1/39. Spontaneous coronary artery dissection. Case report and literature review.Primary coronary artery dissection occurring 2 months post partum in a 33-year-old woman is described. Owing to suspected acute myocardial infarction, the patient was treated with thrombolytic therapy but her condition deteriorated. coronary angiography showed dissection of the left anterior descending artery (LAD). Her condition stabilized during treatment with intravenous heparin, aspirin, nitrates, beta-blockers, digoxin, ACE inhibitor and anticoagulants. At discharge she had no symptoms of heart failure. One hundred and forty one cases from the literature are reviewed with special reference to patient characteristics, patient treatment, and prognosis. Primary spontaneous coronary artery dissection is a rare condition but one that must be considered when young people, especially post partum women, present an acute ischaemic syndrome. thrombolytic therapy may be a two-edged sword and therefore early angiography should be considered in making the diagnosis and choosing the therapy.- - - - - - - - - - ranking = 1keywords = coronary (Clic here for more details about this article) |
2/39. coronary artery bypass grafting for spontaneous coronary artery dissection: a case report and a review of the literature.A 37 year-old woman underwent coronary angiography because of chest pain at rest. Selective coronary angiography demonstrated dissection and stenosis with a filling delay from the left main trunk to the left anterior descending coronary artery. The patient was successfully managed with urgent coronary artery bypass grafting. Spontaneous coronary artery dissection is relatively rare and threatens both elderly and young patients with acute coronary disturbances. patients can be divided etiologically into three groups. The first was comprised of those in the postpartum period. The second was those with atherosclerotic coronary artery disease, and the third was those associated with coronary vasospasm. Dissections are frequently fatal and most of the known cases have been diagnosed at autopsy. Only a few cases have been documented by coronary angiography, and operative cases of spontaneous coronary artery dissection have rarely been reported.- - - - - - - - - - ranking = 2.3333333333333keywords = coronary (Clic here for more details about this article) |
3/39. Coronary artery dissection during pregnancy and the postpartum period: two case reports and review of literature.Spontaneous coronary dissection is a rare event occurring particularly in women during the peripartum and postpartum period. Two cases related to the early postpartum period with a successful outcome are described, together with a comprehensive review of all the previously published cases. Diagnostic and therapeutic considerations of this unique clinical entity are discussed and reviewed.- - - - - - - - - - ranking = 0.16666666666667keywords = coronary (Clic here for more details about this article) |
4/39. Postpartum coronary artery dissection complicated by heparin-induced thrombocytopenia and thrombosis.A 32-year-old woman presented with an acute anterior-lateral myocardial infarction 7 days postpartum. coronary angiography revealed an occlusive left main coronary artery dissection. After coronary artery bypass surgery the patient's cardiac function improved and stabilized. thrombocytopenia and a femoral artery thrombosis after 9 days of heparin exposure marked the development of heparin-induced thrombocytopenia and thrombosis that was successfully managed with argatroban, a direct thrombin inhibitor anticoagulant.- - - - - - - - - - ranking = 1keywords = coronary (Clic here for more details about this article) |
5/39. Transesophageal echo detection of postpartum coronary artery dissection.A 40-year-old woman, 1 week postpartum, presented with an acute anterior-septal myocardial infarction, caused by an intrawall hematoma (dissection without intimal flap) in her proximal left anterior descending coronary artery-the diagnosis being initially suggested by transesophageal echo. Discussion of this entity follows.- - - - - - - - - - ranking = 0.83333333333333keywords = coronary (Clic here for more details about this article) |
6/39. Asymptomatic coronary artery disease in a pregnant patient. A case report and review of literature.BACKGROUND: Acute myocardial infarction during pregnancy has been reported and has been shown to be associated with poor maternal and fetal outcomes. However, the vast majority of these patients do not have previously recognized ischemic heart disease. pregnancy and delivery pose significant cardiac stress and risk to the mother and fetus. However, it is unknown how available therapies can be utilized in the pregnant patient with identified ischemic heart disease to minimize these risks. CASE REPORT: We present a 39-year-old asymptomatic diabetic female with a positive stress echocardiogram at 16 weeks of pregnancy who remained asymptomatic throughout pregnancy with medical management and went on to have a normal vaginal delivery in the process suffering a small non-ST elevation myocardial infarction with pulmonary edema following delivery due to volume overload. She ultimately underwent cardiac catheterization and successful four-vessel CABG 1 months after her delivery. CONCLUSION: We present this patient to suggest a successful strategy of managing a patient with non-revascularized asymptomatic coronary artery disease during pregnancy. In addition to reviewing the appropriate medical therapy during pregnancy, we discuss the data on revascularization procedures as well as recommendations for delivery and stress testing for such patients.- - - - - - - - - - ranking = 0.83333333333333keywords = coronary (Clic here for more details about this article) |
7/39. Recurrent myocardial infarction in a postpartum patient receiving bromocriptine.myocardial infarction in puerperium is infrequently reported. Spasm, coronary dissection, or atheromatous etiology has been described. bromocriptine has been implicated in several previous case reports of myocardial infarction in the puerperium. Our case (including an inadvertent rechallenge) suggests such a relationship. Although generally regarded as "safe," possible serious cardiac effects of bromocriptine should be acknowledged.- - - - - - - - - - ranking = 0.16666666666667keywords = coronary (Clic here for more details about this article) |
8/39. Postpartum acute myocardial infarction induced by ergonovine administration.We report a primigravida woman with acute myocardial infarction caused by coronary artery spasm induced by intravenous administration of methyl ergometrine maleate just after delivery. Despite the frequent usage of ergot derivatives to promote uterine contractions, cardiac complications related to this drug are rare. myocardial infarction may be overlooked in young women in the early postpartum period. Careful monitoring and prompt evaluation should be performed when this drug is administered for obstetrical purposes.- - - - - - - - - - ranking = 0.16666666666667keywords = coronary (Clic here for more details about this article) |
9/39. Dissecting intramural haematoma of the coronary artery with intimal tears.A dissecting intramural haematoma of the coronary artery is an infrequent cause of sudden and unexpected death. Most cases are women and in a significant number of these women, the haematoma occurred at term to 80 days postpartum. Because the intimal rupture and communication with the lumen were not found in most of the cases, the site of rupture has been considered to be a vasa vasorum. The authors report on a case of one woman who was at a later postpartum period (106 days). The microscopic finding of the dissected coronary artery revealed two intimal tears in a section. The case showed that the dissecting intramural haematoma of the coronary artery is caused not only by the rupture of the vasa vasorum but also by the rupture of the intima.- - - - - - - - - - ranking = 1.1666666666667keywords = coronary (Clic here for more details about this article) |
10/39. hellp syndrome, multifactorial thrombophilia and postpartum myocardial infarction.A case of postpartum acute myocardial infarction with intraventricular thrombus occurred in a woman with hellp syndrome. Since coronary artery disease was ruled out angiographically, the assumed pathophysiological mechanism for myocardial malperfusion was intermittend coronary vasospasm and thrombosis. There were several thrombophilic risk factors detectable (heterozygous factor v Leiden, low levels of antithrombin iii, protein s deficiency), whose possible impact in this rare but severe clinical condition is discussed.- - - - - - - - - - ranking = 0.33333333333333keywords = coronary (Clic here for more details about this article) |
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