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ct coronary angiogram

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...
July 17, 2018: American Journal of Cardiology
Rohan Poulter, David A Wood, Andrew Starovoytov, Stephanie Smith, Mehran Chitsaz, John Mayo
BACKGROUND: The aim of this study was to develop and describe percutaneous coronary angiographic techniques to create a porcine model of acute coronary stenosis with methacrylate plugs that can by assessed using fractional flow reserve (FFR), invasive coronary angiography and coronary computed tomographic (CT) perfusion imaging without introducing artefacts associated with surgical models. METHODS: Following animal care and institutional approval and using percutaneous coronary catheterisation techniques within an animal laboratory we introduced precision drilled methacrylate plugs into one of the three main coronary arteries of 10 experimental female pigs...
July 11, 2018: Heart, Lung & Circulation
Gokulakrishnan Mohan, Srinivas Kalyanaraman, Sivakumar Ramakrishnan, Sanjay Theodore
Congenital Bochdalek diaphragmatic hernia (DH) is often diagnosed incidentally in adulthood. It is recommended that all cases of DH be repaired immediately at diagnosis since acute presentation after the complications have already developed has higher morbidity and mortality. A 47-year-old male presented with Grade III angina and dyspnea. A routine chest radiograph revealed bowel shadows in the right thorax, and subsequent computerized tomography (CT) scan confirmed the same. Coronary angiogram revealed coronary artery disease which needed surgery...
July 2018: Annals of Cardiac Anaesthesia
Shintaro Katahira, Katsuhiko Oda, Koki Ito, Goro Takahashi, Susumu Nagamine
An anomalous aortic origin of coronary artery is a cause of sudden death in young people. We report a surgical case of an anomalous aortic origin of the left coronary artery. A 16-year-old man with chest pain, which occurred while playing football, was taken in an ambulance. Electrocardiogram (ECG) revealed an ST-segment elevation in V1-V5. We performed coronary angiogram (CAG) and detected the anomalous aortic origin of left anterior descending artery. The computer tomography( CT) angiography revealed the intramural pathway of the left coronary artery...
June 2018: Kyobu Geka. the Japanese Journal of Thoracic Surgery
Amornpol Anuwatworn, Pratima Karta, Jimmy Yee, Shenjing Li, Vishesh Kumar, Kelly Steffen
There are many variations of coronary anatomy encountered during coronary angiogram. Anatomy demonstrating a single coronary artery is a rare congenital coronary artery anomaly. The entire heart is supplied solely by a coronary artery with single coronary ostium. We present a rare case of single coronary artery arising from the right sinus of Valsalva. The patient had presented with atypical chest pain and a stress test was performed, which was abnormal. We proceeded with coronary angiography which showed a common ostium of the right and left coronary artery coming from the right coronary cusp...
March 2018: South Dakota Medicine: the Journal of the South Dakota State Medical Association
Chloe Grace Meyer, Thomas Paul Vacek, Mohammed Abdulrazzaq, Ravi Gurujal, Analkumar Parikh
Although rare, usually asymptomatic, and without concurrent disease, dual left anterior descending arteries (LAD) poses great challenges. We describe a 55-year-old male with no history of coronary disease, who presented with worsening substernal chest pain with exertion, and was ruled out for myocardial infarction. On left heart catheterization and subsequent computed tomography angiogram, he was determined to have a dual LAD with a long LAD emerging from the right coronary artery. Moreover, this long LAD gave collaterals to a native long diagonal that ran parallel to this vessel from the left system and was chronically occluded...
May 2018: Oxford Medical Case Reports
Hans David Huang, William L Lombardi, Zachary Louis Steinberg
CLINICAL INTRODUCTION: A man in his early 30s with remote history of a febrile rash as a toddler presented to the emergency room following an out-of-hospital cardiac arrest while riding his bicycle. He received bystander cardiopulmonary resuscitation and one shock from an automatic external defibrillator, successfully restoring sinus rhythm. On arrival, he was haemodynamically stable without ECG evidence of ST segment changes to suggest active ischaemia, and an initial troponin I was mildly elevated at 0...
June 22, 2018: Heart: Official Journal of the British Cardiac Society
Richard C Cook, Anthony Y Fung, Edward D Percy, John R Mayo
OBJECTIVE: Robotically assisted minimally invasive direct coronary artery bypass is an alternative to sternotomy-based surgery in properly selected patients. Identifying the left anterior descending artery when it is deep in the epicardial fat can be particularly challenging through a 5- to 6-cm mini-thoracotomy incision. The objective of this study was to evaluate a technique for predicting conversion to sternotomy or complicated left anterior descending artery anastomosis using preoperative cardiac-gated computed tomography angiograms...
May 2018: Innovations: Technology and Techniques in Cardiothoracic and Vascular Surgery
Jennifer Sweeney, Nainesh Parikh
Left-sided inferior vena cava (IVC) is the second most common anatomical anomaly of the IVC. We report a drainage pattern of the left IVC into a left duplicated superior vena cava (SVC) diagnosed during IVC filter placement consultation. The patient was a 66-year-old man with symptomatic hematuria caused by bladder cancer diagnosed with IVC thrombus and a left IVC found on a staging computed tomography urogram. The patient underwent computed tomography pulmonary angiogram, which ruled out pulmonary embolism, but demonstrated hemiazygous continuation of the left IVC above the diaphragm to meet a persistent left SVC (prevalence approximately 0...
April 2018: Radiology Case Reports
Amanda Grant-Orser, Brennan Ballantyne, Wael Haddara
A 68-year-old male presented to the emergency department with retrosternal chest pain, presyncope, and then a pulseless electrical activity cardiac arrest. An ECG prior to his arrest revealed ST elevations in leads V1-V3, Q waves in lead V2, and reciprocal ST depressions in the lateral and inferior leads. He received thrombolytic therapy for a presumptive diagnosis of ST elevation myocardial infarction. Return of spontaneous circulation was achieved and he underwent a coronary angiogram. No critical disease was found and his left ventriculogram showed normal contraction...
2018: Case Reports in Critical Care
Mette Sørensen Resen, Mai Bang Poulsen, Karsten Overgaard, Rune Skovgaard Rasmussen, Anne Merete Boas Soja, Brian Nilsson, Mariana Obreja Kristensen, Christina Kruuse, Peter Sommer Ulriksen
Objective Transoesophageal echocardiography (TEE) is the gold standard for the detection of cardiac emboli sources in ischaemic stroke patients, but new computed tomography (CT) scanners are able to visualize the heart. This pilot study aimed to compare findings on TEE with combined cardiovascular scan and cerebral CT angiography in cryptogenic ischaemic stroke patients. Methods This pilot study enrolled patients with cryptogenic ischaemic stroke who underwent a combined cardiovascular and cerebral CT angiography scan and a TEE examination, which were interpreted in a blinded manner...
January 1, 2018: Journal of International Medical Research
Muhammad Hashim Kalwar, Jawaid Akbar Sial, Tahir Saghir, Nadeem Hassan Rizvi, Nadeem Qamar
Iatrogenic aortic dissection caused by primary percutaneous coronary intervention (PCI) is a rare but potentially fatal complication; therefore prompt recognition of this life-threatening condition is crucial. We present herein a case of a 70-year-old lady who underwent primary PCI for transmural myocardial infarction of left anterior descending artery territory. Manipulation of the extra backup (EBU) guiding catheter during an attempt to cannulate the left system resulted in an aortic dissection. The patient was managed conservatively with strict monitoring in the coronary care unit (CCU), and underwent serial evaluation with non-invasive imaging studies including a computed tomography angiography (CTA)...
April 2018: JPMA. the Journal of the Pakistan Medical Association
Firas Al-Janabi, Regina Mammen, Grigoris Karamasis, John Davies, Thomas Keeble
BACKGROUND: An unusual case of typical angina which occurred on a long haul flight is presented. This case is notable as this was the index presentation, with no previous symptoms prior to this. Physiological changes at altitude can be marked, and include hypoxia, tachycardia and an increase in cardiac output. These changes were enough to expose underlying angina in our patient. CASE PRESENTATION: A 68 year old man presented with typical cardiac chest pain on a long haul flight...
April 5, 2018: BMC Cardiovascular Disorders
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
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
Nicholas Chan, Brian M Yuen, Ji Yang, Stuart L Cohen, Loukas Boutis, John N Makaryus
A 57-year-old male former smoker presented to the Emergency Department (ED) with blurry vision, headache, and generalized weakness. He was hypoxic on room air and ECG showed sinus tachycardia. A CT pulmonary angiogram was ordered in the ED and revealed no pulmonary embolism but incidentally noted a likely significant stenosis in the proximal LAD. Subsequent cardiac catheterization revealed a 90% stenotic lesion with percutaneous coronary intervention leading to symptom resolution. Unlike coronary CTA, CTPA is performed with non-ECG gated helical scanning and generates motion artifacts associated with myocardial contraction...
July 2018: American Journal of Emergency Medicine
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...
May 2018: Radiographics: a Review Publication of the Radiological Society of North America, Inc
Philippa Howlett, Jane K Cleal, Huihai Wu, Nikunj Shah, Alex Horton, Nick Curzen, Michael Mahmoudi
Objective: MicroRNAs (miRNAs) may serve as potential biomarkers in a variety of pathologies. The aim of this study was to determine whether miRNAs could serve as blood-based markers of isolated coronary artery calcification (CAC) defined as CAC in the absence of an underlying metabolic abnormality. Methods: 24 age-matched and sex-matched patients who had been referred for elective CT coronary calcium score and angiography as part of investigation for cardiac chest pain were recruited...
2018: Open Heart
Jamie K Harrington, Warren A Zuckerman, Anjali Chelliah
If coronary artery sequelae are the only suggestive signs of previous Kawasaki disease, the diagnosis may easily be missed. We describe a rare case of a child with severe occlusive coronary disease likely owing to missed Kawasaki disease. This diagnosis was not initially considered given the age and absence of suggestive history. Careful echocardiographic assessment and low-radiation coronary CT angiogram resulted in successful diagnosis and treatment.
May 2018: Cardiology in the Young
Ansgar Adams, Waldemar Bojara, Klaus Schunk
Background: A study was conducted as to whether the early diagnosis of coronary heart disease in asymptomatic subjects with advanced atherosclerosis of the carotid artery which additionally shows at least one risk factor is successful using ultrasound technology. Methods: Within the scope of an occupational screening program using subjects from diverse employment sectors, people were given the opportunity to determine their risk of heart attack. During the study the total plaque area (TPA), the maximum plaque thickness in the carotid artery and the PROCAM-Scores of 3,748 healthy men and 2,260 healthy women between the ages of 20 and 64 years were determined...
February 2018: Cardiology Research
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