readbyqxmd.com/read/29401041/perivascular-epicardial-fat-stranding-at-coronary-ct-angiography-a-marker-of-acute-plaque-rupture-and-spontaneous-coronary-artery-dissection
#14
Sandeep Hedgire, Vinit Baliyan, Evan J Zucker, Daniel O Bittner, Pedro V Staziaki, Richard A P Takx, Jan-Erik Scholtz, Nandini Meyersohn, Udo Hoffmann, Brian Ghoshhajra
Purpose To evaluate the frequency and implications of perivascular fat stranding on coronary computed tomography (CT) angiograms obtained for suspected acute coronary syndrome (ACS). Materials and Methods This retrospective registry study was approved by the institutional review board. The authors reviewed the medical records and images of 1403 consecutive patients (796 men, 607 women; mean age, 52.8 years) who underwent coronary CT angiography at the emergency department from February 2012 to March 2016. Fat attenuation, length and number of circumferential quadrants of the affected segment, and attenuation values in the unaffected epicardial and subcutaneous fat were measured...
February 5, 2018: Radiology
https://www.readbyqxmd.com/read/29399586/a-case-of-myocarditis-and-near-lethal-arrhythmia-associated-with-interleukin-2-therapy
#15
Stephanie Wu, Anna Sarcon, Khuyen Do, Jerold Shinbane, Rahul Doshi, Helga Van Herle
We present a case of a 48-year-old female who developed myocarditis and near fatal arrhythmias during high dose Il-2 therapy for metastatic renal cancer. On day 5 of therapy, the patient developed sudden onset chest pain, elevated cardiac enzymes and ST segment changes on EKG. Coronary angiogram was normal, however echocardiogram showed reduced ejection fraction and hemodynamic measurements showed elevated bilateral elevated filling pressures. The patient then developed episodes of recurrent ventricular arrhythmia, precipitated by bradycardia and PVC, requiring defibrillation and temporary pacemaker placement...
January 2018: Journal of Investigative Medicine High Impact Case Reports
https://www.readbyqxmd.com/read/29348279/-clinically-suspected-myocarditis-with-pseudoinfarct-presentation-complicated-with-left-ventricular-aneurysm
#16
Annick Haouzi, Ahmed Ahmed
A 51-year-old man presented with chest pain, high troponin level, inflammatory syndrome and ST-segment elevation in the anterior leads. While the transthoracic echocardiogram (TTE) showed anteroseptal hypokinesis and apical akinesis, the coronary angiogram was normal. Cardiac MR demonstrated a typical aspect of myocarditis (multiple areas of mid-myocardial late gadolinium enhancement, sparing the subendocardial layer, along with oedema). The initial diagnosis was clinically suspected myocarditis with pseudoinfarct presentation...
January 17, 2018: BMJ Case Reports
https://www.readbyqxmd.com/read/29333788/enhancement-of-standard-ecgs-by-a-new-method-for-multi-cycle-superimposition-and-summation
#17
Aharon Frimerman, Simcha Meisel, Avraham Shotan, David S Blondheim
BACKGROUND: Since the introduction of the electrocardiogram (ECG) in 1902, the fundamentals of ECG data acquisition, display, and interpretation in the clinical arena have not changed much. OBJECTIVES: To present a new method to enhance and improve acquisition, analysis, and display of the standard ECG. METHODS: We performed ECG enhancement by superimposition and summation of multiple standard ECG cycles of each lead, by temporal alignment to peak R wave and voltage alignment to an improved baseline, at the T-P segment...
January 2018: Israel Medical Association Journal: IMAJ
https://www.readbyqxmd.com/read/29331435/complications-of-chronic-total-occlusion-percutaneous-coronary-intervention-subepicardial-hematoma
#18
Punag Divanji, Kendrick Shunk
A 67-year-old man with coronary artery disease and previous coronary underwent successful Guideliner reverse CART percutaneous coronary intervention of a chronic total occlusion of the right coronary artery. He later developed evidence of myocardial ischemia, and imaging, including angiogram, echocardiogram, and cardiac computed tomography revealing active dye extravasation from the previously normal RV marginal branches, in addition to a large subepicardial hematoma. Despite these dramatic findings, the patient remained hemodynamically stable and pain-free, with resolving ECG changes...
December 30, 2017: Cardiovascular Revascularization Medicine: Including Molecular Interventions
https://www.readbyqxmd.com/read/29317980/a-history-of-kawasaki-disease-from-childhood-and-coronary-artery-ectasia-with-recurrent-st-elevation-myocardial-infarction-a-therapeutic-challenge
#19
Ashraf Abugroun, Daniel Vilchez, Osama Hallak, Anahita Shahrrava
Coronary artery ectasia (CAE) is an uncommon anomaly, usually found in 1.2-2% of patients undergoing coronary angiography, defined as a segment of the coronary artery that has a diameter of more than 1.5 times the normal adjacent segments. Atherosclerosis is considered as the cause of half of the CAE cases. We herein present a 65-year-old Asian male with past medical history of Kawasaki disease (KD) who developed recurrent episodes of inferior wall ST-elevation myocardial infarction (STEMI) despite treatment with dual antiplatelet therapy (DAPT)...
December 2017: Cardiology Research
https://www.readbyqxmd.com/read/29317970/evaluation-of-the-tp-te-interval-qtc-and-p-wave-dispersion-in-patients-with-coronary-artery-ectasia
#20
Ronan Conlon, Richard Tanner, Santhosh David, Gabor Szeplaki, Joseph Galvin, John Keaney, Edward Keelan, Usama Boles
Background: Coronary artery ectasia (CAE) is defined as a diffuse dilatation of the diameter of the ectatic segment of the coronary artery, 1.5 times greater than that of the adjacent segment. The Tp-Te interval, P-wave and QTc dispersions are relatively new electrocardiographic markers associated with an increased risk of developing arrhythmias. Despite CAE increasing in prevalence in recent years, there is a sparsity of data available about its arrhythmogenic effect. The aim of the study was to evaluate QTc, P-wave dispersion and Tp-Te and Tp-Te/QT ratio in patients with CAE...
December 2017: Cardiology Research
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