The Prevalence and Clinical Profile of Angiographic Coronary Ectasia

2003 ◽  
Vol 11 (2) ◽  
pp. 122-126 ◽  
Author(s):  
Peter Nyamu ◽  
Mullasari S Ajit ◽  
Peter K Joseph ◽  
Lakshmi Venkitachalam ◽  
Nancy A Sugirtham
Keyword(s):  
Coronary Artery ◽  
Clinical Presentation ◽  
Review Of Literature ◽  
Management Options ◽  
The Past ◽  
Left Anterior Descending Artery ◽  
Coronary Ectasia ◽  
High Prevalence ◽  
History Of ◽  
The Right

Coronary artery ectasia, a variant of coronary atherosclerosis, is a relatively rare entity. Review of literature did not reveal an exclusive study on isolated ectasia. We decided to analyse the clinical presentation and angiographic prevalence of this subset. A retrospective study of patients who underwent coronary angiogram in our institute over the past six years was carried out and the epidemiological, clinical and angiographic characteristics of patients with isolated ectasia were analysed. Distribution of ectasia was with a modification of the Markis classification. Among 6938 angiograms analysed, 134 (2%) had isolated ectasia. Of the 118 symptomatic patients, 34 (25%) had a history of or presented with infarction, with correlation between the territory of infarction and the ectatic vessel in 32 patients. Of 62 patients with lipid abnormality, Hypertriglyceridemia in 42 (65%) was the most common. The left anterior descending artery was the most common vessel involved. Diffuse ectasia most commonly involved the right coronary artery. One patient had spontaneous coronary dissection. There is a relatively high prevalence of isolated coronary ectasia with predominant involvement of the right coronary vessel when diffuse and the left anterior descending artery when discrete. This entity is not innocuous and warrants a detailed study on the available management options.

scholarly journals A Combination of Two Rare Coronary Anomalies Makes It Even Rarer: Right Sided Single Coronary Artery with Dual Left Anterior Descending Artery

2016 ◽  
Vol 2016 ◽  
pp. 1-4 ◽  
Author(s):  
Aram Barbaryan ◽  
Theodore Addai ◽  
Monahar Kola ◽  
Muhammad Wajih Raqeem ◽  
Sergey Barsamyan ◽  
...  
Keyword(s):  
Coronary Artery ◽  
Cardiac Catheterization ◽  
Coronary Intervention ◽  
Common Trunk ◽  
Single Coronary Artery ◽  
Aortic Sinus ◽  
Exertional Dyspnea ◽  
Left Anterior Descending Artery ◽  
History Of ◽  
The Right

An 82-year-old female with history of hyperlipidemia and hypertension presented to the clinic with chief complaint of nonradiating chest tightness accompanied by exertional dyspnea. Cardiac catheterization showed the absence of left coronary system; the entire coronary system originated from the right aortic sinus as a common trunk which then gave off the right coronary artery and the left main coronary artery. Cardiac catheterization demonstrated also another rare coronary anomaly: dual left anterior descending artery. Patient underwent percutaneous coronary intervention and subsequent multidetector computed tomography angiography confirmed the above angiography findings. Patient was subsequently discharged home on double antiplatelet therapy with aspirin and clopidogrel and has been asymptomatic since then.

Dose All of the Coronary Fistulas been Created by the Reopening Wire After Successful Revascularization of Chronic Total Occlusion?

2020 ◽  
Author(s):  
Rong Fan ◽  
Haipeng Tan ◽  
Yanan Song ◽  
Wang Yao ◽  
Yawei Yang ◽  
...  
Keyword(s):  
Coronary Artery ◽  
Right Coronary Artery ◽  
Chronic Total Occlusion ◽  
Coronary Intervention ◽  
Complete Revascularization ◽  
Total Occlusion ◽  
Left Anterior Descending Artery ◽  
Percutaneous Coronary ◽  
History Of ◽  
The Right

Abstract Background: Coronary fistulas may be congenital or acquired generally as consequence of coronary interventions, mainly chronic total occlusion (CTO) reopening. When the reopening wire passes through the occlusion it may microperforate the advential vascular layers, favoring the fistulous communication between coronary vessel and cardiac chambers. But some of acquired coronary fistulas (ACFs) had been already present at the CTO vessels and would been seen after revascularization. This study was designed to investigate the characteristics of ACFs, which albeit mostly benign can cause concern and unnecessary treatment post successful CTO percutaneous coronary intervention (PCI).Methods: Data, including clinical and procedural characteristics, medical history, and findings in electrocardiography, echocardiography and coronary angiography, from 2169 consecutive patients undergoing CTO PCI between January 2018 and December 2019 were analyzed retrospectively. Results: 1844 (85.0%) underwent successful CTO PCI with complete revascularization. Among them, there were 49 cases (mean age, 62.80 ± 11.24 years; 40 men) of ACFs: 24 (49%) involved the right coronary artery, 19 (38.8%) the left anterior descending artery, and 6 (12.2%) the circumflex branch; and 38 (77.6%) were coupled with multiple fistulas (>3), and 29 (59.2%) affected multiple branches of the CTO vessel (>3). The majority of patients with ACFs had a history of MI or Q-wave (n=34, 69.4%), and angina was the most common complaint (n=41, 83.7%). None of them had pericardial effusion, tamponade and Hemodynamic abnormalities before or after PCI.Conclusion: ACFs after successful CTO PCI mostly developed in patients with MI history, originated from the right coronary artery or left anterior descending artery, and involved multiple fistulas and CTO vessel branches.

A Giant Right Coronary Artery of Diffuse Ectasia Induced by a Right Ventricular Fistula

2015 ◽  
Vol 18 (6) ◽  
pp. 253
Author(s):  
Renyuan Li ◽  
Yiming Ni ◽  
Peng Teng ◽  
Weidong Li
Keyword(s):  
Coronary Artery ◽  
Right Coronary Artery ◽  
Artery Bypass ◽  
Coronary Artery Fistula ◽  
Rare Entity ◽  
Fistula Closure ◽  
Unique Case ◽  
Coronary Ectasia ◽  
The Right ◽  
Giant Size

<p>Coronary artery fistula (CAF) is a rare entity. Sometimes it may associate with mild diffuse or segmental coronary ectasia. CAF with giant coronary artery is exceptionally rare. We present a unique case of a 49-year-old female patient with a giant right coronary artery of diffuse ectasia coexisting with a fistula draining into the right ventricle. To our best knowledge, CAF with diffuse coronary ectasia of such giant size has never been reported. The patient was treated successfully by resection of the dilated right coronary artery, fistula closure, and coronary artery bypass grafting.</p>

COMMONWEALTH Forum: The Politics of Science or the Science of Politics

Commonwealth ◽  
2017 ◽  
Vol 19 (1) ◽  
Author(s):  
John Arway
Keyword(s):  
Public Policy ◽  
Natural Resource ◽  
Factual Information ◽  
The Past ◽  
Difference Of Opinion ◽  
History Of ◽  
The Right ◽  
Scientific Facts ◽  
Environmental Agency ◽  
Laws And Regulations

The challenges of including factual information in public policy and political discussions are many. The difficulties of including scientific facts in these debates can often be frustrating for scientists, politicians and policymakers alike. At times it seems that discussions involve different languages or dialects such that it becomes a challenge to even understand one another’s position. Oftentimes difference of opinion leads to laws and regulations that are tilted to the left or the right. The collaborative balancing to insure public and natural resource interests are protected ends up being accomplished through extensive litigation in the courts. In this article, the author discusses the history of environmental balancing during the past three decades from the perspective of a field biologist who has used the strength of our policies, laws and regulations to fight for the protection of our Commonwealth’s aquatic resources. For the past 7 years, the author has taken over the reins of “the most powerful environmental agency in Pennsylvania” and charted a course using science to properly represent natural resource interests in public policy and political deliberations.

Accelerating Agricultural Growth—Is Irrigation Institutional Reform Necessary? (Distinguishedl Lecture)

1996 ◽  
Vol 35 (4I) ◽  
pp. 399-417 ◽  
Author(s):  
John W. Mellor
Keyword(s):  
Growth Rates ◽  
Irrigation System ◽  
Institutional Reform ◽  
Residual Effect ◽  
Agricultural Growth ◽  
The Past ◽  
Major Reform ◽  
History Of ◽  
The Right ◽  
Economic Growth Rates

The right to the flow of income from water is vigorously pursued, protected, and fought over in any arid part of the world. Pakistan is of course no exception. Reform of irrigation institutions necessarily changes the rights to water, whether it be those of farmers, government, or government functionaries. Those perceived rights may be explicit and broadly accepted, or simply takings that are not even considered legitimate. Nevertheless they will be fought over. Pakistan has a long history of proposals for irrigation reform, little or none being implemented, except as isolated pilot projects. Thus, to propose major changes in irrigation institutions must be clearly shown to have major benefits to justify the hard battles that must be fought and the goodwill of those who might win those battles for reform. Proponents of irrigation institution reform have always argued the necessity of the reforms and the large gains to be achieved. Perhaps, however, those arguments have not been convincing. This paper will briefly outline the failed attempts at irrigation reform to provide an element of reality to the discussion. It will then proceed to make the case of the urgency of reform in a somewhat different manner to the past. Finally, current major reform proposals will be presented. This paper approaches justification of irrigation reform by focusing on the agricultural growth rate. It does so because that is the critical variable influencing poverty rates and is a significant determinant of over-all economic growth rates. The paper decomposes growth rates and suggests a residual effect of deterioration of the irrigation system that is large and calls for policy and institutional reform. The data are notional, suggesting the usefulness of the approach and paves the way for more detailed empirical analysis and enquiry for the future.

Giant right coronary artery aneurysm

2020 ◽  
Vol 28 ◽  
pp. 1-3
Author(s):  
Alexandre Bonfim ◽  
Ronald Souza ◽  
Sérgio Beraldo ◽  
Frederico Nunes ◽  
Daniel Beraldo
Keyword(s):  
Coronary Artery ◽  
Right Coronary Artery ◽  
Coronary Artery Aneurysm ◽  
Clinical Course ◽  
Artery Aneurysm ◽  
Giant Aneurysm ◽  
Coronary Artery Aneurysms ◽  
History Of ◽  
Artery Disease ◽  
The Right

Right coronary artery aneurysms are rare and may result from severe coronary disease, with few cases described in the literature. Mortality is high, and therapy is still controversial. We report the case of a 72-year-old woman with arterial hypertension, and a family history of coronary artery disease, who evolved for 2 months with episodes of palpitations and dyspnea on moderate exertion. During the evaluation, a giant aneurysm was found in the proximal third of the right coronary artery. The patient underwent surgical treatment with grafting of the radial artery to the right coronary artery and ligation of the aneurysmal sac, with good clinical course.

Comorbid Depressive Disorders in Epilepsy

CNS Spectrums ◽  
2010 ◽  
Vol 15 (S4) ◽  
pp. 3-6 ◽  
Author(s):  
Andres M. Kanner ◽  
Andrew J. Cole
Keyword(s):  
Emergency Room ◽  
Depressive Disorders ◽  
Clonic Seizure ◽  
Resonance Imaging ◽  
Abnormal Signal ◽  
The Past ◽  
History Of ◽  
Magnetic Resonance Imaging Mri ◽  
The Right ◽  
History Of Depression

A 27-year-old woman presented to the emergency room after having witnessed generalized tonic clonic seizure while asleep. Birth and development were normal. She had suffered a single febrile seizure at 13 months of age, but had no other seizure risk factors. She was otherwise well except for a history of depression for which she was taking sertraline. Depressive symptoms had been well controlled over the past 3 months, but she had been under increased stress working to finish a doctoral thesis. Neurological examination was normal. Magnetic resonance imaging (MRI) showed modest asymmetry of the hippocampi, slightly smaller on the right, but no abnormal signal and well-preserved laminar anatomy. An electroencephalogram was negative. She was discharged from the emergency room with no treatment. Three weeks later, the patient's boyfriend witnessed an episode of behavioral arrest with lip smacking and swallowing automatisms lasting 45 seconds, after which the patient was confused for 20–30 minutes. The next morning she and her boyfriend kept a previously scheduled appointment with a neurologist.

scholarly journals Recurrent Thrombotic Vasculopathy in a Former Cocaine User

2015 ◽  
Vol 2015 ◽  
pp. 1-3
Author(s):  
Preeti Jadhav ◽  
Hassan Tariq ◽  
Masooma Niazi ◽  
Giovanni Franchin
Keyword(s):  
Clinical Presentation ◽  
Rehabilitation Program ◽  
The Body ◽  
Drug Rehabilitation ◽  
Cocaine User ◽  
Cocaine Use ◽  
The Past ◽  
Urine Toxicology ◽  
History Of ◽  
Infectious Etiology

We report a case of a 35-year-old female who presented to the emergency room (ER) complaining of a pruritic rash involving multiple areas of the body. She had a significant history of cocaine use in the past. She had first developed a similar rash in 2013 when she was diagnosed with cocaine-induced vasculitis. Her urine toxicology had been positive for cocaine in the past until July 2013. She was incarcerated and attended a drug rehabilitation program after which she quit cocaine use, which was consistent with negative urine toxicology on subsequent admissions. Further workup did not reveal any other, autoimmune or infectious, etiology of this clinical presentation. The patient underwent biopsy of the skin lesion that was consistent with thrombotic vasculopathy likely secondary to levamisole.

scholarly journals The Belarusian estate of Ya. F. Golovatsky

2020 ◽  
pp. 442-448
Author(s):  
Yuriy A. Labyntsev ◽  
Larisa L. Shchavinskaya
Keyword(s):  
Research Laboratory ◽  
The Past ◽  
History Of ◽  
The Right

The article describes the history of Votnya, a small estate on the right bank of Dniepr river in Bykhovsky uyezd of Mahilyow Governorate, at the time it belonged to the well-known slavist Ya. F. Golovatsky and his family. After Ya. F. Golovatsky ceased to be a professor of Lviv University, he, a subject of the Austrian Empire, spent here at least two years in total surrounded by the local Belarusians, predominantly Or-thodox. Ya. F. Golovatskij would regularly come here year after year in the summer months. He invested “all his savings” into the development and improvement of his Belarusian estate and created a strong household with a beautiful park. For Ya. F. Golovatsky, Votnya gradually became a vibrant research laboratory to study both the past and the present of Belarusians. This was refl ected, for example, in his assessment of the famous “Dictionary of the Belarusian dialect” by I. I. Nosovich. For many years after the death of the owner of Votnya in 1888, his widow and daughters lived in the estate. It brought income that was also used to create a special scholarship foundation named after Yakov Golovatsky in the framework of the Shevchenko Scientifi c society in Lviv.

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