1/147. fibromuscular dysplasia involving coronary arteries--a case report.The authors report a young patient with fibromuscular dysplasia involving multivessels including coronary arteries. If young patients have chest pain on effort, fibromuscular dysplasia of coronary arteries must be considered. As fibromuscular dysplasia is a chronic progressive disease and some cases progress rapidly in a few months, careful follow-up and comprehensive medical management may be necessary in such patients.- - - - - - - - - - ranking = 1keywords = coronary (Clic here for more details about this article) |
2/147. Treatment of a large congenital coronary fistula with coil embolization.A 77-year-old woman suffering from progressive dyspnea and chest pain for 2 1/2 years was admitted to hospital. There were no ECG changes at exercise test and a dobutamine stress echocardiography was normal. At catheterization, right-sided pressures were within normal limits. coronary angiography revealed a congenital coronary fistula, 3-4 mm in diameter, from the left anterior descending artery to the proximal pulmonary artery. There was no significant rise in blood oxygen saturation in the pulmonary artery. Transcatheter coil embolization was performed in the distal part of the tortuous fistula. Flow ceased within minutes, demonstrating the feasibility and efficacy of this technique for treating large fistulas.- - - - - - - - - - ranking = 0.83333333333333keywords = coronary (Clic here for more details about this article) |
3/147. Chronic radiodermatitis following repeated percutaneous transluminal coronary angioplasty.We review three patients who developed chronic radiodermatitis subsequent to undergoing multiple percutaneous transluminal coronary angioplasties (PTCAs). All patients had had chronic ischaemic heart disease (IHD) and had undergone lengthy PTCA on several occasions. The skin eruption was characterized by an atrophic rectangular plaque on the left upper back, presenting as mottled hyper- and hypopigmentation with reticulate telangiectasia. Histologically, the eruption demonstrated epidermal atrophy, hyalinized and irregularly stained collagen, and telangiectasia of superficial vessels in the dermis. Although the risk of radiation injury in most patients undergoing cardiac catheterization is low, this danger should not be ignored. In particular, patients with long-standing IHD and numerous repeated catheterizations to only one or two occluded coronary arteries should be considered at high risk.- - - - - - - - - - ranking = 1keywords = coronary (Clic here for more details about this article) |
4/147. anemia due to massive chronic foetomaternal hemorrhage.We report a case of massive chronic foetomaternal hemorrhage. The labor course was uncomplicated. The newborn presented with pallor. tachypnea, and moderate hepatosplenomegaly. The initial hemoglobin was 6.5 g/dl. The Kleihauer-Betke stain on a maternal blood sample was 12%, which is equivalent to 540 ml of fetal blood in the maternal circulation. A clot in the umbilical vein was demonstrated sonographically. The possible association of foetomaternal hemorrhage with umbilical vein thrombosis is discussed.- - - - - - - - - - ranking = 0.021709198407806keywords = circulation (Clic here for more details about this article) |
5/147. Pseudochylothorax in pleural effusion due to coronary artery bypass surgery.This study describes a 64-yr-old male with a chronic left pleural effusion following a coronary artery bypass 3 yrs earlier. On thoracocentesis, turbid fluid was obtained with crystals of cholesterol on microscopic examination, establishing the diagnosis of pseudochylothorax. The pleural fluid cholesterol level was 207 mg x dL(-1) (5.36 mmol x L(-1)). This is the first report of pseudochylothorax in a chronic pleural effusion due to coronary artery bypass surgery.- - - - - - - - - - ranking = 1keywords = coronary (Clic here for more details about this article) |
6/147. Chronic intrauterine meconium aspiration causes fetal lung infarcts, lung rupture, and meconium embolism.Three neonates with chronic intrauterine meconium aspiration are reported. All had distinctive subpleural plate-infarcts of the lungs caused by meconium-induced vasoconstriction of peripheral preacinar arteries. These vessels showed plexogenic arteriopathy with medionecrosis and obliterative hyaline sclerosis. Organized thrombi and systemic-pulmonary arterial anastomoses were numerous. The infarcts contained inspissated meconium with a granulomatous reaction.In one case, lung rupture occurred, causing meconiumthorax and meconium embolism to hilar lymphatics and lymph nodes; this suggests that particulate meconium may enter the circulation. This fetus had rubella and probable acute twin-twin transfusion following the intrauterine death of the co-twin. The cause of the hypoxia that led to intrauterine passage of meconium in the other cases is unknown. meconium-stained amniotic fluid was noted in only one case.- - - - - - - - - - ranking = 0.021709198407806keywords = circulation (Clic here for more details about this article) |
7/147. association of rickettsia helvetica with chronic perimyocarditis in sudden cardiac death.BACKGROUND: rickettsia helvetica is the only non-imported rickettsia found in scandinavia. It was first detected in ixodes ricinus ticks, but has never been linked to human disease. We studied two young Swedish men who died of sudden cardiac failure during exercise, and who showed signs of perimyocarditis similar to those described in rickettsial disease. methods: Samples from the heart and other organs were analysed by PCR and dna sequencing. May-Grunwald-Giemsa, Grocott, and acridine-orange stains were used for histopathological examinations. Staining of R. helvetica grown on shell-vials in vero cells, and the early descriptions of R. rickettsii by H T Ricketts and S B Wohlbach served as controls. immunohistochemistry was done with proteus OX-19 rabbit antisera as the primary antibody. The structure of rickettsia-like organisms was investigated by transmission electron microscopy. Serological analyses were carried out by indirect immunofluorescence with R. helvetica as the antigen. FINDINGS: By use of a semi-nested PCR, with primers specific for the 16S rRNA and 17-kDa outer-membrane-protein genes, and sequence analysis of the amplified products, genetic material from R. helvetica was detected in the pericardium and in a lymph node from the pulmonary hilum in case 1, and in a coronary artery and the heart muscle in case 2. A serological response in case 1 revealed an endpoint titre for R. helvetica of 1/320 (1/256 with R. rickettsii as the antigen). Examination of PCR-positive tissue showed chronic interstitial inflammation and the presence of rickettsia-like organisms predominantly located in the endothelium. These organisms reacted with proteus OX-19 antisera, and their size and form were consistent with rickettsia. Electron microscopy confirmed that the appearance of the organisms was similar to that described for spotted-fever rickettsia. INTERPRETATION: R. helvetica, transmitted by I. ricinus ticks, may be an important pathogen in the aetiology of perimyocarditis, which can result in sudden unexpected cardiac death in young people.- - - - - - - - - - ranking = 0.16666666666667keywords = coronary (Clic here for more details about this article) |
8/147. Chronic/subacute total occlusion of the left main coronary artery--a case report and review of literature.Total occlusion of the left main coronary artery is rare. Acute occlusion is invariably fatal; however, survival is possible if the patient reaches the hospital in time. patients usually present with acute myocardial infarction, cardiogenic shock, and sudden cardiac death. Chronic total occlusion presents with angina, myocardial infarction, or congestive heart failure. The authors describe complete occlusion of the left main coronary artery in a patient who presented with recent-onset angina. They review the clinical and angiographic features of 60 cases described in the literature.- - - - - - - - - - ranking = 1keywords = coronary (Clic here for more details about this article) |
9/147. Utility of bilateral coronary injections during complex coronary angioplasty.We describe a technique useful in complex coronary interventions wherein timed bilateral contrast injections are given in both coronary arteries. This technique is useful in chronic total occlusions in which the distal coronary vessel is not visualized except by collateral filling via the contralateral artery. This technique was applied in 12 patients; 11 with native coronary occlusion and one in whom the target site was visualized by contrast injections into a vein graft supplying competitive flow to an otherwise patent native vessel. With this technique, the distal coronary artery segment can be better visualized, which helps to aim and track the guide wire across the occluded segment.- - - - - - - - - - ranking = 2.1666666666667keywords = coronary (Clic here for more details about this article) |
10/147. Filleted toe flap for chronic forefoot ulcer reconstruction.Chronic plantar and dorsal forefoot ulcer may result from injury, structural deformity, and abnormal sensation or circulation. It is not uncommon that the distal portion of the affected toes is deficient functionally in these patients. A filleted toe flap from the expendable functionless toe can provide a durable, stable, and sensate skin flap of 4 to 5.5 cm for coverage of the forefoot defect. In this report, five cases of dorsal forefoot defects and four cases of plantar forefoot defects due to ischemia (N = 3), trophic change (N = 2), and diabetes (N = 4) were treated with filleted toe flaps. One flap failed due to postoperative deep infection. The other eight filleted toe flaps survived but 2 patients underwent secondary amputations 7 months and 2 two years later because of secondary diabetic foot infections.- - - - - - - - - - ranking = 0.021709198407806keywords = circulation (Clic here for more details about this article) |
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