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normal coronary angiograms

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https://www.readbyqxmd.com/read/28169140/influence-of-cardiovascular-risk-factors-on-the-prevalence-of-coronary-atherosclerosis-in-patients-with-angiographically-normal-coronary-arteries
#1
Daniel O Bittner, Lutz Klinghammer, Mohamed Marwan, Jasmin Schmid, Christian Layritz, Udo Hoffmann, Stephan Achenbach, Tobias Pflederer
RATIONALE AND OBJECTIVES: Cardiovascular (CV) disease is predominately influenced by CV risk factors and coronary computed tomography angiography (CTA) is capable of detecting early-stage coronary artery disease. We sought to determine the influence of CV risk factors on the prevalence of nonobstructive atherosclerosis in patients with normal-appearing coronary arteries in invasive coronary angiography (ICA). MATERIALS AND METHODS: In this retrospective analysis, we included 60 consecutive symptomatic patients, having undergone ICA and coronary CTA...
February 3, 2017: Academic Radiology
https://www.readbyqxmd.com/read/28142134/coronary-spasm-after-an-injection-of-vincristine
#2
Rosine Gros, Vincent Hugon, Jean-Marc Thouret, Vincent Peigne
Cardiotoxicity, including heart failure, thromboembolic events, and myocardial ischemia, is a concern for cardiologists and oncologists. The most frequently involved drugs are anthracyclines. We report an episode of coronary spasm due to vincristine, a vinca alkaloid, in a 49-year-old man treated for a diffuse undifferentiated carcinoma. The patient suffered recurrent episodes of typical chest pain with ST-elevation in the inferior area. Coronary spasm was confirmed by an angiogram, which showed normal coronary arteries...
February 1, 2017: Chemotherapy
https://www.readbyqxmd.com/read/28133551/large-left-ventricular-thrombus-in-a-patient-with-systemic-and-venous-thromboembolism-secondary-to-protein-c-and-s-deficiency
#3
Mohit Pahuja, Bujji Ainapurapu, Aiden Abidov
58-year-old Hispanic female presented with an altered mental status. A CT scan of the head demonstrated multiple scattered infarcts and a large right temporal lobe infarct. We also diagnosed the patient with right popliteal and femoral vein thrombosis, bilateral pulmonary embolism, and a transient right radial artery occlusion. Her 12-lead EKG showed lateral ST elevation. Emergent coronary angiogram revealed normal coronaries. Echocardiogram demonstrated a large mobile mass attached to the anterolateral free wall with overall normal contractility of the left ventricle...
2017: Case Reports in Cardiology
https://www.readbyqxmd.com/read/28063138/are-biventricular-systolic-functions-impaired-in-patient-with-coronoray-slow-flow-a-prospective-study-with-three-dimensional-speckle-tracking
#4
Tuğba Kemaloğlu Öz, Mehmet Eren, Işıl Atasoy, Tayfun Gürol, Özer Soylu, Bahadır Dağdeviren
The newly developed three dimensional speckle-tracking echocardiography (3D-STE) technology provides quick and comprehensive quantitative assessment of biventricular myocardial dynamics. The impact of coronary slow flow phenomenon (CSFP) on biventricular functions has not been comprehensively evaluated using this new technology. Therefore, the aim of this study was to evaluate the effects of CSFP on biventricular systolic functions using 3D-STE. Forty patients with CSFP and otherwise normal coronary arteries (NCAs) and 40 age- and sex-matched controls with normal coronary angiograms (CAGs) were prospectively enrolled...
January 6, 2017: International Journal of Cardiovascular Imaging
https://www.readbyqxmd.com/read/28047848/tu-h-campus-iep2-02-four-dimensional-coronary-artery-visualization-based-on-image-propagation
#5
B Liu, B Liang, X Xu, B Guo, R Wei, S Xu, F Zhou, Q Wu
PURPOSE: 4D visualization of coronary artery using X-ray angiograms rotationally acquired on C-arm has many valuable applications, like dynamic roadmapping. In this work we propose and validate a method to visualize 4D artery based on 3D coronary image propagation. METHODS: After sorting the angiograms into different cardiac phases using nearest-neighbor ECG gating, a high quality 3D coronary image was reconstructed at one phase using a motion-compensated iterative reconstruction method...
June 2016: Medical Physics
https://www.readbyqxmd.com/read/28000218/supra-hisian-conduction-block-as-an-unusual-presenting-feature-of-takotsubo-cardiomyopathy
#6
Mukund Aravind Prabhu, Praveen Gopalakrishna Pai, Anjith Vupputuri, Saritha Shekhar, Madhavankutty Santhakumari Harikrishnan, Natarajan Umayammal Kumaraswamy
BACKGROUND: Atrioventricular (AV) block is rare in Takotsubo cardiomyopathy (TC). CASE REPORT: A 66-year-old female presented with fatigue. Her electrocardiogram revealed 3:2 Mobitz Type II AV block, confirmed to be supra-Hisian by electrophysiological study. Echocardiogram and left ventricular angiogram showed moderate left ventricular dysfunction and apical ballooning, whereas coronary angiogram revealed mildly ectatic coronaries. At 2 weeks AV block persisted, needing permanent pacemaker implantation...
December 21, 2016: Pacing and Clinical Electrophysiology: PACE
https://www.readbyqxmd.com/read/27993910/a-38-year-old-man-with-progressive-dyspnoea-and-ventricular-tachycardia
#7
Alphonsus C Liew, Claire E Raphael, Raad Mohiaddin
CLINICAL INTRODUCTION: A previously healthy 38-year-old man presented with a 3-month history of progressive dyspnoea and ventricular tachycardia (VT). He suffered a viral illness 4 months earlier. There was no family history of cardiac disease or sudden cardiac death (SCD). ECG showed left bundle branch block (LBBB). Echocardiography revealed a dilated left ventricle with severely impaired systolic function. Coronary angiogram showed angiographically normal coronary arteries. He was diagnosed as having dilated cardiomyopathy and was referred for further assessment with cardiovascular magnetic resonance (CMR) (figure 1) and subsequently CT thorax...
December 19, 2016: Heart: Official Journal of the British Cardiac Society
https://www.readbyqxmd.com/read/27957255/pulmonary-vein-thrombosis-in-a-patient-with-polycythemia-vera
#8
Bhaskar Bhardwaj, Dany Jacob, Amit Sharma, Mouhanna Abu Ghanimeh, Paramdeep Baweja
Pulmonary vein thrombosis (PVT) is a rarely encountered disease entity with varied clinical presentations. It is usually associated with lung carcinoma, lung surgeries and as a complication of the radiofrequency catheter ablation procedure for atrial fibrillation. Its clinical manifestations can vary from mild hemoptysis to lung infarction with hemodynamic compromise. A 76-year-old male presented with a 2-d history of pleuritic left sided chest pain. His past medical history included polycythemia vera, atrial fibrillation, coronary artery disease, pulmonary embolism and pulmonary hypertension...
November 26, 2016: World Journal of Cardiology
https://www.readbyqxmd.com/read/27934810/effect-of-hypertension-at-presentation-on-prognosis-in-patients-with-dilated-cardiomyopathy-presenting-with-normal-renal-angiogram
#9
Swetha Balije, Ashutosh Kumar, Goru Bhawani, Kasturi S N Murthy, Neera Kumari
BACKGROUND & OBJECTIVES: Dilated cardiomyopathy (DCM) is a progressive disease of heart with systolic and diastolic dysfunction carrying a poor long-term prognosis. The prognostic index and predictors of mortality are considered to be useful in guiding the treatment. This study was undertaken to evaluate the effects of hypertension at presentation on prognosis in patients with DCM presenting with normal renal and coronary angiogram. METHODS: An observational, analytical, non-interventional and a combination of retrospective and prospective study was conducted in patients between 15 and 75 yr of age with DCM having on and off symptoms while receiving treatment in a cardiology outpatient department for more than a year...
August 2016: Indian Journal of Medical Research
https://www.readbyqxmd.com/read/27933639/assessment-of-left-atrial-volume-and-function-by-real-time-three-dimensional-echocardiography-in-obese-patients
#10
Julide Yagmur, Mehmet Cansel, Ertugrul Kurtoglu, Siho Hidayet, Nusret Acıkgoz, Necip Ermis, Fatma Ozyalin
OBJECTIVE: To evaluate left atrial (LA) volume and functions in obese subjects using real time three-dimensional echocardiography (RT3DE) and also the relationship between LA mechanical functions and N-terminal pro-atrial natriuretic peptide (NT-proANP). METHODS: This study included 40 obese (26 females and 14 males, mean age 51.9 years) and 40 normal weight subjects (23 females and 16 males, mean age 53.5 years) with normal coronary angiograms. All the study participants underwent RT3DE to assess LA volume and mechanical function...
December 9, 2016: Echocardiography
https://www.readbyqxmd.com/read/27915215/cha2ds2-vasc-hsf-score-new-predictor-of-severity-of-coronary-artery-disease-in-2976-patients
#11
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...
February 1, 2017: 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
#12
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
#13
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
#14
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
#15
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
#16
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...
November 15, 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
#17
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
#18
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
#19
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
#20
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
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