scholarly journals Primary Left Atrial Angiosarcoma Presenting as Acute Coronary Syndrome

2019 ◽  
Vol 22 (2) ◽  
pp. E162-E164 ◽  
Author(s):  
Sandra Jaksic Jurinjak ◽  
Josip Vincelj ◽  
Igor Rudez ◽  
Ante Lisicic ◽  
Ivana Jurin ◽  
...  
Keyword(s):  
Acute Coronary Syndrome ◽  
Differential Diagnosis ◽  
Left Atrium ◽  
Transoesophageal Echocardiography ◽  
Malignant Neoplasms ◽  
Circumflex Artery ◽  
Left Circumflex Artery ◽  
Coronary Syndrome ◽  
Cardiac Neoplasms ◽  
Rare Differential Diagnosis

Primary cardiac neoplasms are extremely rare and often overlooked as differential diagnosis. Angiosarcomas are the most common primary malignant neoplasms of the heart often with nonspecific symptoms. We present a 43-year-old woman admitted to our hospital with chest pain and inferoposterolateral myocardial infarction. Coronary angiography indicated the distal occlusion of the left circumflex artery. Transthoracic and transoesophagic echocardiography revealed a mass in the left atrium with probable myocardial infiltration and vascularisation. The mass in the left atrium was removed by surgical resection, and histopathology confirmed angiosarcoma. We emphasize the pivotal role of transthoracic and transoesophageal echocardiography in evaluating even rare differential diagnosis of acute coronary syndrome as cardiac neoplasms.

scholarly journals Left Circumflex Artery Rupture with Left Atrial Tamponade and Functional Mitral Stenosis

2018 ◽  
Vol 2018 ◽  
pp. 1-5
Author(s):  
Weiting Huang ◽  
Khaled Mohamed Emadeldin Moheb Hammad ◽  
Victor Tar Toong Chao ◽  
Khung Keong Yeo
Keyword(s):  
Left Atrium ◽  
Coronary Sinus ◽  
Mitral Stenosis ◽  
Left Atrial ◽  
Pulmonary Veins ◽  
Fluid Collection ◽  
Artery Dissection ◽  
Circumflex Artery ◽  
Left Circumflex Artery ◽  
Coronary Syndrome

The growth in percutaneous transluminal devices has enabled operators to tackle more complex, native, and post-bypass surgery anatomy. However, complications such as coronary artery dissection, coronary perforation, retrograde aortic dissection, arrhythmias, and acute coronary syndrome still occur with resulting mortality rates of up to 4.2% in complex interventions. Perforation of the circumflex artery is of particular interest in view of its position and relation to the surrounding cardiac structures. This is a site of potential fluid collection, and as the left atrium is fixed to the parietal pericardium at the entry of the pulmonary veins, fluid in the oblique sinus can accumulate enough pressure to compress the left atrium and the coronary sinus. We present a case of left circumflex artery perforation which demonstrates the physiologic complications of coronary sinus and left atrial compression and the resultant functional mitral stenosis.

Usefulness of late diastolic mitral annular velocity for predicting cardiac events in acute coronary syndrome patients with dilated left atrium

Choonpa Igaku ◽  
2010 ◽  
Vol 37 (5) ◽  
pp. 577-585
Author(s):  
Hideaki MATSUURA ◽  
Akira YAMADA ◽  
Kunihiko SUGIMOTO ◽  
Yoshimi OHIRA ◽  
Ayako TAKAHASHI ◽  
...  
Keyword(s):  
Acute Coronary Syndrome ◽  
Left Atrium ◽  
Cardiac Events ◽  
Coronary Syndrome ◽  
Mitral Annular Velocity

Letter in reply to the letter to the editor of Geerts N and Schanhorst V with the title “Roche Troponin T hs-STAT meets all expert opinion analytical laboratory practice recommendations for the use of the differential diagnosis of acute coronary syndrome”

2020 ◽  
Vol 0 (0) ◽  
Author(s):  
Anne Marie Dupuy ◽  
Anne Sophie Bargnoux ◽  
François Roubille ◽  
Jean Paul Cristol
Keyword(s):  
Acute Coronary Syndrome ◽  
Differential Diagnosis ◽  
Expert Opinion ◽  
Troponin T ◽  
Analytical Laboratory ◽  
Laboratory Practice ◽  
Coronary Syndrome ◽  
Practice Recommendations ◽  
Letter To The Editor

AbstractOver the period from December 3rd, 2019 to March 13th, 2020, after the urgent field safety notice reported by Roche, we performed double determinations of all troponins from the same tube in parallel and in the same run. We used the same Elecsys troponin T hs reagent (ref 08469873190), first result was obtained with the current hs-cTnT application (18 min) and the second measurement was with the STAT application (9 min). On the 11,388 results in the range from 3 to 500 ng/L, we observed 4.18% discordant results (above 18.8% RCV). Overall, we observed an overestimation of the hs-cTnT STAT assay. The Elecsys Troponin T hs STAT assay demonstrated good analytical performances on Cobas e801 analyzer. However, its use according to the ESC recommendations for the 0 h/1 h algorithm should be carefully evaluated and requires further studies with serial cTn testing.

scholarly journals Extensively Thrombosed Ectatic Circumflex Coronary Artery Fistula Presenting as Acute Coronary Syndrome

2019 ◽  
Vol 15 (4) ◽  
pp. 316-319
Author(s):  
Nooraldaem Yousif ◽  
Mohammady Shahin ◽  
Robert Manka ◽  
Slayman Obeid
Keyword(s):  
Acute Coronary Syndrome ◽  
Coronary Artery ◽  
Coronary Artery Fistula ◽  
Circumflex Artery ◽  
St Segment Elevation ◽  
Clear Cut ◽  
Coronary Syndrome ◽  
St Segment ◽  
Previous Medical History

Background: Coronary artery fistula (CAF) is an abnormal communication between the termination of a coronary artery or its branches and a cardiac chamber, a great vessel or other vascular structure. Symptomatic patients with large CAF should undergo surgical or percutanous closure of the fistula at the drainage site while still the debate on closing asymptomatic CAF and reopening symptomatic occluded CAF is ongoing. Case Summary: We are reporting a 30-year-old male patient with no previous medical history presented as non-ST segment elevation myocardial Infarction. Coronary angiography showed an entirely thrombosed ectatic circumflex artery with a suspicion of thrombosed coronary arterial fistula. In view of the ongoing ischemia in the setting of acute coronary syndrome; we tried to open percutaneously but all efforts were to no avail. Discussion: In this case report, we are sharing our experience in the management of this challenging case in view of the rarity of such peculiar clinical condition and the unfavourable presentation along with the lack of clear-cut Guideline and Consensus whether to/not to open such huge and immensely thrombosed symptomatic coronary artery fistula as well as the dilemma of choosing the best long-term medical treatment between antiplatelets vs anticoagulants in such young patient.

scholarly journals Elevation of troponin values in differential diagnosis of chest pain in view of pulmonary thromboembolism

2012 ◽  
Vol 69 (10) ◽  
pp. 913-916 ◽  
Author(s):  
Rada Vucic ◽  
Slavko Knezevic ◽  
Zorica Lazic ◽  
Olivera Andrejic ◽  
Dragan Dincic ◽  
...  
Keyword(s):  
Acute Coronary Syndrome ◽  
Differential Diagnosis ◽  
Heart Disease ◽  
Chest Pain ◽  
Muscle Injury ◽  
Clinical Presentation ◽  
Pulmonary Thromboembolism ◽  
Coronary Syndrome ◽  
Electrocardiographic Abnormalities ◽  
D Dimer

Introduction. Acute coronary syndrome, as unstable form of ischaemic heart disease, beside clinical presentation and electrocardiographic abnormalities, is characterized by increased value of troponin one of cardiospecific enzimes. Although troponin is a high specific and sensitive indicator of acute coronary syndrome, any heart muscle injury may induce its increasing, so there are some other diseases with the increased troponin value. Case report. We presented a female patient with chest pain, admitted because of suspicioun of acute coronary sindrome. Performed coronarography excluded ischemic heart disease. Considering symtomatology, electrocardiographic abnormalities, increased troponin and D-dimer values, as well as echocardiography finding we considered pulmonary embolism as a differential diagnosis, which was confirmed by pulmoangiography. Conclusion. Isolated increased troponin values are not enough for diagnosis of acute coronary syndrome.

scholarly journals Modified double guiding catheter ‘Ping Pong’ technique to treat large coronary perforation: a case report

2021 ◽  
Vol 5 (5) ◽  
Author(s):  
Himanshu Gupta ◽  
Navjyot Kaur ◽  
Yashpaul Sharma ◽  
Soo Teik Lim
Keyword(s):  
Strong Support ◽  
Covered Stent ◽  
Circumflex Artery ◽  
Femoral Access ◽  
Left Circumflex Artery ◽  
Coronary Syndrome ◽  
Guide Catheter ◽  
Ping Pong ◽  
Coronary Perforation ◽  
Guiding Catheter

Abstract Background  Despite improvement in available tools and techniques, procedural complications like coronary perforation can occur during percutaneous coronary intervention (PCI). Severe proximal coronary perforations are usually caused by balloon and vessel size mismatch but can also occur with appropriately sized balloons or stents if the coronary vessel has very eccentric calcification or if there is negative remodelling of the vessel. Case summary  A 74-year-old man with a history of type II diabetes mellitus, hypertension, and chronic coronary syndrome (previous PCI 10 years before) presented with unstable angina of 2 weeks of duration. Coronary angiography revealed a patent stent in left anterior descending artery, significant disease in left circumflex artery and diffuse calcified lesion in dominant right coronary artery (RCA). During angioplasty of RCA, the patient developed severe Ellis grade III perforation, which was successfully managed with modified double guiding catheter ‘Ping Pong’ technique. In this technique, the already engaged 7 French (F) Amplatz Left 1 guide catheter was used to deliver the bulky covered stent in highly tortuous and calcified RCA while a second 6F guide catheter (Judkin Right) introduced through contralateral femoral access was used for introducing the balloon, which initially sealed the perforation and subsequently acted as a distal anchor to provide strong support to deliver the covered stent. Conclusion  In a case of severe coronary perforation, modified Ping Pong technique using a small-sized second guide catheter complimentary to the first guide catheter, can be used to deploy bulky covered stent.

scholarly journals Iatrogenic acute aortic dissection caused by intervention for spontaneous coronary artery dissection: a surgical case report

2020 ◽  
Vol 15 (1) ◽  
Author(s):  
Yuki Hayashi ◽  
Makoto Taoka ◽  
Shunji Osaka ◽  
Satoshi Unosawa ◽  
Masashi Tanaka
Keyword(s):  
Percutaneous Coronary Intervention ◽  
Coronary Artery ◽  
Type A ◽  
Coronary Intervention ◽  
Artery Dissection ◽  
Circumflex Artery ◽  
Left Circumflex Artery ◽  
Coronary Syndrome ◽  
Left Anterior Descending Artery ◽  
Percutaneous Coronary

Abstract Background Iatrogenic acute aortic dissection (AAD) caused by cardiovascular intervention is rare. Also rare is spontaneous coronary artery dissection (SCAD), a form of acute coronary syndrome, which develops in relatively young women without coronary risk factors. We encountered type A iatrogenic AAD caused by an intervention for SCAD. Case presentation A 53-year-old woman was brought to our hospital after cardiopulmonary resuscitation. She was diagnosed with acute coronary syndrome caused by SCAD, and percutaneous coronary intervention was carried out on her distal left anterior descending artery. The dissection proceeded to the proximal left anterior descending artery and left main coronary artery trunk, so additional percutaneous coronary intervention was performed on the left circumflex artery. After the intervention, type A AAD occurred with a primary entry tear from the left main coronary artery trunk, and computed tomography showed a type A AAD of the aortic arch. We performed emergency ascending aorta replacement and coronary artery bypass grafting to the left anterior descending artery and left circumflex artery. The patient had an uneventful recovery after the operation and was discharged on postoperative day 25. Conclusion To our knowledge, this is the first report of an iatrogenic AAD caused by percutaneous coronary intervention for SCAD.

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