1/49. Myocardial infarction and coronary artery involvement in giant cell arteritis.PURPOSE: To describe the pathologic findings in an unusual case of giant cell arteritis that presented initially with visual loss and rapidly culminated in myocardial infarction. CASE REPORT: After the death of the patient, a complete autopsy was performed, including bilateral enucleation. All specimens, including a temporal artery biopsy completed before the patients death, were processed for routine paraffin histology and initially stained with hematoxylin and eosin. Elastic stains were subsequently used on specimens of temporal and coronary artery. The patient presented with loss of vision in the right eye. The clinical diagnosis was anterior ischemic optic neuropathy, secondary to temporal arteritis. The temporal artery biopsy was positive. Despite high-dose corticosteroid administration, the patient progressed to neurologic impairment, and subsequently to a fatal myocardial infarction. DISCUSSION: Previous reports of temporal arteritis with coronary involvement are summarized. Myocardial infarction may be a more common early complication of temporal arteritis than appreciated previously. This important complication can occur despite administration of high-dose corticosteroid therapy.- - - - - - - - - - ranking = 1keywords = giant (Clic here for more details about this article) |
2/49. Giant blood cyst of the mitral valve.We report a rare case of giant blood cyst originating from the anterior mitral valve leaflet and chordae tendineae, which was incidentally discovered during a 2-dimensional echocardiography examination performed for assessment of left ventricular function after an uncomplicated myocardial infarction in a 50-year-old man.- - - - - - - - - - ranking = 0.2keywords = giant (Clic here for more details about this article) |
3/49. Thrombosed giant coronary artery aneurysm presenting as an intracardiac mass.Giant coronary artery aneurysms are rare in adults and are usually found in association with Kawasaki's disease arising in childhood. We report a case of a thrombosed giant right coronary artery aneurysm presenting as an intracardiac mass detected after inferior wall myocardial infarction. Histologic analysis indicated that fibromuscular dysplasia was the underlying cause of the aneurysm.- - - - - - - - - - ranking = 1keywords = giant (Clic here for more details about this article) |
4/49. Multivessel coronary thrombosis, acute myocardial infarction, and no reflow in a patient with essential thrombocythaemia.Essential thrombocythaemia (ET) has been reported rarely to cause coronary thrombosis, but the management is still undefined. A 63 year old woman with multivessel coronary thrombosis, acute myocardial infarction (MI), and no reflow in reperfused coronary artery in association with ET is presented. The patient's platelet count was only moderately raised at the onset of MI, but peripheral blood smear and bone marrow evaluation revealed clumping giant platelets and numerous large hyperploid megakaryocytes. Long term prophylaxis with antiplatelet agents in patients with ET is recommended, even if the platelet count is not largely raised. Cytoreductive treatment may also be effective for secondary prevention when thrombotic complications occur.- - - - - - - - - - ranking = 0.2keywords = giant (Clic here for more details about this article) |
5/49. antiphospholipid syndrome with acute myocardial infarction and portal vein occlusion: a case report.A 62-year-old woman was admitted to hospital because of chest oppression and abdominal discomfort. Coronary arteriography revealed that the proximal left anterior descending artery had a large thrombus with TIMI (Thrombolysis in Myocardial Infarction) Grade 3 flow. On the second hospital day, she had sudden hematemesis because of esophageal varices. Her general condition became stable with conventional therapy. On the 20th hospital day, coronary arteriography and arterial portography showed that the thrombus had diminished. Arterial portography also revealed total occlusion of the portal vein as well as giant gastric varices. She was diagnosed as antiphospholipid syndrome, based on the presence of lupus anticoagulant. The treatment of this case was very complicated because of the bleeding from the esophageal varices induced by the anticoagulant therapy for the thrombus. prednisolone was administered for 1 month, but no remarkable effects were observed. Therefore, she was treated with endoscopic sclerotherapy for the esophageal varices and anticoagulant therapy for prevention of thrombosis.- - - - - - - - - - ranking = 0.2keywords = giant (Clic here for more details about this article) |
6/49. Giant R-waves in a patient with an acute inferior myocardial infarction.We describe a case of a male patient with "giant" R-waves (GRWs) in association with an acute inferior myocardial infarction (MI). Such electrocardiogram (ECG) pattern has been associated heretofore with the hyperacute phase of an anterior MI, and unstable, and variant angina, although it is found in illustrations of many previous publications in conjunction with inferior MI. The GRWs, along with ST-segment elevations, were noted transiently in the inferior ECG leads, early in the clinical course of our patient. Subsequent evolution of the ECG revealed classic appearances for an inferior MI. Cardiac enzymes, and thallium-201 myocardial perfusion scintigraphy revealed evidence for inferiorly-located myocardial necrosis. Coronary arteriography showed stenosis of the right coronary artery, for which the patient underwent an uneventful angioplasty and "stenting" of the culprit vessel. The pathophysiology of the syndrome of GRWs is briefly discussed.- - - - - - - - - - ranking = 0.2keywords = giant (Clic here for more details about this article) |
7/49. Acute myocardial infarction due to a regressed giant coronary aneurysm as possible sequela of Kawasaki disease.We report on a young patient admitted with an acute myocardial infarction due to a regressed coronary aneurysm who was treated with balloon angioplasty. The wall morphology of the coronary aneurysm using intravascular ultrasound imaging closely resembled that occurring after Kawasaki disease (KD), although our patient had no obvious past history of KD, suggesting so-called atypical KD.- - - - - - - - - - ranking = 0.8keywords = giant (Clic here for more details about this article) |
8/49. A giant left ventricular thrombus in a patient with acute myocardial infarction--a case report.The authors report a patient with acute anteroseptal myocardial infarction with a giant left ventricular thrombus at the apex. The patient also had nephrotic syndrome due to diabetic nephropathy. coronary angiography showed 90% stenosis at segment 6 of the left anterior descending coronary artery. Percutaneous transluminal coronary angioplasty and intracoronary stenting were performed on the 30th day, and effective coronary blood flow was obtained. heparin was injected intravenously for the first 7 days, and warfarin was administered thereafter. The left ventricular thrombus disappeared after 46 days. No evidence of arterial thromboembolism was found during the disappearance of the left ventricular thrombus as determined by echocardiography.- - - - - - - - - - ranking = 1keywords = giant (Clic here for more details about this article) |
9/49. Late-term myocardial infarction after surgical ligation of a giant coronary artery fistula.A case is presented of a patient with recurrent myocardial infarctions after surgical treatment of a giant coronary artery fistula. The etiology was due to thrombus development in a large blind pouch, with propagation into more proximal vessels. Stenting of the proximal vessel provided temporary benefit, but recurrence eventually required surgical closure of the blind pouch.- - - - - - - - - - ranking = 1keywords = giant (Clic here for more details about this article) |
10/49. coronary artery disease obscuring giant cell myocarditis--a case report.A case in which the diagnosis of idiopathic giant cell myocarditis was obscured by the presence of severe coronary artery disease is described. A 47-year-old man presented with recurrent inferior myocardial infarction and complete heart block. cardiac catheterization confirmed severe 2-vessel disease and left ventricular dysfunction. Incessant ventricular arrhythmia rapidly ensued, which did not respond to anti-arrhythmic therapy and overdrive pacing despite complete surgical revascularization. He eventually died. autopsy revealed giant cell myocarditis superimposed on coronary artery disease. Acute myocarditis masquerading as myocardial infarction has been well known, but virtually all reported cases had normal coronary arteries. This case illustrated the fact that even in the presence of obvious coronary artery disease the remote possibility of myocarditis should not be entirely disregarded. Although giant cell myocarditis is a rare and frequently fatal disorder, recent studies suggest that combined immunosuppressive therapy may improve the prognosis.- - - - - - - - - - ranking = 1.4keywords = giant (Clic here for more details about this article) |
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