Cases reported "Angina Pectoris"

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1/9. Multiple spontaneously occurring coronary artery-left ventricular communications: a case report.

    A search of the literature revealed that spontaneous coronary artery-left ventricular communications have only rarely been reported. These fistulae are frequently associated with angina pectoris which has been attributed to a ventricular steal phenomenon. The patient described herein presented with angina pectoris and was found to have multiple coronary arterioventricular communications without significant coronary atherosclerosis.
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2/9. Telangiectatic fistula between the conal branch of the left coronary artery and the pulmonary trunk.

    A rare case of telangiectatic communication between the conal branch of the left coronary artery and the pulmonary trunk in a 50-year-old woman is reported. Unusual features included the presence of clear-cut angina on effort, unstable auscultatory findings and a RSR' pattern in lead V1, probably related to concommitant diffuse coronary atherosclerosis. Ten previously reported cases of the condition are briefly reviewed.
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3/9. Unidirectional communication between the circumflex and right coronary arteries: a very rare coronary anomaly and cause of ischemia.

    Intercoronary communication is an exceptionally rare congenital malformation. A 43-year-old male was admitted to our cardiology department with symptomatic stable angina. ECG and echocardiography was normal. exercise electrocardiography showed ST depression in inferior leads. No atherosclerotic plaque in the coronary arteries was detected on coronary angiography. However, a unidirectional intercoronary communication between the circumflex and right coronary arteries, which was leading a coronary steal from right to left, was observed. Although intercoronary communication is generally not related with ischemia, ischemic symptoms and exercise ECG changes of this case suggested that unidirectional flow might cause myocardial ischemia via coronary steal. Consequently, intercoronary communication, a very rare coronary anomaly and a cause of ischemia, is discussed in this case report.
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4/9. Internal mammary artery graft to pulmonary vasculature fistula: a cause of recurrent angina.

    Recurrent angina pectoris developed in a 59-year-old man 3 years after coronary artery bypass grafting using the left internal mammary artery. cardiac catheterization showed a fistula between the left internal mammary artery and the pulmonary vasculature. This is an unusual documented case of postoperative internal mammary artery graft to pulmonary vasculature fistula after coronary artery bypass grafting. Division of this fistulous communication resulted in resolution of the patient's angina.
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5/9. Fate of omental graft after revascularization of the heart.

    Three patients who had had epicardiectomy, and internal mammary artery and omental grafts implanted as part of myocardial revascularization, recently underwent a second operation for coronary artery bypass grafting. All internal mammary artery implants were patent and appeared to revascularize the myocardium distal to the occluded segment of the coronary artery, as determined by angiography. Although adhesions were present at operation, there was no evidence of the free omental graft in two patients. The pedicled omental graft was present and viable in the remaining patient, but did not appear to have vascular communication with the epicardiectomized myocardium.
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6/9. Pulmonary steal syndrome: an unusual case of coronary-bronchial pulmonary artery communication.

    The authors report a patient with angina pectoris in whom selective left coronary angiography demonstrated that the pulmonary artery branch to an apical lung segment was supplied by a bronchial collateral vessel which arose from the left circumflex artery. The anatomic and physiological developmental mechanisms, and the clinical implications, are discussed. Relief of the patient's angina following ligation of the pulmonary artery branch indicated the development of a form of pulmonary steal syndrome.
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7/9. Traumatic right coronary artery--right atrial fistula.

    Traumatic coronary artery fistulae and intracardiac shunts due to penetrating wounds of the heart are rare, with only 19 reported cases in the literature. The communication, which may involve one or both coronary arteries, is classified into two major types depending on whether the drainage is into the left or right heart. We report a right coronary artery (RCA) right atrial fistula (RA) secondary to shrapnel injury in 1944.
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8/9. Case report: a case of multiple coronary artery to left ventricular communications.

    A 39-year-old man with anginal pain had multiple coronary artery to left ventricular communications. His electrocardiogram showed evidence of left ventricular hypertrophy, and an echocardiogram revealed a dilated left ventricle. A coronary angiogram revealed multiple coronary artery to left ventricular fistulae involving three major coronary arteries with no evidence of atherosclerotic lesions. Only 17 cases of such fistulous communications involving three major coronary arteries have been reported in the literature. It is suggested that the fistulous communications to the left ventricle was a cause of his angina pectoris, probably because of the coronary steal phenomenon.
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9/9. Ventriculo-venous communications in adults: ventriculographic observations in two female patients.

    Ventriculo-venous communications (VVC) were angiographically demonstrated in two adult female patients clinically presented with effort angina. During oxymetric studies there were minor to moderate left-to-right shunts. Concomitant, mild valvular aortic stenosis (AS) was present in one patient and hypertrophic obstructive cardiomyopathy (HOCM) in the other. It is believed that ventriculo-venous communications have contributed to the symptomatology in both patients. Symptoms were controlled medically in combination with dual (DDD) cardiac pacing with short AV-delay in one patient and only medically in the other patient. From the differential diagnostic point of view, superselective contrast injection into an 'inert' myocardial sinusoid or intramural contrast staining has been considered but could be excluded.
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