Computed Tomography Angiographic Demonstration of an Unexpected Left Main Coronary Artery Dissection in a Patient With Polycystic Kidney Disease

2011 ◽  
Vol 26 (1) ◽  
pp. W4-W6 ◽  
Author(s):  
Chih-Chia Lee ◽  
Chih-Yuan Fang ◽  
Chung-Cheng Huang ◽  
Shu-Hang Ng ◽  
Hon-Kan Yip ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Coronary Artery ◽  
Kidney Disease ◽  
Polycystic Kidney Disease ◽  
Left Main Coronary Artery ◽  
Artery Dissection ◽  
Polycystic Kidney ◽  
Left Main ◽  
Coronary Artery Dissection ◽  
Angiographic Demonstration

scholarly journals Spontaneous coronary artery dissection in a patient with hereditary polycystic kidney disease and a recent liver transplant: a case report

2019 ◽  
Vol 3 (4) ◽  
pp. 1-5 ◽  
Author(s):  
Ezther Verlaeckt ◽  
Laurens Van de Bruaene ◽  
Mathieu Coeman ◽  
Sofie Gevaert
Keyword(s):  
Case Report ◽  
Coronary Artery ◽  
Kidney Disease ◽  
Liver Transplant ◽  
Polycystic Kidney Disease ◽  
Artery Dissection ◽  
High Dose ◽  
Spontaneous Coronary Artery Dissection ◽  
Polycystic Kidney ◽  
Coronary Artery Dissection

Abstract Background Spontaneous coronary artery dissection (SCAD) is an underestimated cause of acute coronary syndromes. A predisposing arteriopathy is often present and a stressor can sometimes be identified. Autosomal dominant polycystic kidney disease (ADPKD) is the most common hereditary kidney disorder; its associated arteriopathy has been described as a predisposing condition for SCAD. Case summary A 44-year-old woman with ADPKD presented in the emergency room with recent onset thoracic pain radiating to the left arm at rest. She had undergone a recent liver transplant, for which she had received high-dose corticosteroids during 1 month. She was still taking tacrolimus and mycophenolate mofetil. She had no traditional risk factors but had experienced stress postoperatively. She was known with moderate chronic kidney disease. The initial electrocardiogram (ECG) was normal but high-sensitive troponin T was significantly elevated. Coronary angiography demonstrated diffuse narrowing of the distal left anterior descending artery with preserved flow, compatible with a SCAD Type 2 that was treated conservatively. However, under dual antiplatelet therapy (DAPT) with clopidogrel, the coronary dissection was progressive with new ischaemic ECG changes, further rise of troponins and development of apicoseptal hypokinesia. Because of the small vessel diameter and the preserved distal flow, conservative treatment was maintained. Clopidogrel was interrupted and the patient remained stable. Discussion As SCAD remains an underestimated cause of myocardial infarction, clinicians should be aware of the possibility of SCAD in ADPKD patients with chest pain. This case report illustrates that the decision DAPT vs. aspirin should be individualized in these patients.

Imaging of left main coronary artery dissection with multislice computed tomography

2007 ◽  
Vol 115 (3) ◽  
pp. e111-e113 ◽  
Author(s):  
Giuseppe Andò ◽  
Francesco Saporito ◽  
Marco Cerrito ◽  
Ignazio Salamone ◽  
Alessia Pandolfo ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Coronary Artery ◽  
Multislice Computed Tomography ◽  
Left Main Coronary Artery ◽  
Artery Dissection ◽  
Left Main ◽  
Coronary Artery Dissection

Surgical management of spontaneous left main coronary artery dissection

1998 ◽  
Vol 66 (1) ◽  
pp. 258-260 ◽  
Author(s):  
Patricia A Thistlethwaite ◽  
Riyad Y Tarazi ◽  
Frank J Giordano ◽  
Stuart W Jamieson
Keyword(s):  
Coronary Artery ◽  
Surgical Management ◽  
Left Main Coronary Artery ◽  
Artery Dissection ◽  
Left Main ◽  
Coronary Artery Dissection

Salvage myocardial revascularisation in spontaneous left main coronary artery dissection with cardiogenic shock – the role of mechanical circulatory support

Perfusion ◽  
2016 ◽  
Vol 32 (2) ◽  
pp. 171-173 ◽  
Author(s):  
Ashok Padukone ◽  
Ahmed K. Sayeed ◽  
Nandor Marczin ◽  
Diana García Sáez ◽  
Bartlomiej Zych ◽  
...  
Keyword(s):  
Coronary Artery ◽  
Cardiogenic Shock ◽  
Mechanical Circulatory Support ◽  
Left Main Coronary Artery ◽  
Artery Bypass ◽  
Myocardial Revascularization ◽  
Circulatory Support ◽  
Artery Dissection ◽  
Left Main ◽  
Coronary Artery Dissection

Spontaneous left main coronary artery dissection is a rare cause of acute coronary events or sudden cardiac death, constituting less than 1% of all epicardial coronary artery dissections. It is often fatal and is mostly recognized at post-mortem examination in young victims of sudden death. More than 70% of the reported cases occurred in women, particularly during pregnancy and the peripartum period and those on oral contraceptives. The clinical presentation is highly variable and prognosis varies widely, depending predominantly on the speed of diagnosis. Treatment options include medical therapy, revascularization with coronary artery bypass grafting (CABG) or percutaneous coronary intervention (PCI) and mechanical circulatory support in cases of cardiogenic shock. We report a case of spontaneous dissection of the left main stem coronary artery, with extension into the left coronary territory, which occurred in a 41-year-old lady, complicated by profound cardiogenic shock requiring recovery with extracorporeal mechanical circulatory support after salvage myocardial revascularization.

scholarly journals Left anterior descending coronary artery dissection during ventricular tachycardia ablation – case report

2018 ◽  
Vol 56 (1) ◽  
pp. 63-66
Author(s):  
Kresimir Kordic ◽  
Sime Manola ◽  
Ivan Zeljkovic ◽  
Ivica Benko ◽  
Nikola Pavlovic
Keyword(s):  
Ventricular Tachycardia ◽  
Coronary Artery ◽  
Left Main Coronary Artery ◽  
Left Ventricular ◽  
Artery Dissection ◽  
Complication Rates ◽  
Left Main ◽  
Coronary Artery Dissection ◽  
Ventricular Tachycardia Ablation ◽  
First Case

Abstract Fascicular left ventricular tachycardia (VT) is the second most frequent idiopathic left VT in the setting of a structurally normal heart. Catheter ablation is curative in most patients with low complication rates. We report a case of ostial left anterior descending coronary artery (LAD) occlusion during fascicular ventricular tachycardia ablation. Dissection was the most likely cause of LAD obstruction. To the authors’ best knowledge, this is the first case reporting selective LAD dissection during electrophysiology study with no left main coronary artery (LMCA) affection.

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