1/69. 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 = angina (Clic here for more details about this article) |
2/69. Bifurcating aneurysm of the left main coronary artery involving left anterior descending and left circumflex arteries--a case report.Coronary artery aneurysm is a rare coronary abnormality, usually diagnosed incidentally by coronary angiography. Major causes of coronary aneurysms include coronary ectasia, Kawasaki disease, and atherosclerosis. Most of the discrete coronary aneurysms are of atherosclerotic origin. The incidence of atherosclerotic coronary aneurysms is about 0.2%, and the left main coronary artery is the least frequently involved artery. Only a few cases of left main coronary artery aneurysm have been reported in the literature, and a left main coronary artery aneurysm involving the proximal segments of the left anterior descending and the left circumflex arteries has not been reported previously. The authors describe this finding in a man who presented with worsening exertional angina pectoris. coronary angiography demonstrated an aneurysm of the distal left main coronary artery extending into the proximal segments of the left anterior descending and the left circumflex arteries. In addition, a significant flow-limiting atherosclerotic lesion was present in the proximal portion of the left anterior descending artery distal to the aneurysm.- - - - - - - - - - ranking = 1keywords = angina (Clic here for more details about this article) |
3/69. Long non-iatrogenic right coronary artery dissection in stable angina pectoris treated with stenting.An extensive spontaneous right coronary artery dissection was the only abnormal angiographic finding detected in a 67-year-old man with chronic exercise-induced angina pectoris. The lesion was treated with multiple stenting with good angiographic results. The clinical implications of this finding and the details of the intervention performed are discussed in light of published data concerning this increasingly recognized angiographic entity.- - - - - - - - - - ranking = 5.0040978850721keywords = angina, stable (Clic here for more details about this article) |
4/69. Inadvertent stenting of left main coronary artery complicated by later in-stent restenosis.Stenting of both the protected and unprotected left main coronary artery has been described. This case presents a patient who had inadvertent left main stent deployment. A 47-year-old female presented with a non-Q-wave infarction and subsequent angina leading to angiography and angioplasty of her proximal ramus intermedius artery. Recurrent angina and ECG changes necessitated repeat coronary angiography and angioplasty on the same day with Wiktor stent deployment to treat a resultant dissection. Poststent deployment pictures revealed that the stent had been partially deployed in the left main coronary artery. Additional balloon dilatations were performed at the ostia of the left anterior descending and circumflex arteries through the stent. Three months later the patient presented with progressive angina and was discovered to have severe distal left main stenosis. In a case such as this, stent removal may be preferable to leaving an unnecessary stent within the left main coronary artery. Cathet. Cardiovasc. Intervent. 48:194-197, 1999.- - - - - - - - - - ranking = 3keywords = angina (Clic here for more details about this article) |
5/69. Aorto-coronary dissection during angioplasty in a patient with myxedema.A 67-year-old man with overt hypothyroidism and medically controlled hypertension was admitted for coronary angiography because of exertional angina. His triiodothyronine (T3) and thyroxine (T4) levels had been low for 4 years. Although signs and symptoms of hypothyroidism were apparent, his hypercholesterolemia was mild. coronary angiography revealed an eccentric stenosis in the distal portion of the right coronary artery and it was decided to perform angioplasty because his angina had continued in spite of medication. The dissection appeared at the lesion site after the first nominal inflation, and a subsequent image disclosed a spiral dissection from the dilated site to the aortic sinus and peripheral coronary artery. Although emergency stenting could not prevent the extension near the origin of the brachiocephalic artery, the false lumen thrombosed and then diminished with conservative therapy. Aorto-coronary dissection is potentially life-threatening and has been recently reported as a complication during cardiac catheterization procedures. Chronic hypothyroid insufficiency may be one of the risk factors for this complication.- - - - - - - - - - ranking = 2keywords = angina (Clic here for more details about this article) |
6/69. Nonatherosclerotic aneurysm of the left circumflex coronary artery presenting with accelerated angina pectoris: response to medical management--a case report.Coronary artery aneurysm is defined as coronary dilatation with a diameter of more than 1.5 times the adjacent normal coronary artery. Most of the coronary aneurysms remain asymptomatic. More than 90% of coronary aneurysms are of atherosclerotic origin. Nonatherosclerotic coronary aneurysms are rare, and the majority of them are diffuse. Among the three major coronary arteries, the left circumflex artery is the least commonly involved. The management strategies for nonatherosclerotic coronary aneurysms are not clear, and each case should be managed on an individual basis depending on the clinical context. Here described is a case of a discrete nonatherosclerotic aneurysm of the left circumflex coronary artery in a 46-year-old man who presented with accelerated angina pectoris and was treated medically. The patient was free of symptoms on 2-year follow-up. The clinical perspectives of the nonatherosclerotic coronary aneurysm are discussed.- - - - - - - - - - ranking = 5keywords = angina (Clic here for more details about this article) |
7/69. Coexistence of giant aneurysm of sinus of valsalva and coronary artery aneurysm associated with idiopathic hypereosinophilic syndrome.Aneurysms of the coronary sinuses of Valsalva and coronary artery aneurysms are uncommon cardiac anomalies, and cases in which these two uncommon lesions occur at the same time are extremely rare. A case of a woman with unstable angina who had a giant aneurysm of the left coronary sinus and multiple coronary artery aneurysms associated with an idiopathic hypereosinophilic syndrome is presented. Her sustained eosinophilia, elevated eosinophilic cationic protein concentration, and pathological findings of eosinophil infiltration of the aortic wall suggested the association of eosinophilia induced vascular injury as the cause of these aneurysms. This is the first such case to survive following surgical treatment.- - - - - - - - - - ranking = 1.001024471268keywords = angina, stable (Clic here for more details about this article) |
8/69. Calcified aneurysms in coronary arteries of a 48-year-old patient.This is a case report of a 48-year-old female patient with a compatible history of Kawasaki disease during childhood, who was admitted to the emergency coronary unit with unstable angina pectoris. coronary angiography identified two coronary aneurysms, one causing right coronary occlusion and the other causing severe obstruction of the left anterior descending coronary artery. coronary artery bypass surgery was indicated.- - - - - - - - - - ranking = 1.001024471268keywords = angina, stable (Clic here for more details about this article) |
9/69. A coronary aneurysm complicated by acute myocardial infarction. A case report.Coronary artery aneurysm (CAA) is a relatively rare disease that may cause angina, myocardial infarction, sudden death due to thrombosis, embolisation, or rupture. This report describes the case of a man aged 65 years old who had an anterior myocardial infarction due to left anterior descending artery (LAD) aneurysm. We attempted early percutaneous transluminal coronary angioplasty (PTCA) for treatment of acute myocardial infarction, but were not successful. He was then treated with intracoronary streptokinase. Serial coronary angiographies showed recanalisation and aneurysm on the LAD. The patient was operated on with coronary bypass surgery, and treated with an oral anticoagulant, nitrate, and blocker. He was well after one year of follow-up.- - - - - - - - - - ranking = 1keywords = angina (Clic here for more details about this article) |
10/69. death related to coronary artery fistula after rupture of an aneurysm to the coronary sinus.Large coronary fistulas are considered to cause myocardial ischemia due to diversion of the coronary blood flow. In this case the authors report the reverse effect--the spontaneous closure of a large fistulation between the left circumflex artery and the coronary sinus evoked angina pectoris in a middle aged man, who died several years later. Postmortem examination revealed a coronary aneurysm that had ruptured and dissected into the coronary sinus and finally thrombosed. The origin of the aneurysm could be congenital but perhaps also represents a healed stage of Kawasaki disease.- - - - - - - - - - ranking = 1keywords = angina (Clic here for more details about this article) |
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