scholarly journals P870 The role of transthoracic doppler echocardiography in chronic total occlusion diagnosis in a patient with stable angina and cerebral atherosclerosis

2020 ◽  
Vol 21 (Supplement_1) ◽  
Author(s):  
N Pavlova
Keyword(s):  
Coronary Angiography ◽  
Medical Therapy ◽  
Doppler Echocardiography ◽  
Stable Angina ◽  
Left Ventricular ◽  
Optimal Medical Therapy ◽  
Actual Problem ◽  
Transthoracic Doppler Echocardiography ◽  
Eversion Endarterectomy ◽  
Stress Echo

Abstract Introduction The issue of sudden cardiac death (SCD) remains one of the most actual problem in healthcare. Several reports underscores that about 50-80% of SCD is linked to ischemic heart disease (IHD). The usage of contemporary risk-stratification criteria of SCD and implementation of new noninvasive ultrasound methods allow to improve patient’s prognosis through early start of optimal medical therapy and surgical treatment. Material and methods: 63 years-old male with moderate class II stable angina. Patient undergone eversion endarterectomy 2 years prior to initial admittance due to an 80% left internal carotid stenosis and received appropriate optimal medical therapy provided by the modern dyslipidemia guidelines. We’ve used ECG (MAC 1600, GE); transthoracic doppler echocardiography, stress-echo, triplex scanning (VIVID E9, E95, GE); ergometry stress test (eBike, GE), quantitative coronary angiography (Innova 3100, GE). Results ECG (sinus rhythm, 62bpm, left ventricular hypertrophy) and brachiocephalic arteries triplex scan were unremarkable. Patient had dyslipidemia with low HDL. Transthoracic echocardiography revealed no region wall motion abnormalities, concentric remodeling, mild diastolic dysfunction, preserved ejection fraction (57%, Simpson). Transthoracic doppler echocardiography showed retrograde mid-LAD flow and patient was scheduled for noninvasive stress-echocardiography (Level III, 100W 2:00 min). Stress-echo was positive with apical anterior and lateral akinesia, septal and mid-lateral hypokinesia, GLS rest 15 %, GLS peak 13% and dynamic ST-segment changes in V4-V6. Invasive coronary angiography showed LAD CTO and subtotal LCx lesion. Then LAD and LCx PTCA with stenting were performed with good clinical outcome. Conclusion Novel methods of cardiac and coronary visualization are feasible in coronary flow reserve assessment and chronic total occlusions identification, especially in patients with multifocal atherosclerosis.

A Case of Multiple Coronary Artery-Left Ventricular Microfistulae Demonstrated by Transthoracic Doppler Echocardiography

2003 ◽  
Vol 33 (4) ◽  
pp. 338 ◽  
Author(s):  
Seong Hun Choi ◽  
Hyesun Seo ◽  
Sung Jin Oh ◽  
Geu Ru Hong ◽  
Seok Min Kang ◽  
...  
Keyword(s):  
Coronary Artery ◽  
Doppler Echocardiography ◽  
Left Ventricular ◽  
Transthoracic Doppler Echocardiography

scholarly journals Risk factor Analysis and Angiographic Profiles in First 228 Cases Undergone Coronary Angiography in Cardiac Cath Lab of Dhaka Medical College Hospital

1970 ◽  
Vol 3 (2) ◽  
pp. 122-125 ◽  
Author(s):  
AEMM Islam ◽  
M Faruque ◽  
AW Chowdhury ◽  
HIR Khan ◽  
MS Haque ◽  
...  
Keyword(s):  
Risk Factors ◽  
Myocardial Infarction ◽  
Risk Factor ◽  
Coronary Angiography ◽  
Medical Therapy ◽  
Stable Angina ◽  
College Hospital ◽  
Mortality And Morbidity ◽  
Medical College ◽  
Single Vessel

Background: Coronary artery diseases are one of the major challenges faced by cardiologists. Control of certain risk factors for CAD is associated with decrease in mortality and morbidity from myocardial infarction and unstable angina. So, identification and taking appropriate measures for primary and secondary prevention of such risk factors is, therefore, of great importance. This retrospective study was carried at the newly set up cath lab in Dhaka Medical college. Materials and Methods: Total 228 consecutive case undergone diagnostic coronary angiogram from 10th January 2007 to31st January 2009 out of which 194(80%) were male and 34 (20%) were female. In both sexes most of the patients were between 41 to 60 years of age. Risk factors of the patients were evaluated. Results: In females commonest risk factor was Diabetes (58.8%) followed by dyslipidaemia (35.3%). In males commonest risk factor was hypertension (30.9%) followed by smoking (29.9%) and diabetes (28.3%). In males 44.3% patients presented with acute myocardial infarction followed by stable angina (43.3%); but in females stable angina was the commonest presentation (50.0%) followed by myocardial infarction (38.2%).CAG findings revealed that in males 33.5% had double vessel disease 26.8% followed by single vessel 26.8% and multivessel disease 25.3%. In females normal CAG was found in 35.5% followed by double vessel 23.5%, multivessel 20.6% and single vessel 20.6%. On the basis of CAG findings; in males 41.8% patients were recommended for CABG, followed by PTCA & stenting 26.3% and medical therapy 30.0%; where as in females 55.9% were recommended for medical therapy , followed by CABG 32.4% and PTCA & stenting11.8%. Conclusion: The commonest presentation of CAD was 4th and 5th decades in both sexes. Diabetes and dyslipidaemia were more common in females whereas hypertension and smoking were more common in males. Myocardial infarction and stable angina were most common presentation in both sexes though in males myocardial infarction was more common. In males the angiographic severity of CAD was more and they were more subjected for CABG in comparison to females. Key words: Risk factors; Coronary angiography. DOI: http://dx.doi.org/10.3329/cardio.v3i2.9179 Cardiovasc. J. 2011; 3(2): 122-125

Myocardial revascularization: symptomatic and prognostic indications

ESC CardioMed ◽  
2018 ◽  
pp. 1393-1395
Author(s):  
Jean-Claude Tardif ◽  
Philippe L. L’Allier ◽  
Fabien Picard
Keyword(s):  
Coronary Artery ◽  
Medical Therapy ◽  
Coronary Revascularization ◽  
Myocardial Revascularization ◽  
Left Ventricular ◽  
Optimal Medical Therapy ◽  
Left Ventricular Ejection ◽  
Major Adverse Cardiovascular Events ◽  
Large Area ◽  
Artery Disease

The primary goal of therapy in patients with chronic ischaemic heart disease is to relieve symptoms, delay or prevent progression of coronary artery disease, and decrease the risk of major adverse cardiovascular events. This is primarily achieved with optimal medical therapy. When coronary revascularization is considered, symptomatic and prognostic indications must be differentiated. For symptomatic indications, revascularization is justified if there is a large area of inducible ischaemia or if there is persistent limiting angina despite optimal medical therapy. The key prognostic indications for revascularization are left main disease with stenosis greater than 50%, any proximal left anterior descending artery stenosis greater than 50%, two-vessel or three-vessel disease with stenosis greater than 50% with impaired left ventricular function (left ventricular ejection fraction <40%), a large area of ischaemia (>10% of the left ventricle), or a single remaining patent coronary artery with stenosis greater than 50%.

scholarly journals A study of changes in various echocardiographic parameters in patients with chronic stable angina undergoing percutaneous coronary intervention (PCI)

2015 ◽  
Vol 9 (2) ◽  
pp. 99-106
Author(s):  
Muhammad Mobarock Hossain ◽  
AKM Fazlur Rahman ◽  
Md Abu Siddique ◽  
Sajal Krishna Banerjee ◽  
Chowdhury Meskat Ahmed ◽  
...  
Keyword(s):  
Percutaneous Coronary Intervention ◽  
Strain Rate ◽  
Doppler Echocardiography ◽  
Stable Angina ◽  
Myocardial Function ◽  
Chronic Stable Angina ◽  
Coronary Intervention ◽  
Tissue Doppler ◽  
Left Ventricular ◽  
Percutaneous Coronary

PCI has been used increasingly for revascularization in ischemic heart disease patients. In the cardiology practice, the assessment of left ventricular (LV) function is of paramount importance. Two-dimensional echocardiography and Doppler echocardiography remain the most important diagnostic tests/tool for the evaluation of left ventricular function. The present study was conducted to determine the impact of PCI on myocardial function assessed by 2D, M mode and tissue Doppler echocardiography in patients with chronic stable angina. The interventional study was carried out in the Department of Cardiology, University Cardiac Centre, Bangabandhu Sheikh Mujib Medical University Hospital, Dhaka over a period of 1 year between January 2013 to December 2013. Patients with chronic stable angina undergoing percutaneous coronary intervention (PCI) during the study period were the study population. A total of 40 such patients were consecutively included in the study. The myocardial function parameters were assessed by 2D, M mode and Tissue Doppler echocardiography before PCI and 48 hours and 6 weeks after PCI. Left ventricular end diastolic dimension (LVEDD) did not experience any change 2 days after PCI, but a significant reduction was noted 6 weeks after PCI (P < 0.001). Similarly no change was observed 48 hours after PCI in left ventricular end systolic dimension (LVESD) but a significant decrease was evident 6 weeks after PCI (p < 0.001). LVEF also did not exhibit any change in the first 2 days after PCI, but significantly raised 6 weeks after PCI (p < 0.001). Tissue Doppler Imaging (TDI) showed that there was insignificant improvement in Em, Am, and Em/ Am ratio 48 hours after PCI. But there was significant improvement of the same parameters at the lateral mitral annulus 6 weeks after PCI (p = 0.044, p = 0.036 and p = 0.021 respectively). While DTm did not experience any change in first 2 days after PCI, it exhibited significant change at endpoint of study (p = 0.018), RTm and Sm peak velocity however, did not improve following PCI. Q-wave increased from 7.0 cm/sec before PCI to 7.2 cm/ sec 48 hours after PCI and 7.5 cm 6 weeks after PCI (p < 0.001). Percentage of strain decreased from -15.0 before PCI to -15.4 at the endpoint (p < 0.001) and strain rate from -1.3% before PCI to -1.4% 6 at the endpoint. From the findings of the study it can be concluded that Tissue Doppler echocardiographic indices Strain, strain rate and Q analysis can detect the early changes of improvement in the left ventricular myocardium in patient with chronic stable angina after 48 hours of PCI . Other 2D , M mode and tissue Doppler echocardiographic indices showed improvement after 6 weeks of PCI.University Heart Journal Vol. 9, No. 2, July 2013; 99-106

A Case of Coronary Artery-Left Ventricular Microfistulae Demonstrated by Transthoracic Doppler Echocardiography

2006 ◽  
Vol 14 (4) ◽  
pp. 157
Author(s):  
Sung Il Choi ◽  
Soon Kil Kim ◽  
Jin Ho Shin ◽  
Jae Ung Lee ◽  
Kyung Soo Kim ◽  
...  
Keyword(s):  
Coronary Artery ◽  
Doppler Echocardiography ◽  
Left Ventricular ◽  
Transthoracic Doppler Echocardiography
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