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Coronary artery dissection

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https://www.readbyqxmd.com/read/28932360/very-late-bioresorbable-scaffold-thrombosis-and-reoccurrence-of-dissection-two-years-later-chronic-total-occlusion-recanalization-of-the-left-anterior-descending-artery
#1
Luigi Di Serafino, Plinio Cirillo, Tullio Niglio, Francesco Borgia, Bruno Trimarco, Giovanni Esposito, Eugenio Stabile
We describe the case of a patient presenting with ST-segment elevation myocardial infarction due to very late scaffold thrombosis. The patient was already admitted for an elective percutaneous recanalization of a chronically occluded left anterior descending artery (LAD). The procedure was performed according the sub-intimal tracking and re-entry (STAR) technique with 4 bioresorbable vascular scaffolds implantation. However, even though the coronary flow was preserved at the end of the procedure, the dissected segment was only partially sealed at the distal segment of the LAD...
August 26, 2017: World Journal of Cardiology
https://www.readbyqxmd.com/read/28927697/aortic-regurgitation-in-acute-type-a-aortic-dissection-a-clinical-classification-for-the-perioperative-echocardiographer-in-the-era-of-the-functional-aortic-annulus
#2
REVIEW
Prakash A Patel, Joseph E Bavaria, Kamrouz Ghadimi, Jacob T Gutsche, Prashanth Vallabhayosula, Hanjo A Ko, Nimesh D Desai, Emily Mackay, Stuart J Weiss, John G T Augoustides
The functional aortic annulus offers a clinical approach for the perioperative echocardiographer to classify the mechanisms of aortic regurgitation in acute type-A dissection. Comprehensive examination of the functional aortic annulus in this setting using transesophageal echocardiography can guide surgical therapy for the aortic root by considering the following important aspects: severity and mechanism of aortic regurgitation, extent of root dissection, and the pattern of coronary artery involvement. The final choice of surgical therapy also should take into account factors, such as patient presentation and surgical experience, to limit mortality and morbidity from this challenging acute aortic syndrome...
June 7, 2017: Journal of Cardiothoracic and Vascular Anesthesia
https://www.readbyqxmd.com/read/28925655/pleuritic-chest-pain-sorting-through-the-differential-diagnosis
#3
Brian V Reamy, Pamela M Williams, Michael Ryan Odom
Pleuritic chest pain is characterized by sudden and intense sharp, stabbing, or burning pain in the chest when inhaling and exhaling. Pulmonary embolism is the most common serious cause, found in 5% to 21% of patients who present to an emergency department with pleuritic chest pain. A validated clinical decision rule for pulmonary embolism should be employed to guide the use of additional tests such as d-dimer assays, ventilation-perfusion scans, or computed tomography angiography. Myocardial infarction, pericarditis, aortic dissection, pneumonia, and pneumothorax are other serious causes that should be ruled out using history and physical examination, electrocardiography, troponin assays, and chest radiography before another diagnosis is made...
September 1, 2017: American Family Physician
https://www.readbyqxmd.com/read/28924604/is-it-possible-to-perform-gastric-endoscopic-submucosal-dissection-without-discontinuation-of-a-single-antiplatelet-of-thienopyridine-derivatives
#4
Satoshi Ono, Masahiro Myojo, Hideaki Harada, Kunihiro Tsuji, Daisuke Murakami, Satoshi Suehiro, Hisashi Doyama, Jiro Ando, Itaru Saito, Mitsuhiro Fujishiro, Issei Komuro, Kazuhiko Koike
BACKGROUND AND STUDY AIMS : Combined use of thienopyridine derivatives and other antithrombotic agents is reported to be a risk factor for postoperative bleeding after gastric endoscopic submucosal dissection (ESD). However, risk associated with a single thienopyridine derivative has not been evaluated. In this study, we aimed to evaluate bleeding risks of gastric ESD without discontinuation of a single thienopyridine derivative agent. PATIENTS AND METHODS:  This multicenter, prospective, observational cohort study included patients who had undergone implantation of a coronary artery stent and who were taking a combination of aspirin antiplatelet therapy and a thienopyridine derivative agent...
September 2017: Endoscopy International Open
https://www.readbyqxmd.com/read/28917517/delayed-left-main-coronary-artery-obstruction-after-radiofrequency-induced-coronary-dissection-and-spasm-insights-from-optical-frequency-domain-imaging-and-intravascular-ultrasound-imaging
#5
Umihiko Kaneko, Yoshifumi Kashima, Daitaro Kannno, Takayuki Kitai, Hiroshi Taniguchi, Kikuya Uno, Tsutomu Fujita
No abstract text is available yet for this article.
September 6, 2017: JACC. Cardiovascular Interventions
https://www.readbyqxmd.com/read/28913687/non-atherosclerotic-vascular-disease-in-women
#6
REVIEW
Lee Joseph, Esther S H Kim
Takayasu arteritis, fibromuscular dysplasia (FMD), spontaneous arterial dissection, Raynaud's phenomenon, and chilblains are vascular conditions that are associated with an increased predisposition in women and are often underdiagnosed. Takayasu arteritis has an incidence rate of 2.6 cases per million individuals per year in the USA and predominantly affects women of childbearing age. HLA-B5 genetic locus is linked with Takayasu arteritis susceptibility. Methods to determine active disease are limiting; currently utilized clinical and imaging findings and laboratory tests are of limited value for this purpose...
September 14, 2017: Current Treatment Options in Cardiovascular Medicine
https://www.readbyqxmd.com/read/28891472/characteristics-of-extension-and-de-novo-recurrent-spontaneous-coronary-artery-dissection
#7
Anthony Main, Andrew Starovoytov, Amir Sabbaghan, Eve Aymong, G B John Mancini, Jacqueline Saw
AIMS: Spontaneous coronary artery dissection (SCAD) is an under-recognized and important cause of myocardial infarction in young women. Recurrent SCAD is frequent but poorly understood. We aim to explore the clinical and angiographic characteristics, and outcomes of recurrent SCAD. METHODS AND RESULTS: Patients with SCAD extension or recurrence prospectively followed at Vancouver General Hospital were included in this retrospective study. SCAD diagnosis was confirmed by 2 experienced cardiologists...
September 12, 2017: EuroIntervention
https://www.readbyqxmd.com/read/28886389/localized-constrictive-pericarditis-compressing-and-obstructing-the-right-ventricular-inflow-tract-due-to-a-giant-anterior-calcified-cardiac-mass-a-case-report
#8
Klodian Krakulli, Edvin Prifti, Hortensa Gjergo, Endri Hasimi
INTRODUCTION: Localized pericardial constriction is a rare form of constrictive pericarditis CP. Depending on the CP location, clinical presentation may be variable, including compression and obstruction of right ventricular inflow tract(RVIT), coronary obstruction, or pulmonary stenosis. CASE PRESENTATION: A 72-year-old man presented a 2-year history of dyspnea and atrial fibrillation. A contrast enhanced angio computerized tomography clearly demonstrated a large spherical mass about 11×9×4cm in the anterior pericardium, presenting as a mediastinal tumor causing compression and obstruction of the RVIT...
August 25, 2017: International Journal of Surgery Case Reports
https://www.readbyqxmd.com/read/28884028/spontaneous-coronary-artery-dissection-a-rare-manifestation-of-alport-syndrome
#9
Amornpol Anuwatworn, Prince Sethi, Kelly Steffen, Orvar Jonsson, Marian Petrasko
Alport syndrome (AS) is a genetic disorder due to inheritance of genetic mutations which lead to production of abnormal type IV collagen. AS has been associated with renal, auditory, and ocular diseases due to the presence of abnormal alpha chains of type IV collagen in the glomerulus, cochlea, cornea, lens, and retina. The resulting disorder includes hereditary nephritis, corneal opacities, anterior lenticonus, fleck retinopathy, temporal retinal thinning, and sensorineural deafness. Aortic and aortic valve pathologies have been described as extrarenal manifestations of AS in multiple case reports...
2017: Case Reports in Cardiology
https://www.readbyqxmd.com/read/28846541/a-randomized-comparison-of-incidence-of-radial-artery-occlusion-and-symptomatic-radial-artery-spasm-associated-with-elective-transradial-coronary-intervention-using-6-5-fr-sheathless-eaucath-guiding-catheter-vs-6-0-fr-glidesheath-slender
#10
Kazunori Horie, Norio Tada, Tsuyoshi Isawa, Takashi Matsumoto, Masataka Taguri, Shigeaki Kato, Taku Honda, Tatsushi Ootomo, Naoto Inoue
AIMS: To compare incidences of radial artery occlusion (RAO) and spasm (RAS) associated with transradial coronary intervention (TRI) using 6.5-Fr Sheathless hydrophilic-coated guide catheter (SH-GC) vs. 6.0-Fr Glidesheath Slender (GSS). METHODS AND RESULTS: We conducted an open-label, single-centre, randomized study to compare radial complications in 600 consecutive patients undergoing elective TRI using 6.5-Fr SH-GC (n=300) or 6.0-Fr GSS (n=300) between 2015 and 2016...
August 29, 2017: EuroIntervention
https://www.readbyqxmd.com/read/28844446/recurrent-unexpected-myocardial-infarction-in-a-young-woman-insights-on-spontaneous-coronary-artery-dissection-and-multimodality-imaging
#11
Vincent Roule, Katrien Blanchart, Adrien Lemaitre, Mathieu Bignon, Rémi Sabatier, Farzin Beygui
A 45-year-old female was admitted for a transient anterior ST-segment elevation myocardial infarction (STEMI). Coronary angiogram showed a diffuse severe stenosis of the distal left anterior descending (LAD) coronary artery, which was managed medically. Three years later, a recurrent transient anterior STEMI led to a second coronary angiography showing a tubular stenosis of the mid-LAD with normal distal coronary bed. An optical coherence tomography (OCT) revealed a spontaneous coronary artery dissection (SCAD) with an extensive compressive mural hematoma without any intimal tear...
July 19, 2017: Cardiovascular Revascularization Medicine: Including Molecular Interventions
https://www.readbyqxmd.com/read/28844282/brugada-phenocopy-during-right-coronary-artery-dissection
#12
Aldo G Carrizo, Anahi Goransky, Adrian Baranchuk
CASE PRESENTATION: A 68-year-old female presented with non-ST-segment elevation myocardial infarction, and urgency coronary angiography was performed. The procedure was complicated with right coronary artery dissection leading to type-1 Brugada ECG pattern. DISCUSSION: Brugada phenocopies (BrP) are clinical entities that present with electrocardiograms identical to those found in Brugada Syndrome (BrS) but are the result of different medical conditions. This report provides evidence that atypical causes of myocardial ischemia may induce BrP...
July 12, 2017: Journal of Electrocardiology
https://www.readbyqxmd.com/read/28838365/insights-into-spontaneous-coronary%C3%A2-artery%C3%A2-dissection-can-recurrence-be-prevented
#13
EDITORIAL
Marysia S Tweet, Jeffrey W Olin
No abstract text is available yet for this article.
August 29, 2017: Journal of the American College of Cardiology
https://www.readbyqxmd.com/read/28838364/spontaneous-coronary-artery-dissection-clinical-outcomes-and-risk-of-recurrence
#14
Jacqueline Saw, Karin Humphries, Eve Aymong, Tara Sedlak, Roshan Prakash, Andrew Starovoytov, G B John Mancini
BACKGROUND: Spontaneous coronary artery dissection (SCAD) is underdiagnosed and an important cause of myocardial infarction (MI), especially in young women. Long-term cardiovascular outcomes, including recurrent SCAD, are inadequately reported. OBJECTIVES: This study sought to describe the acute and long-term cardiovascular outcomes and assess the predictors of recurrent SCAD. METHODS: Nonatherosclerotic SCAD patients were prospectively followed at Vancouver General Hospital systematically to ascertain baseline, predisposing and precipitating stressors, angiographic features, revascularization, use of medication, and in-hospital and long-term cardiovascular events...
August 29, 2017: Journal of the American College of Cardiology
https://www.readbyqxmd.com/read/28826896/incidence-treatment-and-outcomes-of-coronary-perforation-during-chronic-total-occlusion-percutaneous-coronary-intervention
#15
Barbara Anna Danek, Aris Karatasakis, Peter Tajti, Yader Sandoval, Dimitri Karmpaliotis, Khaldoon Alaswad, Farouc Jaffer, Robert W Yeh, David E Kandzari, Nicholas J Lembo, Mitul P Patel, Ehtisham Mahmud, James W Choi, Anthony H Doing, William L Lombardi, R Michael Wyman, Catalin Toma, Santiago Garcia, Jeffrey W Moses, Ajay J Kirtane, Raja Hatem, Ziad A Ali, Manish Parikh, Judit Karacsonyi, Bavana V Rangan, Houman Khalili, M Nicholas Burke, Subhash Banerjee, Emmanouil S Brilakis
Coronary perforation is a potential complication of chronic total occlusion (CTO) percutaneous coronary intervention (PCI). We analyzed 2,097 CTO PCIs performed in 2,049 patients from 2012 to 2017. Patient age was 65 ± 10 years, 85% were men, and 36% had prior coronary artery bypass graft surgery. Technical and procedural success were 88% and 87%, respectively. A major periprocedural adverse cardiovascular event occurred in 2.6%. Coronary perforation occurred in 85 patients (4.1%); The frequency of Ellis class 1, 2, and 3 perforations was 21%, 26%, and 52%, respectively...
July 24, 2017: American Journal of Cardiology
https://www.readbyqxmd.com/read/28818859/renal-denervation-suppresses-coronary-hyperconstricting-responses-after-drug-eluting-stent-implantation-in-pigs-in-vivo-through-the-kidney-brain-heart-axis
#16
Hironori Uzuka, Yasuharu Matsumoto, Kensuke Nishimiya, Kazuma Ohyama, Hideaki Suzuki, Hirokazu Amamizu, Susumu Morosawa, Michinori Hirano, Tomohiko Shindo, Yoku Kikuchi, Kiyotaka Hao, Takashi Shiroto, Kenta Ito, Jun Takahashi, Koji Fukuda, Satoshi Miyata, Yoshihito Funaki, Hatsue Ishibashi-Ueda, Satoshi Yasuda, Hiroaki Shimokawa
OBJECTIVE: Drug-eluting stent-induced coronary hyperconstricting responses remain an important issue. The adventitia harbors a variety of components that potently modulate vascular tone, including sympathetic nerve fibers (SNF) and vasa vasorum. Catheter-based renal denervation (RDN) inhibits sympathetic nerve activity. We, thus, examined whether RDN suppresses drug-eluting stent-induced coronary hyperconstricting responses, and if so, what mechanisms are involved. APPROACH AND RESULTS: Protocol 1: pigs implanted with everolimus-eluting stents into the left coronary arteries underwent coronary angiography at 1 month after implantation for assessment of coronary vasomotion and adventitial SNF formation...
August 17, 2017: Arteriosclerosis, Thrombosis, and Vascular Biology
https://www.readbyqxmd.com/read/28818410/optical-coherence-tomography-guided-percutaneous-coronary-intervention
#17
REVIEW
Francis J Ha, Joel P Giblett, Nitesh Nerlekar, James D Cameron, Ian T Meredith, Nick E J West, Adam J Brown
Optical coherence tomography (OCT) is an increasingly available intracoronary imaging modality that provides high-resolution imaging of coronary arteries. Its fundamental reliance on the emission and reflection of light enables rapid data acquisition without compromise of image resolution. As such, OCT can inform operators planning percutaneous coronary intervention (PCI) by accurately defining luminal geometry and detailing plaque composition. Following PCI, OCT imaging delivers a thorough assessment of the treated arterial segment and can identify specific features not always visible on alternate imaging modalities, including stent edge-related dissection, plaque tissue prolapse, incomplete stent apposition and the presence of intra-coronary thrombus...
August 4, 2017: Heart, Lung & Circulation
https://www.readbyqxmd.com/read/28815187/a-rare-presentation-of-fibromuscular-dysplasia-postpartum-vascular-catastrophe-and-brief-literature-review
#18
Fatima Khan, Ali Raza Ghani, Larami Mackenzie, Ashwin Matthew, Usman Sarwar, Bruce Klugherz
Spontaneous coronary artery dissection is a very rare cause of acute coronary syndromes and can be life threatening given the rarity of the condition. It should be part of differentials in young females presenting with acute coronary syndromes without routine risk factors for coronary artery disease, especially before, during, and after pregnancy. It is closely associated with fibromuscular dysplasia and management can be very challenging at times. We present a case of spontaneous coronary artery dissection presenting with recurrent ST segment elevation myocardial infarction in association with fibromuscular dysplasia...
July 2017: Journal of Investigative Medicine High Impact Case Reports
https://www.readbyqxmd.com/read/28814587/a-case-of-cardiopulmonary-arrest-due-to-spontaneous-coronary-artery-dissection-in-a-pregnant-woman
#19
Emiko Ejima, Yoshinobu Murasato
We present the case of a young pregnant woman with cardiopulmonary arrest due to acute coronary syndrome. Emergent coronary angiography (CAG) and intravascular ultrasound (IVUS) showed extensive coronary artery dissection in the left anterior descending artery, which was treated with primary percutaneous coronary intervention. After managing the heart failure and disseminated intravascular coagulation, a dead fetus was delivered via caesarean section 4 days after admission to the hospital. Follow-up CAG and IVUS at 18 months showed persistent dissection in the non-stented site; hence, another stent was implanted...
August 16, 2017: BMJ Case Reports
https://www.readbyqxmd.com/read/28804589/spontaneous-coronary-artery-dissection-an-under-recognized-cause-of-acute-coronary-syndromes
#20
Hanan Al Naabi, Hatim Al Lawati
Spontaneous coronary artery dissection (SCAD) is a rare condition that is often underdiagnosed given limitations of conventional cineangiography. In addition to the diagnostic challenge, the condition poses a major therapeutic dilemma given paucity of literature to guide management. We report the case of a 55-year-old woman, who presented with acute coronary syndrome. Coronary angiography at the time of the index hospitalization revealed type 2 SCAD. She was managed conservatively. Repeat coronary angiography three months later showed complete resolution of the previously noted dissection...
July 2017: Oman Medical Journal
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