1/15. Hibernating myocardium associated with coronary artery dissection and vasospastic angina.Hibernating myocardium is an uncommon clinical state involving persistently impaired myocardial function. A 61-year-old man was admitted because of vasospastic angina. coronary angiography revealed coronary artery dissection in the midportion of the right coronary artery, and segmental vasoconstriction was evoked by acetylcholine. In this patient, hibernating myocardium in the dissected region was clearly demonstrated by dipyridamole thallium-201 imaging. This report describes the first documented case of hibernating myocardium associated with coronary artery dissection, and the usefulness of dipyridamole thallium-201 imaging in the assessment of this state. Coronary artery spasm might be relevant to the etiology of coronary artery dissection.- - - - - - - - - - ranking = 1keywords = coronary (Clic here for more details about this article) |
2/15. Treatment of saphenous vein graft thrombosis with distal protection, thrombectomy, and adenosine prior to reperfusion: a complete approach to preserving microvascular integrity.We report the treatment of an acute myocardial infarction presenting late with thrombotic total occlusion of a saphenous vein graft. A novel approach was used to prevent microvascular obstruction and reperfusion injury, with a distal protection system, a thrombectomy device, and administration of intracoronary adenosine prior to restoration of flow, so that initial reperfusion was done with maximal microvascular vasodilatation.- - - - - - - - - - ranking = 0.125keywords = coronary (Clic here for more details about this article) |
3/15. Histopathological findings of the no-reflow phenomenon following coronary intervention for acute coronary syndrome.Although no-reflow phenomenon may occur in patients that experience reperfusion after ischemia, there have been no reports describing the postmortem findings in these patients. We describe the findings of an autopsy in a 56-year-old man who experienced acute coronary syndrome with no-reflow phenomenon after coronary intervention. Macroscopic study demonstrated myocardial infarction with diffuse hemorrhage, and microscopic analysis revealed vascular damage and microembolization in the no-reflow area. In conclusion, coronary microembolization and damage to the small coronary artery may contribute to the pathogenesis of no-reflow phenomenon following coronary intervention in humans.- - - - - - - - - - ranking = 1.625keywords = coronary (Clic here for more details about this article) |
4/15. Reperfusion-related polymorphic ventricular tachycardia as a possible mechanism of sudden death in patients with anomalous coronary arteries.We describe a patient with anomalous origin of the left coronary artery in whom polymorphic ventricular tachycardia developed immediately after an episode of chest pain with ST segment elevation. This is the first report providing direct evidence that reperfusion arrhythmias may be the cause of sudden death in individuals with anomalous coronary arteries.- - - - - - - - - - ranking = 0.75keywords = coronary (Clic here for more details about this article) |
5/15. Complete rupture of the posterior papillary muscle caused by late reperfusion for acute myocardial infarction.We describe a patient with acute mitral regurgitation due to complete rupture of the papillary muscle immediately after successful late reperfusion for inferior myocardial infarction. An 81-year-old woman was admitted complaining of mild chest discomfort. Although the electrocardiograms, biochemical test results, and her clinical history showed that several days had passed since the onset of acute myocardial infarction, a late coronary stenting was performed. Immediately after successful stenting, she suddenly developed acute pulmonary edema, leading to cardiogenic shock. In addition to high pulmonary capillary wedge pressure (mean 35 mmHg), color Doppler imaging revealed massive mitral regurgitation caused by complete rupture of the posterior papillary muscle. Emergent mitral valve replacement with a prosthetic valve was performed, saving the patient. Hence, late reperfusion should be considered carefully when treating a patient with a high risk, such as an elderly patient or a patient with single-vessel disease or initial transmural myocardial infarction.- - - - - - - - - - ranking = 0.125keywords = coronary (Clic here for more details about this article) |
6/15. Intra-myocardial haemorrhage following recanalisation of a venous coronary arterial bypass by balloon angioplasty.We report the case of a patient presenting an intra-myocardial hematoma after recanalisation of a saphenous aorto-right coronary arterial bypass graft implanted 10 years previously after posterior myocardial infarction. The intra-myocardial hematoma occurred immediately after recanalisation of the graft and was complicated by transient complete atrio-ventricular block. An acute increase of coronary capillary perfusion pressure may cause intramyocardial bleeding when capillary permeability is altered by prolonged ischemia or necrosis. In this case the resulting hematoma was limited to the segment of left ventricular wall affected by the previous necrosis and there was no further myocardial damage.- - - - - - - - - - ranking = 0.75keywords = coronary (Clic here for more details about this article) |
7/15. Relationship between coronary blood flow and perfusion pressure during reactive hyperemia: a case report in an awake unanesthetized woman with normal coronary arteries.The linear relationship between coronary blood flow and mean arterial pressure during reactive hyperemia is presented for the first time in an awake unanesthetized woman with normal coronary arteries during systemic hypotension induced by pharmacologic vasodilation. This case demonstrates the critical dependence of coronary flow reserve on simultaneous perfusion pressure.- - - - - - - - - - ranking = 1.375keywords = coronary (Clic here for more details about this article) |
8/15. Preservation of regional myocardial function during coronary angioplasty with an autoperfusion balloon catheter: a case report.Echocardiographic assessment of regional myocardial function was performed during standard balloon coronary angioplasty followed by autoperfusion balloon angioplasty of a proximal left anterior descending artery stenosis. Septal and apical akinesis occurred within 60 seconds of standard balloon inflation, but regional function was well preserved during prolonged autoperfusion balloon inflation.- - - - - - - - - - ranking = 0.625keywords = coronary (Clic here for more details about this article) |
9/15. Clinicopathological study of myocardial infarction with normal or nearly normal extracardiac coronary arteries. Quantitative analysis of contraction band necrosis, coagulation necrosis, hemorrhage, and infarct size.In order to clarify the pathogenesis of acute myocardial infarction (MI) in hearts with normal coronary arteries, infarct size, and the extent of contraction band necrosis (CBN), coagulation necrosis, and hemorrhage were quantitatively examined using an image analyzer in 5 autopsy cases of MI with normal or nearly normal extracardiac coronary arteries. One patient died 40 h after acute MI. A second patient with acute MI due to severe spasm of segment 6, confirmed by cineangiography, died three days later. The third patient had already suffered a subarachnoid hemorrhage, and died 10 h after the onset of acute MI. The fourth patient had aortic stenosis and regurgitation. She developed acute MI due to total occlusion of segment 6, confirmed by cineangiography 4 h after the onset, and died 61 days later. autopsy revealed old anteroseptal MI with normal coronary arteries and valvular thrombi. The fifth patient had a malignancy, and died one day after the onset of acute MI. autopsy revealed multiple occlusive thrombi in the small intramural coronary arteries of the left ventricular wall supplied by segment 14, without any stenosis in the feeding vessel. Most infarcts were localized in the territory supplied by 1 or 2 of the 3 epicardial coronary arteries, and coincided with the clinically diagnosed infarct site. The infarct size ranged from 3%-26% of the left ventricular wall, and infarcts were generally localized to the inner third of the wall (67 /- 20%). Histological examination of the four patients with acute MI revealed diffuse CBN (86 /- 14% of the infarcted area) and/or hemorrhage.(ABSTRACT TRUNCATED AT 250 WORDS)- - - - - - - - - - ranking = 1.125keywords = coronary (Clic here for more details about this article) |
10/15. Acute myocardial infarction shortly after negative exercise test and reperfusion by intracoronary thrombolysis.A 67-year-old man developed an acute myocardial infarction shortly after normal exercise testing. His clinical history and findings from emergency coronary arteriography suggested that coronary artery spasm followed by intraluminal thrombosis might have been responsible for the myocardial infarction. Although intracoronary thrombolysis two hours after the onset of chest pain provided continued patency of an occluded vessel, serial myocardial perfusion scintigraphies documented myocardial injury, which was probably induced by reperfusion, rather than myocardial salvage.- - - - - - - - - - ranking = 0.875keywords = coronary (Clic here for more details about this article) |
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