1/124. Echocardiographic features of an unusual case of aortic valve endocarditis.In a patient with aortic valve endocarditis a myocardial abscess, complete heart block and acute aortic regurgitation developed. echocardiography gave evidence of large aortic valve vegetations, and at operation vegetations were found to have destroyed the right coronary cusp and part of the noncoronary cusp. Following surgery the patient recovered. echocardiography may prove to be a useful noninvasive technique to aid in the timing of surgical therapy in patients with valvular vegetations.- - - - - - - - - - ranking = 1keywords = coronary (Clic here for more details about this article) |
2/124. Inverse paradoxical embolism in a patient on chronic hemodialysis with aortic bacterial endocarditis.We present a 45-year-old patient on chronic hemodialysis who suffered aortic endocarditis by staphylococcus haemolyticus after bacteremia associated with a venous catheter, which was used temporarily during the maturing phase of a Cimino-Brescia arteriovenous fistula in the left forearm. Three weeks after starting antibiotic therapy, the patient suffered a septic pulmonary embolism. The catheter had been removed 4 weeks before the embolism. thrombophlebitis of lower limbs, infection or thrombosis of the vascular access, and the involvement of right-sided cardiac structures were all discarded. We assumed that the pulmonary episode was probably a consequence of the paradoxical passage of embolic material, detached from the aortic valve, from arterial to venous circulation through the arteriovenous fistula.- - - - - - - - - - ranking = 0.0081724868356877keywords = circulation (Clic here for more details about this article) |
3/124. Intermittent left coronary occlusion caused by native aortic valve thrombosis in a patient with protein s deficiency.A 77-year-old woman presented with chest pain and cardiogenic shock. Transesophageal echocardiography showed a mobile mass occluding intermittently the left coronary ostium. The mass was surgically resected, and histologic examination revealed an organized thrombus. Coagulation study demonstrated a protein s deficiency. This is the first case of aortic thrombosis associated with protein s deficiency, and it is the first time that transesophageal echocardiography provided definite evidence that a mass can cause intermittent left ostium coronary obstruction.- - - - - - - - - - ranking = 3keywords = coronary (Clic here for more details about this article) |
4/124. minocycline pigmentation of heart valves.minocycline, a derivative of tetracycline, is a broad spectrum antibiotic used in the treatment of gram-positive and gram-negative infections. Benitz et al. (1) were the first to report black discoloration of the thyroid gland in rats, dogs, and monkeys given minocycline. Since that time, there have been numerous reports in the literature describing minocycline related black pigmentation of the skin, thyroid gland, and other sites. We report an unusual case of minocycline induced pigmentation of the cardiac valves and coronary vessels. The pigment stained with Fontana-Masson and was reduced with bleaching. The exact nature of the pigment is unclear; however, various theories have been advocated. ochronosis is another cause of black pigmentation of the heart valves; the clinical history should allow distinction between the two.- - - - - - - - - - ranking = 0.5keywords = coronary (Clic here for more details about this article) |
5/124. Cardiac valvular papillary fibroelastoma: a report of 2 cases.Papillary fibroelastomas are rare cardiac valve tumors with potential for life-threatening complications such as stroke or sudden death. We report 2 cases of papillary fibroelastoma that were found by echocardiography. The 1st tumor arose from the mitral valve in a patient who presented after multiple transient neurologic events. The 2nd tumor arose from the aortic valve and was found incidentally during coronary artery bypass grafting. Both patients underwent successful surgical removal of the tumor.- - - - - - - - - - ranking = 0.5keywords = coronary (Clic here for more details about this article) |
6/124. Coronary artery erosion and dissection: an unusual complication of mitral annular calcification.This article describes a 42-year-old male patient with a longstanding history of insulin-dependent diabetes mellitus, systemic arterial hypertension, and chronic renal failure. The patient had severe mitral annular calcification (MAC) identified at autopsy. This MAC was of an amorphous, caseous-appearing type; it displaced the posterior mitral valve leaflet and extruded into the myocardium of the lateral and posterolateral left ventricle to involve the epicardial surface. The MAC produced extramural erosion of the wall, and dissection into the media, of the first left/obtuse marginal coronary artery. This coronary artery involvement by, and other complications of, MAC are discussed.- - - - - - - - - - ranking = 1keywords = coronary (Clic here for more details about this article) |
7/124. The postpericardiotomy syndrome as a cause of pleurisy in rehabilitation patients.Pleuritic chest pain in patients on a rehabilitation unit may be caused by several conditions. We report 2 cases of postpericardiotomy syndrome (PPS) as a cause of pleuritic pain. PPS occurs in 10% to 40% of patients who have coronary bypass or valve replacement surgery. The syndrome is characterized by fever, chest pain, and a pericardial or pleural friction rub. Its etiology is believed to be viral or immunologic. The syndrome can be a diagnostic challenge, and an increase in length of hospitalization because of it has been documented. Identified risk factors for PPS include age, use of prednisone, and a history of pericarditis. A higher incidence has been reported from May through July. Many patients undergo a battery of expensive procedures before PPS is diagnosed. The pain is sharp, associated with deep inspiration, and changes with position. Pleural effusions may be present and tend to occur bilaterally. Pericardial effusions are a documented complication. A pericardial or pleural rub may be present and is often transient. Serial auscultation is important. Laboratory work provides clues with a mild leukocytosis and an elevated erythrocyte sedimentation rate. However, this does not provide the definitive diagnosis. Cardiac enzymes are not reliably related to the syndrome. An electrocardiogram will show changes similar to those associated with pericarditis. The patient may have a fever, but it is rarely higher than 102.5 degrees F. Complications include pericardial effusions, arrhythmias, premature bypass graft closure, and cardiac tamponade. Treatment consists of a 10-day course of nonsteroidal anti-inflammatory drugs.- - - - - - - - - - ranking = 0.5keywords = coronary (Clic here for more details about this article) |
8/124. Combined therapeutic strategy for multiple coronary thromboemboli.A female with mitral valvular disease presented an acute myocardial infarction. She suddenly complained of recurrent chest pain with symptoms of pulmonary edema. The angiogram evidenced multiple coronary thromboemboli. A combined strategy using intracoronary thrombolysis, a platelet glycoprotein IIb/IIIa antagonist (abciximab) and percutaneous transluminal coronary angioplasty to help disrupt the thrombus was performed. Clinical and angiographic signs of coronary reperfusion were rapidly achieved. No bleeding complications appeared.- - - - - - - - - - ranking = 4keywords = coronary (Clic here for more details about this article) |
9/124. angina pectoris after aortic valve replacement.angina pectoris after aortic valve replacement may be due to reduced myocardial blood flow (coronary artery stenosis or valvular dysfunction) or to increased myocardial oxygen demand (idiopathic hypertrophic subaortic stenosis or valvular dysfunction). If a patient does not do well after an aortic valve replacement, causes other than dysfunction of the prosthesis should be sought.- - - - - - - - - - ranking = 0.5keywords = coronary (Clic here for more details about this article) |
10/124. Calcified bicuspid aortic valve mass prolapsing into the left main coronary artery.We report a case of a mobile calcific mass on the aortic valve that prolapsed into the left main coronary artery of a 51-year-old man. This case and a review of the literature suggest that calcific embolization to coronary arteries is a rare but possibly underrecognized complication of calcified degenerative or bicuspid aortic valves. This potentially catastrophic complication of calcified aortic valves needs to be suspected and recognized in clinical practice.- - - - - - - - - - ranking = 3keywords = coronary (Clic here for more details about this article) |
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