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ct coronary angiogram

Yu Wang, Yuan-Lin Guo, Qiu-Ting Dong, Jian-Jun Li
We report a 14-year-old boy finally diagnosed with sitosterolemia, presenting with severe aortic valve stenosis. Genetic analysis revealed homozygous null mutation c.1336 C > T (p.R446X) in ABCG5 gene. His cardiac ultrasound presented aortic valve stenosis and moderate aortic regurgitation. His whole aorta computed tomography angiogram scan revealed aortic stenosis superior to the aortic valve, followed by ascending aorta dilation, whereas his coronary and peripheral arteries appeared normal. His maximum total cholesterol and low-density lipoprotein-cholesterol levels dropped dramatically after diet control, and ezetimibe was prescribed for treatment...
November 14, 2018: Journal of Clinical Lipidology
Kei Fujiwara, Hiromichi Ohsaka, Shunsuke Madokoro, Youichi Yanagawa
The patient was a 60-year-old male fell whose head and left chest hit the ground after falling from a height of 2 m. He complained of the left shoulder and chest pain after regaining consciousness. On arrival, he showed left bloody otorrhea, left chest tenderness, and a limited range of motion due to the left shoulder pain. Emergency chest roentgenography revealed multiple left rib fractures, left clavicular fracture with decreased radiolucency in the left lung field, suggesting lung contusion. When the patient was being transported for computed tomography, he suddenly displayed ventricular tachycardia with pulse and subsequently became VF storm, which required percutaneous cardiopulmonary support...
July 2018: Journal of Emergencies, Trauma, and Shock
Sayuri Tokioka, Shinichiro Masuda, Masamitsu Shirokawa, Takashi Shibui
High-quality cardiopulmonary resuscitation (CPR) is crucial for survival from cardiac arrest. However, various chest compression-associated injuries have been reported. Internal mammary artery (IMA) injury is one of the rare complications after CPR, and most of cases include rib and sternum fractures. In this report, we describe a rare case of IMA injury without chest wall fractures after CPR. An 85-year-old man with a history of acute myocardial infarction 2 weeks prior visited to our hospital for sustained ventricular tachycardia (VT)...
2018: Case Reports in Emergency Medicine
Brandon R Allen, Grant G Simpson, Ideen Zeinali, Jared T Freitas, Jeffrey J Chapa, Liam J Rawson, Julie A Richter, Thomas F Payton, Joseph Adrian Tyndall
Chest pain can be a challenging complaint to manage in the emergency department. A missed diagnosis can result in significant morbidity or mortality, whereas avoidable testing and hospitalizations can lead to increased health care costs, contribute to hospital crowding, and increase risks to patients. The HEART score is a validated decision aid to identify patients at low risk for acute coronary syndrome who can be safely discharged without admission or objective cardiac testing. In the largest and one of the longest studies to date (N = 31,060; 30 months), we included the HEART score into a larger, newly developed low-risk chest pain decision pathway, using a retrospective observational pre/post study design with the objective of safely lowering admissions...
December 2018: Critical Pathways in Cardiology
Naoki Onoda, Kenichi Izumi
Spontaneous coronary artery dissection (SCAD) is a rare cause of acute myocardial ischemia. Identification of intimal flap, true and false lumens in coronary angiogram (CAG) is the standard method to diagnose SCAD. In cases of obscure intimal flap, intravascular ultrasound (IVUS) is a useful method to diagnose, although crossing the wire and IVUS in the dissected lesion is invasive. Multidetector computed tomography (MDCT) provides valuable information in any clinical setting less invasively. We report here a rare case of spontaneous dissecting coronary artery pseudoaneurysm diagnosed by CAG and MDCT, healed by medical treatment, and followed up by MDCT over a 2-year period...
November 2018: Journal of Cardiology Cases
Hassan Tahir, Sajjad Ahmad, Muhammad U Awan, Bassam Omar, Joey Glass, Jason Cole
Congenital coronary anomalies are uncommon and are mostly asymptomatic; however, patients may have symptoms depending on the origin and course of anomalous artery. Very rarely, coronary anomalies can also lead to life-threatening complications especially in young athletes. A malignant course of the left main (LM) or left anterior descending (LAD) artery between aorta and pulmonary artery is considered the most significant risk factor for such complications. Various noninvasive tests are available to evaluate myocardial ischemia due to anomalous coronary artery...
August 28, 2018: Curēus
Abdol-Mohammad Kajbafzadeh, Reza Khorramirouz, Seyedeh Maryam Kameli, Kiarad Fendereski, Seyedeh Sima Daryabari, Seyed Mohammad Tavangar, Bahram Azizi Garajegayeh
BACKGROUND: Various investigations have reported that the internal mammary artery (IMA) is an efficient and functional choice of conduit for vascular graft surgeries, especially for coronary artery bypass grafts; however, the quest to find an ideal vascular substitute remains. We hypothesized that acellular IMA could be an appropriate graft for small-diameter vascular bypasses that could be used in various surgeries including coronary artery bypass grafting. METHODS: We decellularized human IMAs and performed histologic evaluations and scanning electron microscopy to confirm the decellularization process and the preservation of the extracellular matrix...
September 28, 2018: Journal of Thoracic and Cardiovascular Surgery
Abhishek Chakraborty, Cesar Mendoza, Juan Infante, Satinder K Sandhu
Anomalous origin of left coronary artery (LCA) from the right coronary cusp with an intramural course is usually managed with unroofing of the intramural segment. Available literature demonstrates an uneventful course following surgery in most patients. Coronary stenosis following the unroofing procedure treated with percutaneous coronary intervention has not been described in the past. We describe a case where an 11-year-old girl with anomalous origin of the LCA from the right coronary cusp presented with near syncope...
October 20, 2018: Pediatric Cardiology
Y Law, N Tsilimparis, S Aleed, F Rohlffs, N Schofer, E S Debus, G Müller, T Kölbel
INTRODUCTION: Thoracic endovascular aortic repair (TEVAR) with self-expanding endo-graft is increasingly used as a viable treatment option for adult aortic coarctation (AC). METHODS: We hereby reported a 55 years old gentleman with late presentation of AC, treated by a novel strategy with thoracic endograft and in situ laser fenestration for left subclavian artery (LSA) revascularization. RESULTS: AC was incidentally discovered during coronary angiogram as an investigation for his angina pectoris...
October 17, 2018: Annals of Vascular Surgery
Wei-Ting Tseng, Tiao-Lai Huang
BACKGROUND: Patients with psychiatric disorders in critical condition are difficult to treat. In this study, we report on a patient with underlying schizoaffective disorder who developed catatonia, cardiac arrest, and pulmonary embolism, as well as a successful treatment strategy. CASE PRESENTATION: The inpatient is a 41-year-old morbidly obese male with schizoaffective disorder whose clozapine dosage was titrated from 100 mg to 175 mg due to auditory hallucination and agitation...
October 19, 2018: BMC Psychiatry
Catherine T Gunther-Harrington, Kathryn L Phillips, Lance C Visser, Samantha L Fousse, Joshua A Stern
Coronary artery anomalies have been reported in Bulldogs and present an increased risk when performing balloon valvuloplasty. Identification of coronary anomalies has been reported using multidetector-row computed tomographic (MDCT) angiography with electrocardiographic gating. However, the utility of non-electrocardiographic-gated 16-row computed tomographic for MDCT for the identification of coronary artery anatomy or anomalies to the authors' knowledge has not been fully investigated. The purpose of this study was to evaluate the feasibility of non-electrocardiographic-gated computed tomographic (CT) angiography to identify coronary anomalies in Bulldogs with pulmonary valve stenosis...
October 14, 2018: Veterinary Radiology & Ultrasound
Dong Seop Jeong, Woosik Han, Young Tak Lee, Wook Sung Kim, Jinyoung Song, I-Seok Kang, Pyo Won Park
Background: This study aimed to review the long-term clinical outcomes and graft patency of coronary artery bypass grafting (CABG) using arterial grafts in patients with Kawasaki disease (KD) affecting the coronary artery. Methods: Twenty patients with KD who underwent CABG from January 2002 to June 2014 were enrolled. There were 4 male (20%) and 16 female (80%) patients with ages at operation ranging from 2 to 42 years (median, 17.5 years). Our routine operative strategy was off-pump CABG with arterial grafts...
October 15, 2018: Journal of Korean Medical Science
Lucky R Cuenza, Christian Comandante, Ed Gabitoya, Tamara Louise Razon
Coronary artery fistulas are rare congenital anomalies usually discovered incidentally on imaging studies. Coronary artery pseudoaneurysms are unusual complications of coronary artery fistulas, which can be due to atherosclerosis, inflammatory, traumatic or iatrogenic causes. We present a case of a 55 year old female with no known atherosclerotic risk factors, history of trauma or connective tissue disease referred because of recurrent palpitations. Work ups revealed a cardiac mass with an initial assessment of pericardial cyst...
June 2018: Journal of Cardiology Cases
Reham R Haroun, Linda C Chu, Elliot K Fishman
OBJECTIVE: The aim of this study was to determine the prevalence and natural history of coronary ostial aneurysms in Marfan patients with aortic root replacement. METHODS: Thirty-one Marfan patients (mean age, 33.7 ± 11.8 years) who underwent aortic root replacement and postoperative electrocardiogram-gated computed tomographic (CT) angiograms between January 2007 and December 2015 were retrospectively identified. A subset of 15 patients underwent follow-up CT angiograms...
September 24, 2018: Journal of Computer Assisted Tomography
Angel I Y Wu, Kenneth K Lau
Coronary artery aneurysms are rare. We present an unusual case of an isolated coronary artery aneurysm in the obtuse marginal artery detected on a computed tomographic coronary angiogram, which is unlikely to be significant for the patient. A Medline literature search did not find a similar case.
October 2018: Radiology Case Reports
William J Yoon, Paul Crisostomo, Pegge Halandras, Carlos F Bechara, Bernadette Aulivola
BACKGROUND: The use of the Agatston calcium scoring method has been described extensively in the coronary circulation, but to date, it has not been investigated in the extracranial carotid domain. We sought to evaluate this calcium scoring method in its ability to predict carotid plaque vulnerability. METHODS: We retrospectively reviewed all computed tomography angiogram studies of the carotid arteries performed between March 2012 and March 2017 at a single institution...
September 10, 2018: Annals of Vascular Surgery
Francisco Roman, Jay-Sheree Allen, Heather Catherine Wurm, Kathy MacLaughlin
A 62-year-old Caucasian man with past medical history significant for coronary artery disease, status post drug eluting stent to the left anterior descending artery 10 years prior, was admitted for elective total right knee arthroplasty. His intraoperative course was uneventful, and he was discharged on hospital day 2 on aspirin 325 mg twice daily for 6 weeks for venous thromboembolism (VTE) prophylaxis. Three weeks later the patient developed chest pain shortly after an approximately 1-hour flight and presented to a local emergency department where computed tomography angiogram showed pulmonary emboli involving segmental and subsegmental pulmonary arteries bilaterally...
January 2018: Journal of Primary Care & Community Health
M Zeitouni, O Barthelemy, A Redheuil, P Leprince
A 58 year-old man was admitted in our ICU for cardiogenic shock and electrical storm. His medical history was marked by a triple redo valvular surgery complicated by a recurrent aortic pseudoaneurysm of the ascending aorta. Coronary angiogram and heart CT scan diagnosed an extensive anterior myocardial infarction related to an extrinsic compression of the left main stem by this massive and calcified pseudoaneurysm. Angioplasty or new cardiac surgery options were rejected by the heart team. Despite an unusual indication, the patient was registered on the heart transplant list, and underwent it successfully...
August 24, 2018: Annales de Cardiologie et D'angéiologie
Sho Hashimoto, Akihiko Takahashi, Yukio Mizuguchi, Takeshi Yamada, Norimasa Taniguchi, Tetsuya Hata, Shunsuke Nakajima
We aimed to evaluate the impact of tissue characterization for in-stent restenosis (ISR) with optical computed tomography (OCT) during excimer laser coronary angioplasty (ELCA) in the drug-eluting stent (DES) era. The effect of ELCA for ISR according to differences in tissue characteristics is unclear. Fifty-three ISR lesions (7 bare metal stents and 46 drug-eluting stents) were treated with an ELCA catheter. After ELCA, balloon dilatation with either the scoring or non-compliant balloons was conducted. The procedure was completed by applying a drug-coated balloon...
August 22, 2018: Cardiovascular Intervention and Therapeutics
Getu Teressa, Mengru Zhang, Philip Lavenburg, Gregg Cantor, Pamela Noack, Jie Yang, Michael Goyfman, Eric J Feldmann, Javed Butler, Michael Poon
Although the majority of acute chest pain patients are diagnosed with noncardiac chest pain after noninvasive testing, identifying these low-risk patients before testing is challenging. The objective of this study was to validate the coronary artery disease (CAD) consortium models for predicting obstructive CAD and 30-day major adverse cardiovascular events (MACE) in acute chest pain patients considered for coronary computed tomography angiogram, as well as to determine the pretest probability threshold that identifies low-risk patients with <1% MACE...
October 15, 2018: American Journal of Cardiology
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