1/481. Coronary dissection and myocardial infarction following blunt chest trauma.myocardial infarction (MI) following blunt chest trauma is rarely diagnosed because the ensuing cardiac pain is commonly attributed to contused myocardium or the traumatic injuries in the local chest wall. There are only scattered reports on the coronary pathology associated with MI secondary to blunt chest trauma. Because differentiation of the pathology is difficult but important, we report here three cases of acute anterior MI secondary to coronary dissection following blunt chest trauma. Coronary dissection was demonstrated by coronary angiography. Two of the patients had intimal tears at the proximal left anterior descending artery (LAD) with normal flow, and the other patient had nearly total occlusion of the LAD associated with filling defects probably caused by an intracoronary thrombus. All three patients received conservative treatment without major complications and remained free from angina or heart failure throughout a 5-year follow-up period. In order to exclude associated MI in cases of blunt chest trauma, electrocardiography is necessary, and coronary angiography may be indicated to demonstrate coronary arterial pathology. dissection of the coronary artery with subsequent thrombus formation is one of the possible pathophysiologic mechanisms of MI following blunt chest trauma.- - - - - - - - - - ranking = 1keywords = coronary (Clic here for more details about this article) |
2/481. Asymptomatic dissection of the ascending aorta: diagnosis by transesophageal echocardiography.A young man with marfanoid habitus underwent transesophageal echocardiography to evaluate an aortic root abnormality visualized on transthoracic echocardiography. Transesophageal echo demonstrated a type A aortic dissection traversing across the right sinus of valsalva but not involving the aortic valve, right coronary artery, or pericardial sac. The aorta was not dilated. This is apparently the first reported case of an asymptomatic and uncomplicated aortic dissection localized to the sinus of valsalva.- - - - - - - - - - ranking = 0.14285714285714keywords = coronary (Clic here for more details about this article) |
3/481. Pseudo-dissection in percutaneous transluminal coronary angioplasty.Percutaneous transluminal coronary angioplasty (PTCA) is a well-established and effective treatment modality for significant coronary artery disease. Because it enlarges the arterial lumen by plaque disruption, minor wall dissection is not infrequent. Complex dissections are, however, uncommon but may lead to acute vessel closure with its attendant major clinical morbidity and mortality. We describe here a case of pseudo-dissection and its potential for misinterpretation and subsequent inappropriate management.- - - - - - - - - - ranking = 0.85714285714286keywords = coronary (Clic here for more details about this article) |
4/481. Spontaneous coronary arterial dissection causing acute myocardial infarction.We report the case of a middle-aged female who presented with an acute inferior myocardial infarction treated with intravenous thrombolytics. Immediate coronary angiography demonstrated the presence of a spiral dissection and a large thrombus. After 1 week of anticoagulation the thrombus had resolved, but a large spiral dissection persisted. This was confirmed by intracoronary ultrasound. We then review the literature on spontaneous coronary arterial dissection.- - - - - - - - - - ranking = 1keywords = coronary (Clic here for more details about this article) |
5/481. Healing of the intimal dissection of the internal thoracic artery graft.We report healing of the intimal dissection of an internal thoracic artery graft. Triple coronary artery bypass grafting was performed using left internal thoracic artery and saphenous vein grafts. One month after operation, the intimal dissection of the internal thoracic artery graft was clearly visible by coronary angiography; however, after 1 year of only medical treatment consisting of warfarin, ticlopidine, and nitrate, the intimal dissection was undetectable by coronary angiography.- - - - - - - - - - ranking = 0.42857142857143keywords = coronary (Clic here for more details about this article) |
6/481. Anomalous coronary artery, aortic dissection, and acute myocardial infarction.The combination of acute coronary occlusion and aortic dissection because of involvement of one or other coronary vessels in the dissection flap is uncommon. Furthermore, the occurrence of an anomalous coronary artery and its involvement in acute myocardial infarction is even more uncommon. We describe a patient with acute myocardial infarction in whom an acute aortic dissection involved the ostium of an anomalous circumflex artery.- - - - - - - - - - ranking = 1keywords = coronary (Clic here for more details about this article) |
7/481. Surgical treatment for ruptured vertebral artery dissecting aneurysms.We analyze 20 cases of ruptured vertebral artery dissecting aneurysms and discuss the best choices for the surgical procedure. The preoperative Hunt and Kosnik grade was I in nine cases, Ia in four cases, II in three cases, III in three cases, and IV in one case. Rebleeding occurred in six cases, in four cases within 24 hours after the initial bleeding, and in every case within 6 days. In two cases surgery was performed within 3 days after the initial bleeding, in two cases within 4 to 7 days, in 16 cases after more than 7 days. A total of 22 operations were performed in the 20 patients (coating in 12, trapping in 6, proximal clipping of the vertebral artery in 2, clipping of the bleeding point in 2). A case of proximal clipping rebled 32 days after the operation and subsequently died. Both cases of clipping of the bleeding point were reoperated because of rebleeding and a slipped clip, respectively. All cases in which trapping or coating was performed resulted in a good outcome. Trapping is the most reliable method of preventing rebleeding. Coating or proximal clipping is an optional procedure, but cannot always prevent rebleeding because of the continuing circulation.- - - - - - - - - - ranking = 0.0027579589984961keywords = circulation (Clic here for more details about this article) |
8/481. Traumatic dissection of the common carotid artery after blunt injury to the neck.BACKGROUND: Occlusive lesions of the common carotid artery (CCA) resulting from blunt injury are extremely rare, and their clinicopathologic and therapeutic features have not yet been clarified. OBJECTIVES AND RESULTS: Five patients with occlusive lesions of the CCA developed neurologic deficits at 1.5 hours to 10 years after blunt neck injury. Lesions included two complete occlusions, one severe stenosis, and two segmental intimal dissections of the CCA. In the two patients with CCA occlusion, bypass surgery was performed using a Dacron graft between the ipsilateral subclavian artery and the carotid bifurcation. In the remaining three patients, the involved segments were replaced with a Dacron graft. Surgical specimens from the early posttraumatic period revealed intimal tears with mural thrombosis and/or subintimal hematomas and those from the later period showed myointimal hyperplasia or fibrotic organization. CONCLUSION: Traumatic occlusive lesions of the CCA tend to evolve from intimal dissections to severe stenoses or occlusion, compromising cerebral circulation. The involved CCA can be diagnosed early by B-mode Doppler sonography and successfully reconstructed using a Dacron graft.- - - - - - - - - - ranking = 0.0027579589984961keywords = circulation (Clic here for more details about this article) |
9/481. Spontaneous coronary artery dissection: favorable outcome illustrated by angiographic data.Spontaneous coronary artery dissection is a rare cause of acute myocardial infarction. It typically occurs in young women receiving oral contraceptive therapy or during the peripartum period. In the case presented here, spontaneous complete healing at angiography and the favorable outcome may support the role of conservative treatment in such patients.- - - - - - - - - - ranking = 0.71428571428571keywords = coronary (Clic here for more details about this article) |
10/481. Coronary dissection and thrombosis associated with exercise testing three months after successful coronary stenting.exercise testing is commonly performed to assess the functional result of coronary revascularization procedures and is usually not associated with any complications. However, this report documents a rare case of coronary dissection and thrombosis, which resulted in an acute myocardial infarction, in a patient who underwent stress testing 3 months following successful coronary stent implantation.- - - - - - - - - - ranking = 1keywords = coronary (Clic here for more details about this article) |
| | Next -> |