1/41. Bilateral subclavian steal syndrome through different paths and from different sites--a case report.Cases of cerebro-subclavian steal syndrome have been reported in the medical literature since 1960. This most often occurs on the left side because of the higher rate of involvement of the left subclavian artery in comparison to the other brachiocephalic branches of the aortic arch. With the use of the internal mammory artery as a conduit for coronary artery bypass, in the past three decades increasing numbers of coronary-subclavian steal in addition to the cerebro-subclavian steal have been observed. The authors report a case of bilateral subclavian steal syndrome through both vertebral arteries, the right common carotid artery, and the left internal mammory artery, without significant signs and symptoms of cerebral ischemia or anginal pain.- - - - - - - - - - ranking = 1keywords = angina (Clic here for more details about this article) |
2/41. Successful Wallstent implantation for extensive iatrogenic renal artery dissection in a patient with fibromuscular dysplasia.PURPOSE: To describe a case of renal artery stenosis with fibromuscular dysplasia (FMD) and extensive iatrogenic dissection treated with Wallstent implantation. methods AND RESULTS: An 83-year-old woman with a history of coronary artery disease and hypertension presented at another facility with exertional angina and poorly controlled hypertension. Renal arteriography uncovered a critical right renal artery stenosis with severe FMD. However, angioplasty resulted in extensive dissection of the renal artery, for which the patient was referred to our institution. The renal artery was recanalized via the left brachial approach with restoration of flow using a Wallstent and a Palmaz stent. The patient's blood pressure was controllable after this procedure, and follow-up duplex imaging with flow velocities at 6 months showed patent right renal artery stents. CONCLUSIONS: Owing to its length and flexibility, the Wallstent endoprosthesis was a useful treatment modality in this case of extensive renal artery dissection.- - - - - - - - - - ranking = 1keywords = angina (Clic here for more details about this article) |
3/41. Coronary ostial stenosis complicating coronary arteriography.Coronary ostial stenosis is a cause of angina pectoris and sudden death. It is due mainly to atherosclerosis, syphilis, and iatrogenic disease. The last is of growing importance because of the frequency of coronary arteriography and surgical procedures on the aortic valve. Since both may cause stenosis of the coronary ostia, these procedures raise the topic from an obscure morphologic entity to an important consideration in the treatment of cardiac disease. We describe a case of ostial stenosis that was complicated by coronary arteriography.- - - - - - - - - - ranking = 1keywords = angina (Clic here for more details about this article) |
4/41. Controlling angina. Management options.BACKGROUND: angina pectoris is a common medical problem in the community requiring a multifaceted approach to treatment in order to improve the quality of life and long term prognosis for the patient. OBJECTIVE: To discuss some of the practical aspects of the medical management of patients with stable angina pectoris, including anti ischaemic medications and secondary prevention strategies. DISCUSSION: Decreasing the risk of rapid progression of atherosclerosis in patients with angina is probably the most important factor in long term management. Also, careful use of anti ischaemic and anti platelet medications may prevent further serious cardiac events and improve quality of life.- - - - - - - - - - ranking = 6keywords = angina (Clic here for more details about this article) |
5/41. Percutaneous transluminal angioplasty and stenting of coeliac artery stenosis in the treatment of mesenteric angina: a case report and review of therapeutic options.We report the case of a 72-year-old gentleman with mesenteric angina who was successfully treated with stenting of a coeliac artery stenosis using a Palmaz stent, and review the therapeutic options in the management of mesenteric angina.- - - - - - - - - - ranking = 6keywords = angina (Clic here for more details about this article) |
6/41. Telangiectatic fistula between the conal branch of the left coronary artery and the pulmonary trunk.A rare case of telangiectatic communication between the conal branch of the left coronary artery and the pulmonary trunk in a 50-year-old woman is reported. Unusual features included the presence of clear-cut angina on effort, unstable auscultatory findings and a RSR' pattern in lead V1, probably related to concommitant diffuse coronary atherosclerosis. Ten previously reported cases of the condition are briefly reviewed.- - - - - - - - - - ranking = 1keywords = angina (Clic here for more details about this article) |
7/41. Management of porcelain aorta and calcified great vessels in coronary artery bypass grafting with off-pump and no-touch technology.A 69-year-old woman presented with postinfarct unstable angina and decreased ventricular function secondary to significant left main coronary artery stenosis in combination with total right coronary artery occlusion. We did successful off-pump coronary revascularization in this patient with severely calcified ascending aorta and great vessels, subtotal aortobiiliac stenoses, a history of previous stroke, and right carotid endarterectomy.- - - - - - - - - - ranking = 1keywords = angina (Clic here for more details about this article) |
8/41. Unstable angina associated with coronary arterial calcification in a thalassemia intermedia patient with a pseudoxanthoma elasticum-like syndrome.The coexistence of a pseudoxanthoma elasticum (PXE)-like syndrome in beta-thalassemia and other hemoglobinopathies is a recently established clinical entity that has been observed with a significant frequency and related to some severe, even life-threatening complications. We present here a thalassemia intermedia patient who developed unstable angina in a setting of severe anemia and PXE-related coronary arterial calcification. Besides the clinical significance of this PXE-like syndrome, its acquired nature may introduce some new thoughts regarding the pathogenesis of atherosclerosis.- - - - - - - - - - ranking = 5keywords = angina (Clic here for more details about this article) |
9/41. Two Italian kindreds carrying the Arg136-->Ser mutation of the Apo E gene: development of premature and severe atherosclerosis in the presence of epsilon 2 as second allele.BACKGROUND AND AIMS: Type III hyperlipoproteinemia, or dysbetalipoproteinemia, is commonly associated with apolipoprotein e2 homozygosity (Cys112, Cys158). Apo E2-Christchurch (Arg136-->Ser), a rare mutation of the Apo E gene, located in the receptor-binding domain of the protein, has been found to be associated in the vast majority of cases of dysbetalipoproteinemia. methods AND RESULTS: This is the first report of two Italian kindreds carrying the Arg136-->Ser mutation. One family is a four-generation kindred from Genoa (Liguria, italy) with a high rate of mortality due to coronary artery disease: the proband was a 51-year-old woman with previous myocardial infarction and residual angina, severe carotid atherosclerosis, peripheral arterial vascular disease and arterial hypertension. The other family was identified in Palermo (sicily, italy): the proband was an overweight 62-year-old man with a mixed form of hyperlipidemia. The mutation, which was identified by means of Apo E genotyping followed by direct sequencing, co-segregated with the same haplotype in the two families. CONCLUSIONS: The family histories and clinical examinations of these subjects clearly show that the Apo E Arg136-->Ser variant fully expresses a type III phenotype in association with a second allele coding for Apo E2, and only partially in association with a second allele coding for Apo E4.- - - - - - - - - - ranking = 1keywords = angina (Clic here for more details about this article) |
10/41. Two cases of variant form angina pectoris associated with myocardial bridge--a possible relationship among coronary vasospasm, atherosclerosis and myocardial bridge.Myocardial bridge (MB) is a congenital anomaly of the coronary artery and may occur in 5 to 12% of the human population. However, the mechanism of MB-induced myocardial ischemia is still speculative. We report 2 cases of variant form angina pectoris associated with MB in which myocardial ischemia seemed to be related to the interaction between coronary perfusion and MB. In case 1, electrocardiography during anginal attack at rest showed ST elevation in the inferior leads and MB was observed after percutaneous transluminal coronary angioplasty at the site of the right coronary artery lesion following successful dilatation. In case 2, MB of the left anterior descending coronary was located in the identical portion where coronary vasospasm was induced by intracoronary acetylcholine injection, although ischemia during the spontaneous anginal attack was limited to the inferior area of myocardium. These 2 cases suggest that MB can be, at least in some patients, one of the possible causes of the endothelial damage which seems to be related to coronary vasospasm; this was documented in both cases.- - - - - - - - - - ranking = 7keywords = angina (Clic here for more details about this article) |
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