1/543. Multiple coronary occlusions associated with ST-segment elevation. We describe the case of a patient with rapid sequential ST-segment elevation in different areas on the electrocardiogram (ECG) associated with lesions of differing etiologies in the corresponding coronary arteries. Prior reports of ST-segment elevations in multiple areas on the ECG have been from obstructions of single coronary vessels whose distribution overlapped separate areas on the ECG or spasm of multiple coronary arteries. We could find no prior reports of such rapid sequential ST-elevation in different areas on the ECG caused by two differing etiologies. ( info) |
| A 19-year-old man developed a huge coronary aneurysm and stenosis in the right coronary artery as a sequela of Kawasaki disease (KD) that resulted in recurrent episodes of myocardial infarction. Coronary ischemic events were successfully prevented after balloon angioplasty followed by coronary stent implantation into the stenotic lesion. The stent deployment may have an advantage compared with balloon angioplasty and other new devices for the treatment for patients with KD showing stenotic lesions without dense calcification. ( info) |
3/543. Calcified right atrial mass in a woman receiving long-term intravenous phosphate therapy. Right atrial masses are easily seen by 2-dimensional echocardiography and may represent primary tumors, secondary tumor invasion of the right atrium, tricuspid valve vegetations, or atrial thrombi. Calcification of right atrial masses is uncommon but easily identified by 2-dimensional echocardiography because of the high echogenicity of calcium deposits. We describe a patient with a heavily calcified right atrial thrombus caused by an indwelling central venous catheter and long-term intravenous phosphate infusion. ( info) |
| We report 3 cases of fatal neutropenia and thrombocytopenia associated with ticlopidine after coronary stenting. patients should be counseled about the early signs of infection and bleeding and to have regularly scheduled complete blood counts. ( info) |
| Septic arthritis and osteomyelitis in children is seldom accompanied by calf vein thrombosis and rarely by atrial thrombosis. We report the case of an 11-year, 5-month-old boy with septic arthritis and osteomyelitis of the sacroiliac region who developed deep venous thrombosis, in addition to life-threatening right atrial thrombosis. After an intensive hematologic investigation, a hereditary protein c deficiency was revealed. The association of venous thrombosis with septic arthritis or osteomyelitis should raise the possibility of the presence of protein c deficiency. ( info) |
6/543. The role of echocardiography in assessing the morphological response of left ventricular thrombus to anticoagulation. We present a patient with idiopathic dilated cardiomyopathy and a large left ventricular apical thrombus in which serial echocardiography over a 1-month period documented progressive enlargement of this mural thrombus. This case illustrates the dramatic progression of left ventricular thrombus size despite aggressive anticoagulation. In addition, the critical role of echocardiography in the diagnosis and follow-up of patients with left ventricular thrombus is emphasized. ( info) |
7/543. Thrombotic occlusion of the main stem of the left coronary artery in a neonate. Thrombotic coronary arterial occlusion, and myocardial infarction, are rare in the newborn. We report such a happening presenting shortly after birth with cardiogenic shock, no left ventricular output and a systemic circulation dependent on flow from a patent arterial duct. ( info) |
8/543. Refractory coronary artery spasm with superimposed thrombosis: successful treatment with Palmaz-Schatz stent. Prinzmetal variant angina due to epicardial coronary artery spasm is a disease usually treated with drug therapy with successful results. A case of variant angina, refractory to conventional pharmacological treatment, and complicated by coronary artery thrombosis, was treated with percutaneous transluminal coronary angioplasty and stenting with good immediate and late clinical results. ( info) |
9/543. Coronary dissection and thrombosis associated with exercise testing three months after successful coronary stenting. exercise testing is commonly performed to assess the functional result of coronary revascularization procedures and is usually not associated with any complications. However, this report documents a rare case of coronary dissection and thrombosis, which resulted in an acute myocardial infarction, in a patient who underwent stress testing 3 months following successful coronary stent implantation. ( info) |
10/543. Acute occlusion of the left main coronary artery following intracoronary ultrasound examination. Intracoronary ultrasound (ICUS) is generally considered as safe procedure, with a low complication rate. We describe a nearly fatal complication of a diagnostic ICUS study that was treated successfully with stent implantation in the left main coronary artery and discuss the indications and remaining risks of this procedure. ( info) |