1/60. Myocardial infarction in patients with systemic lupus erythematosus with normal findings from coronary arteriography and without coronary vasculitis--case reports.The authors present the cases of two young patients, a man and a woman, who presented with myocardial infarction, in the absence of ischemic heart disease or stenosis of the coronary arteries. The woman was known to have systemic lupus erythematosus (SLE) for the past 3 years (the immunoglobulin m [IgM] anticardiolipins antibodies were positive), without a history of coronary risk factors. Suddenly she presented with acute chest pain on rest that lasted 4 hours and culminated in anterior wall myocardial infarction. She was admitted to the coronary care unit, where no thrombolysis was given. She did not have echocardiographic evidence of Libman-Sacks endocarditis, but myocardial infarction was evident at the electrocardiogram (ECG). The young man had SLE (the IgM anticardiolipins were absent, but he was positive for lupus anticoagulant antibodies), he was hyperlipidemic, was a moderate smoker and moderately obese, and had no history of ischemic heart disease. He suddenly presented with an acute myocardial infarction documented by ECG, enzymes, and gammagraphy. In both patients, coronary angiography findings were normal and myocardial biopsy did not show evidence of arteritis. The relevance of these cases is the rare association of ischemic heart disease in SLE, with normal coronary arteries and without evidence of arteritis or verrucous endocarditis.- - - - - - - - - - ranking = 1keywords = coronary (Clic here for more details about this article) |
2/60. Staphylococcal coronary arteritis as a complication of septicemia.We describe a case of staphylococcal coronary arteritis in the setting of sepsis due to arteriovenous fistula and dialysis catheter infection. The left circumflex coronary artery was the only vessel involved. The patient was a 77-year-old, insulin-dependent diabetic man with chronic renal failure. The immunosuppressed state in diabetes with subsequent septicemia may have facilitated a large number of bacteria to lodge in the atheromatous plaque of the coronary artery. We briefly review previously reported cases and suggest that bacterial arteritis may be an underrecognized cause of acute coronary occlusion.- - - - - - - - - - ranking = 0.61538461538462keywords = coronary (Clic here for more details about this article) |
3/60. Unusual complications in an inflammatory abdominal aortic aneurysm.An unusual case of an inflammatory abdominal aortic aneurysm (IAAA) associated with coronary aneurysms and pathological fracture of the adjacent lumbar vertebrae. The associated coronary lesions in cases of IAAA are usually occlusions. In the present case, it was concluded that a possible cause of the coronary aneurysm was coronary arteritis and the etiology of the pathological fracture of the lumbar vertebrae was occlusion of the lumbar penetrating arteries due to vasculitis resulting in aseptic necrosis. Inflammatory AAA can be associated with aneurysms in addition to occlusive disease in systemic arteries. The preoperative evaluation of systemic arterial lesions and the function of systemic organs is essential.- - - - - - - - - - ranking = 0.30769230769231keywords = coronary (Clic here for more details about this article) |
4/60. radiation arteritis following treatment for Wilms' tumor: an unusual case of weight loss.Wilms' tumor is the most common pediatric primary renal cancer and is highly responsive to surgery and chemotherapy. The role of radiotherapy has evolved in the last three decades from the use of stepwise incremental doses in all patients to the current concept of added radiotherapy in advanced cases or in those with unfavorable pathology. To the authors' knowledge, this is the first case of a young woman with prior history of Wilms' tumor and significant weight loss due to radiation arteritis involving the abdominal vasculature. A 31-year-old woman presented with a history of weight loss and severe malnutrition. An angiogram revealed that the aorta was occluded below the renal artery. The celiac artery and the superior mesenteric artery were occluded at the origin, and large intercostal collaterals reconstituted the pelvic circulation. She was initially treated with total parenteral nutrition (TPN) and underwent an infrarenal aortic bypass surgery. Histopathology of the aorta revealed intimal fibrocalcific thickening and changes consistent with radiation-induced arteritis. Later, she was readmitted with progressive hepatic insufficiency. Despite intensive medical therapy, she died of multi-organ failure.- - - - - - - - - - ranking = 0.00036013338894608keywords = circulation (Clic here for more details about this article) |
5/60. Sudden death in a 21-year-old man caused by thrombosed coronary aneurysm: late sequelae or a very late onset of Kawasaki disease?Kawasaki disease (KD; mucocutaneous lymph node syndrome) is an infantile febrile illness of unknown origin that occurs in worldwide epidemics. The main clinical features of the disease, such as fever, mucositis, cervical lymphoadenopathy and skin rash, associated with coronary aneurysms or arteritis are diagnostic. Late sequelae of coronary arteritis are very rare in the second decade of life; we describe the case of a 21-year-old male who died suddenly. The autopsy revealed a large thrombotic coronary aneurysm, coronary arteritis and myocarditis, supporting the diagnosis of a late fatal sequela of KD. The hypothesis of a very late onset of the disease is also considered and discussed.- - - - - - - - - - ranking = 0.61538461538462keywords = coronary (Clic here for more details about this article) |
6/60. Coronary arteritis in systemic lupus erythematosus.Acute myocardial infarction in systemic lupus erythematosus may be due to an atheromatous or arteritic process. Confirmation of the latter etiology has previously been made only at postmortem examination. A 45-year-old white woman with known systemic lupus erythematosus developed anginal pain and multiple episodes of acute myocardial infarction. During this period, there was serologic but no other clinical evidence of active systemic lupus erythematosus. Serial coronary angiographic studies were strongly suggestive of an arteritic process based upon (1) a saccular aneurysm with no obstructive lesions in a coronary artery supplying an area of recent transmural myocardial infarction and (2) the development of significant obstructive lesions in a previously normal coronary artery over a period of 18 days. This case illustrates the difficulties in distinguishing between atherosclerosis and arteritis using a single coronary angiographic study. The distinction is significant because of the different therapeutic interventions required.- - - - - - - - - - ranking = 0.30769230769231keywords = coronary (Clic here for more details about this article) |
7/60. Spontaneous coronary arterial dissection and isolated eosinophilic coronary arteritis: sudden cardiac death in a patient with a limited variant of churg-strauss syndrome.Isolated eosinophilic coronary arteritis expressed as a limited variant of the churg-strauss syndrome (allergic granulomatosis and angiitis) is a rare condition. Equally as rare is the entity of isolated spontaneous coronary arterial dissection associated with eosinophilic arteritis. A 57-year-old woman with a history of asthma and recurrent hypersensitivity (anaphylactoid) reactions to various exogenous allergens was found dead in her home; no premonitory complaints had been noted during the preceding days. autopsy revealed focal occlusion of the left anterior descending and first diagonal coronary arteries by discrete dissecting hematomas of the media as the cause of sudden and unexpected death. Histologically, the affected arterial wall showed eosinophilic inflammation characteristic of this limited expression of the churg-strauss syndrome. To our knowledge, sudden cardiac death caused by arterial dissection in isolated eosinophilic coronary arteritis has not previously been reported.- - - - - - - - - - ranking = 0.92307692307692keywords = coronary (Clic here for more details about this article) |
8/60. Death from spontaneous coronary artery dissection in a healthy postmenopausal woman.Spontaneous dissection of the coronary arteries, in the absence of trauma, is an unusual but well-documented entity that occurs usually in middle-aged women. It is a rare cause of sudden death and myocardial infarction. Coronary eosinophilic arteritis is suggested to result in a predisposition to intimal disruption and dissection. We present the case of the sudden death of a previous healthy, 53-year-old postmenopausal female, while working, in a town of Thessalia in greece. The cause of death was left anterior descending coronary dissection with histologic findings of eosinophilic arteritis and autoimmune thyroiditis.- - - - - - - - - - ranking = 0.46153846153846keywords = coronary (Clic here for more details about this article) |
9/60. Non-arthritic rheumatoid valvulitis with coronary arteritis causing myocardial infarction.Rheumatoid valvulitis occurring in an individual without arthritis has rarely been reported. A 62-year-old woman died after repeated myocardial infarction, with no articular symptoms but with a fever of unknown origin and a positive rheumatoid factor. autopsy examination revealed granulomatous inflammatory lesions with rheumatoid nodules present in the aortic valve and the base of the left coronary artery. Wide-spread myocardial infarction was found in the septal and anterolateral walls of the left ventricle.- - - - - - - - - - ranking = 0.38461538461538keywords = coronary (Clic here for more details about this article) |
10/60. Alterations of the sympathovagal balance evaluated by heart rate variability in a rare case of adult Still's disease.We present a rare case of adult Still's disease with cardiac involvement (myocarditis and coronary arteritis). The autonomic nervous system function was evaluated by heart rate variability (HRV) analysis performed by 24-hour electrocardiographic recording during the acute phase of the disease and the remission (after 1 month and 1 year). The HRV parameters were studied in the time (standard deviation of all NN intervals-total power - SDNN, square root of the mean of the sum of the squares of the differences between adjacent NN - RMS-SD and HRV index) and frequency domains (low frequency, high frequency, and low frequency/high frequency). The results of the analysis of the HRV highlight that in the acute phase of the disease with cardiac involvement the autonomic nervous system is globally altered, with modifications of the sympathovagal balance, due to impairment of the parasympathetic component. This trend tends to persist in the short period (1 month), but seems to resolve completely within 1 year. An altered sympathovagal balance should be considered as a possible marker of vasculitis-related ischemia.- - - - - - - - - - ranking = 0.076923076923077keywords = coronary (Clic here for more details about this article) |
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