1/47. Pathologic findings in a steroid-responsive optic nerve infarct in giant-cell arteritis.OBJECTIVE: To investigate the pathophysiologic mechanism of optic nerve infarction in giant-cell arteritis (GCA). BACKGROUND: Previous pathologic reports of optic nerve infarction in GCA involved patients who were blind at the time of death. The optic nerve infarcts were primarily retrolaminar in localization. Simultaneous short ciliary and ophthalmic artery vasculitis was found in all patients. methods: Clinical neurologic and ophthalmologic examination, temporal artery biopsy, and neuroimaging tests were performed in a patient with an anterior ischemic optic neuropathy secondary to GCA. Pathologic examination of the viscera, eye, and brain were performed at autopsy 1 month later. RESULTS: A prelaminar/retrolaminar infarct was found in this patient. Subsiding vasculitis was limited to the short ciliary arteries, sparing the central retinal, pial, and ophthalmic arteries. CONCLUSIONS: The authors believe that the visual improvement observed in this patient was the result of preserved, anterior optic nerve collateral circulation, as well as the neuroprotective and anti-inflammatory effect of the corticosteroids.- - - - - - - - - - ranking = 1keywords = circulation (Clic here for more details about this article) |
2/47. Juxtapapillary nerve fiber layer infarction as a complication of coronary artery bypass surgery.BACKGROUND: Recent studies have detailed the prevalence and etiology of ocular complications resulting from coronary artery bypass surgery. Of these, retinal nerve fiber layer infarctions are reported most commonly. The clinical sequelae of nerve infarction may include loss of visual acuity, compromised pupillary function, and visual-field defects (the severity of which may be correlated with the location and extent of the insulted tissue). methods: A patient who had experienced bilateral juxtapapillary nerve fiber layer infarction with subsequent loss of visual acuity and peripheral visual field was followed postoperatively for more than 6 weeks. Immediately before our examination, he underwent quadruple coronary artery bypass graft surgery. RESULTS: From the data collected during initial and follow-up examinations, it was determined that the nerve fiber layer infarction was probably the result of a systemic ischemic event during an otherwise uncomplicated surgery. Such events may include hypovolemic blood loss, systemic hypotension during or following surgery, or a host of complications that would prevent adequate perfusion to capillaries in select regions of the eye. CONCLUSION: The pathology of bilateral juxatapapillary nerve fiber layer infarction as a result of substantial transient systemic ischemia may be explained by examining the microcirculation of this region of the retina. Due to certain anatomic and physiologic characteristics, the capillaries supplying the peripapillary zone are most susceptible to arterial vascular events such as ischemia. It is important to recognize this clinical presentation in order to rule out other possible causes for decreased visual acuity and field defects in the postoperative coronary bypass surgery patient.- - - - - - - - - - ranking = 4.9241958154221keywords = circulation, coronary (Clic here for more details about this article) |
3/47. gallbladder and liver infarction occurring as a complication of acute bacterial endocarditis.A case of acute bacterial endocarditis is presented in which gallbladder infarction and areas of hepatic infarction were documented. Selective angiography showed findings consistent with emboli to the gallbladder and hepatic circulations.- - - - - - - - - - ranking = 1keywords = circulation (Clic here for more details about this article) |
4/47. Hepatic infarction associated with terminal hemorrhagic necrotizing enteropathy (THNE): case report.A case of hepatic infarction associated with terminal hemorrhagic necrotizing enteropathy (THNE) in an 84-year-old woman with cardiac failure is presented. The autopsy showed hepatic infarction, THNE, fibrous endocarditis, generalized arteriosclerosis, myocardial hypertrophy, liver congestion, and other findings as described. Both rare infarctions (hepatic and intestinal) seemed to have originated not only as a result of impaired systemic circulation due to cardiac failure, but also from liver congestion due to peripheral circulatory deficiency through the portal vein. The circulatory correlation between these infarcts of the liver and intestine is discussed.- - - - - - - - - - ranking = 1keywords = circulation (Clic here for more details about this article) |
5/47. Gastric infarction associated with septic shock and high-dose vasopressor use.Gastric infarction is rare, owing to the extensive collateral circulation of the stomach. A case of gastric infarction occurring in a patient with septic shock secondary to pneumonia is presented. The aetiology, diagnosis and therapy of gastric infarction are discussed, with consideration of the role of sepsis and vasopressors in pathogenesis and the concept of splanchnic resuscitation in prevention of the condition.- - - - - - - - - - ranking = 1keywords = circulation (Clic here for more details about this article) |
6/47. Use of aspirin and low-molecular-weight heparin to prevent recurrence of maternal floor infarction in women without evidence of antiphospholipid antibody syndrome.During pregnancy, maternal floor infarction (MFI) and massive perivillous fibrin deposition (MFD) often cause fetal growth restriction and death, both being markedly increased by occlusion of the maternal intravenous circulation. Incident rates have been reported to be in the range of 0.09-0.5% and recurrent MFI/MFD might be more frequent in early-onset cases. Thus, prevention measures are necessary for high-risk women who have had MFI/MFD as complications in a previous pregnancy. In this report, the use of oral low-dose aspirin at the early trimester and low-molecular-weight heparin drip infusion from the mid-second trimester was examined for this purpose.- - - - - - - - - - ranking = 1keywords = circulation (Clic here for more details about this article) |
7/47. breast necrosis following harvest of internal mammary artery.The use of internal mammary artery is well established not only in cardiac surgery for coronary artery bypass grafting but also in plastic surgery for breast reconstruction with free autologus tissue. The complications that follow harvest of internal mammary artery for heart surgery usually relate to the wound. This case report documents the first case of complete breast infarction following such a procedure in a patient who had no prior history of breast pathology. The histology of the breast showed extensive calcification of the intima and media of small to medium sized vessels, a condition called calciphylaxis, which is largely unknown outside the fields of nephrology and dermatology.- - - - - - - - - - ranking = 0.56059940220315keywords = coronary (Clic here for more details about this article) |
8/47. Buerger's disease with multisystem involvement. A case report and a review of the literature.Buerger's disease is a recurrent inflammatory, nonatherosclerotic vasoocclusive disease, which typically affects small and medium-sized arteries, veins, and nerves of the upper and lower extremities. Systemic manifestations involving cerebral, mesenteric, and coronary arteries are exceptional. Moreover, multisystem involvement of 2 or more organs is extremely rare. The authors present a case of Buerger's disease in a patient who subsequently developed cerebral and bowel infarcts as well as cavernomatous transformation of the portal vein. Therefore, Buerger's disease, although rare, does have a chronic aggressive nature in some patients.- - - - - - - - - - ranking = 0.56059940220315keywords = coronary (Clic here for more details about this article) |
9/47. Silent pituitary infarction after coronary artery bypass grafting procedure: case report and review of literature.OBJECTIVE: To report a case of silent pituitary infarction that occurred after a coronary artery bypass grafting procedure and review the relevant literature. methods: We describe a female patient with silent pituitary infarction several months after a coronary artery bypass operation and discuss her presentation, clinical findings, and laboratory evaluation. We also review similar cases in the literature. RESULTS: A 73-year-old woman presented with generalized fatigue, weakness, and an elevated creatine kinase level several months after she had undergone a coronary artery bypass procedure. The findings on laboratory evaluation were consistent with hypogonadism, growth hormone deficiency, central hypothyroidism, and adrenal insufficiency. magnetic resonance imaging of the pituitary fossa showed an empty sella turcica and no sellar enlargement. The patient had no headaches, no neuro-ophthalmologic symptoms, and no focal neurologic deficits. The presentation was slow and insidious. The patient received glucocorticoid and thyroid hormone replacement therapy, after which her clinical status improved substantially. Silent pituitary infarction after coronary artery bypass grafting has been reported previously in 3 male patients, but our current case is the first such report in a female patient. CONCLUSION: Silent pituitary infarction can be a complication of a coronary artery bypass grafting procedure, with a delayed and insidious presentation.- - - - - - - - - - ranking = 5.0453946198284keywords = coronary (Clic here for more details about this article) |
10/47. sinus of valsalva thrombosis causing renal infarction.A 72-year-old man was admitted to our hospital with a renal infarction. On admission, computed tomography (CT) of the abdomen revealed total occlusion of the right renal artery, which was found to be recanalized with residual thrombus 7 days later. Transesophageal echocardiography and chest CT demonstrated crescent-shaped thrombus in the non-coronary sinus of valsalva without evidence of aneurysm. After coumadin treatment the patient did not experience recurrent episodes of systemic embolization. Five months after the initiation of anticoagulation, transesophageal echocardiography and chest CT demonstrated disappearance of the thrombus. This is a rare case of renal infarction caused by a thrombus in the non-coronary sinus of valsalva without aneurysm.- - - - - - - - - - ranking = 1.1211988044063keywords = coronary (Clic here for more details about this article) |
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