1/67. Refractory coronary artery spasm with superimposed thrombosis: successful treatment with Palmaz-Schatz stent.Prinzmetal variant angina due to epicardial coronary artery spasm is a disease usually treated with drug therapy with successful results. A case of variant angina, refractory to conventional pharmacological treatment, and complicated by coronary artery thrombosis, was treated with percutaneous transluminal coronary angioplasty and stenting with good immediate and late clinical results.- - - - - - - - - - ranking = 1keywords = angina (Clic here for more details about this article) |
2/67. Interesting cases from the University of texas Medical Branch.This article discusses the cases for four patients with unstable angina. The first case is an example of the "high-risk" patient with widespread ECG changes, heart failure, and enzymatic elevations during an episode of chest pain. The second patient illustrates an unusual cause of unstable angina in a young women. The third patient had a large thrombus visible on angiography and management strategies for dealing with intracoronary thrombus are discussed. The final patient had an extensive past cardiac history with two prior coronary artery bypass operations and we discuss the recent advances made in the treatment of degenerative vein graft disease.- - - - - - - - - - ranking = 1.0017403010518keywords = angina, stable (Clic here for more details about this article) |
3/67. Acute thrombotic-ischemic coronary syndromes: the usefulness of TEC.Transluminal extraction catheter (TEC) is a percutaneous device that performs simultaneous thrombus aspiration and plaque excision. Clinical indications for its application are acute myocardial infarction, unstable angina, and stable angina caused by atherosclerotic, thrombotic lesions located within native coronary arteries and degenerated saphenous vein grafts. The device is useful in management of ischemic patients with contraindications to either pharmacologic thrombolytics or platelet GPIIb/IIIa receptor inhibitors, and can also effectively be used in combination with these agents. A successful TEC procedure requires careful patient selection, strict adherence to recommended indications, optimal equipment selection, familiarity with mechanical components of the device, full understanding of safe and efficacious techniques for deployment and activation, as well as recognition of unique associated angiographic manifestations such as the "empty-pouch phenomenon." As with other debulking devices, the incidence of restenosis post-TEC appears to be directly related to acute luminal gain at the time of procedure and therefore requires the need for adjunct stenting. This communication describes and illustrates various clinical, technical, and angiographic aspects of TEC procedure in patients with acute ischemic-thrombotic coronary syndromes. Cathet. Cardiovasc. Intervent. 48:406-420, 1999.- - - - - - - - - - ranking = 1.0017403010518keywords = angina, stable (Clic here for more details about this article) |
4/67. Postoperative right atrial and pulmonary embolism after prolonged spinal surgery.Perioperative pulmonary thromboembolism can proceed rapidly with grave prognosis, in which immediate or accurate diagnosis and management is not easy. According to the literatures, patients receiving spinal surgery are at relatively lower risk of developing thromboembolism. We would like to present a case of postoperative pulmonary thromboembolism which developed after a prolonged lumbar spinal surgery. tachycardia and unstable hemodynamics were noted postoperatively. Pulmonary and right atrial thrombi were disclosed by transesophageal echocardiography. Although cardiotomy and thrombectomy were immediately performed, the patient finally died 3 days after the operation. The pathogenesis of venous thromboembolism (VTE) in the surgical patients, the risk factors which predispose a patient to VTE, diagnosis, and treatment as well as the prophylactic measures of VTE are herein reviewed and discussed.- - - - - - - - - - ranking = 0.00087015052590547keywords = stable (Clic here for more details about this article) |
5/67. Late thrombosis following intracoronary brachytherapy.Vascular brachytherapy has been the subject of an extensive ongoing investigation into the safety and efficacy of this technique for preventing restenosis. Preclinical studies have demonstrated reduction of the neointimal proliferation and the late vascular constriction with radiation therapy. However, radiation is also known to delay the healing process and may contribute to a new phenomenon of late thrombosis. We report on two cases of patients with in-stent restenosis who underwent intervention followed by intracoronary vascular radiation therapy (utilizing beta and gamma radiation) and presented with acute onset of unstable angina. Angiographic study demonstrated late thrombosis, which were treated successfully with the Angiojet thrombectomy device.- - - - - - - - - - ranking = 0.50087015052591keywords = angina, stable (Clic here for more details about this article) |
6/67. Therapeutic dissolution of an intracoronary thrombus by prolonged intravenous platelet glycoprotein IIb/IIIa antagonism.This case report describes the therapeutic dissolution of an intracoronary thrombus in a patient with ectatic coronary arteries post-myocardial infarction by prolonged intravenous glycoprotein (GP) IIb/IIIa antagonist administration. The report emphasizes the potential thrombotic complications in patients with ectatic coronary arteries and the beneficial use of GP IIb/IIIa receptor antagonists as direct thrombolytic agents even in partially organized thrombus formation. In addition to the well-documented effects of GP IIb/IIIa blockade in the scenario of percutaneous interventions, unstable angina, and non-Q wave infarction, the use of this new class of drugs in acute myocardial infarction seems to be promising and might also be considered in the setting of persistent thrombotic material within the coronary vasculature.- - - - - - - - - - ranking = 0.50087015052591keywords = angina, stable (Clic here for more details about this article) |
7/67. Cold pressure test producing coronary spasm, coronary thrombosis and myocardial infarction in a patient with IgM antibodies against Coxsackie B virus.Several lines of evidence have shown that viral infections are capable of causing coronary spasm and precipitating or mimicking clinical myocardial infarction. Here we report the case of a 41-year-old woman with recurrent angina who was admitted to our hospital because of ventricular tachycardia. Laboratory examination revealed positive IgM titers against Coxsackie B virus. coronary angiography showed normal coronary arteries, but following a cold pressure test severe spasm of all coronaries with thrombotic occlusion of the second marginal branch of the circumflex artery occurred. We conclude that coronary spasm should be clinically suspected in patients with chest pain and ventricular arrhythmia in combination with IgM antibodies against Coxsackie B virus. In these patients, a cold pressure test should be avoided, and antithrombotic and antispastic therapy is recommended.- - - - - - - - - - ranking = 0.5keywords = angina (Clic here for more details about this article) |
8/67. Papillary fibroelastoma of the aortic valve: a sudden death case of coronary embolism with myocardial infarction.Papillary fibroelastoma is a rare benign tumor, occasionally causing angina or sudden death. We report an autopsy case of an aortic valve papillary fibroelastoma with coronary artery embolism. The patient was a 68-year-old Japanese man who had collapsed suddenly in his house. He was a heavy drinker and had a history of liver disease but no notable cardiac event. The autopsy revealed extensive transmural infarction of the inferior wall of the left and right cardiac ventricles. The distal portion of the right coronary artery (segment 4, NYHA) was completely occluded by tumor emboli of the fibroelastoma. At the site of closure of the aortic non-coronary cusp, there was a typical papillary fibroelastoma, which was considered to have originated the coronary embolization.- - - - - - - - - - ranking = 0.5keywords = angina (Clic here for more details about this article) |
9/67. A case of acute myocardial infarction: intracoronary thrombus formation at a previously provoked vasospasm site.A 58-year-old Japanese man with variant angina developed acute myocardial infarction (AMI). Emergency coronary angiography demonstrated thrombotic occlusion in the proximal site of the left anterior descending artery. The occluded region appeared to be coincident with the area in which severe vasospasm had been provoked by intracoronary administration of acetylcholine 1.5 years before the onset of AMI. This case may give us a unique opportunity to consider the role of vasospasm in the etiology of AMI.- - - - - - - - - - ranking = 0.5keywords = angina (Clic here for more details about this article) |
10/67. Adjunctive therapies in the cath lab. Successful medical therapy of left main thrombosis: value of serial coronary angiography.Acute coronary syndromes (ACS), including unstable angina, non-Q wave myocardial infarctions (MI) and Q-wave MIs, are usually the result of plaque rupture and subsequent thrombus formation. Commonly, patients with ACS have significant underlying coronary artery disease (CAD) demonstrable by coronary angiography and are candidates for prompt revascularization. In many cases, however, ACS are due to coronary thrombosis in the absence of obstructive CAD and therefore aggressive medical therapy may be sufficient. coronary angiography is an invaluable resource for individualized treatment decisions. We describe a patient with thrombosis of the left main coronary artery successfully treated with aggressive and prolonged antiplatelet and anticoagulant therapy under the guidance of serial coronary angiography.- - - - - - - - - - ranking = 0.50087015052591keywords = angina, stable (Clic here for more details about this article) |
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