scholarly journals Coronary ectasia due to primary aldosteronism in an exceptional presentation

2021 ◽  
Vol 2021 (3) ◽  
Author(s):  
Hammam Rasras ◽  
Falmata Laouan Brem ◽  
Noha El Ouafi ◽  
Nabila Ismaili
Keyword(s):  
Aortic Aneurysm ◽  
Coronary Angiography ◽  
Unstable Angina ◽  
Female Patient ◽  
Coronary Arteries ◽  
Primary Aldosteronism ◽  
Cardiology Department ◽  
Coronary Ectasia

Primary aldosteronism as a cause of coronary ectasia has been reported only once in the literature and was associated with an aortic aneurysm. Here, we report a second presentation in our cardiology department - a 59-year-old female patient who was admitted for unstable angina. Coronary angiography revealed an ectasia of two major coronary arteries. An etiological assessment revealed an idiopathic primary aldosteronism.

scholarly journals Collateral Circulation in Human Heart

2008 ◽  
Vol 5 (2) ◽  
pp. 87-91
Author(s):  
Aida Hasanović ◽  
Fuad Šišić ◽  
Faruk Dilberović ◽  
Fehim Ovčina
Keyword(s):  
Coronary Artery ◽  
Coronary Angiography ◽  
Left Ventricular Function ◽  
Ventricular Function ◽  
Coronary Arteries ◽  
Collateral Circulation ◽  
Left Ventricular ◽  
Cardiology Department ◽  
Different Types ◽  
The Right

The aim of the investigations was to demonstrate different types of collaterals of coronary arteries using the method of coronary angiography and injection-corrosion method. The investigations were carried out on 30 human cadaveric hearts from the Department of Anatomy, and 30 angiograms of patients from the Cardiology Department of Clinics Centre in Sarajevo. Clinical investigations were retrospective and prospective on patients that were treated in hospital, and on patients that just arrived in hospital (based on findings of coronary angiohra-phy). The results show the existence of different types of collaterals: intercoronary and intra-coronary. We established collaterals in a case with occlusion of the right coronary artery and left coronary artery in which better development of collaterals was established. Our patients were classified in two groups:1) Patients with good collaterals and good left ventricular function;2) Patients with good collaterals and impaired left ventricular function. On the anatomical material we found different types of collaterals as well.Our results show that coronanary angiography is useful diagnostic method for the demonstration of coronary collaterals.The collaterals of human coronary arteries have always attracted the attention of anatomists, pathologists, surgeons, as well as experts in many clinical disciplines. The occurrence of coronary diseases has increased recently so much that it stimulates researchers to become acquainted with collaterals of coronary arteries. Its real significance is expressive in cases with occlusion or stenosis of coronary arteries -angina, myocardial infarction, congenital cardiovascular malformations etc. (1,2,3,4,5). Therefore, the aim of the investigations was to demonstrate different types of collaterals of the coronary arteries in normal condition and the conditions of coronary disease using the method of coronary angiography and injection corrosion method. On the other side, these investigations are important because of contrast opinions that are given in literature concerning coronary arteries collaterals. According to some authors collaterals exist and they are functional (6,7,8,9,10). The others think that collaterals exist, but that they are insufficient for collateral circulation and only develop in pathological conditions (11). Ishemia changes of the heart, variations of coronary arteries and the collaterals have been studied by many authors: Hadžiselimović, Werner, Pohl, Seiler, Kamenica, Šišić, Rockostroh, Rapps, Holmvang, Billinger, Meier and others.

Quantification of Coronary Artery Stenosis with 16-Slice MSCT in Patients before CABG Surgery: Comparison to Standard Invasive Coronary Angiography

2005 ◽  
Vol 8 (1) ◽  
pp. 42 ◽  
Author(s):  
C. Probst ◽  
A. Kovacs ◽  
C. Schmitz ◽  
W. Schiller ◽  
H. Schild ◽  
...  
Keyword(s):  
Coronary Artery ◽  
Coronary Angiography ◽  
Coronary Arteries ◽  
Artery Bypass ◽  
Invasive Coronary Angiography ◽  
Bypass Graft ◽  
Heart Association ◽  
Artery Stenosis ◽  
Vessel Disease ◽  
Selective Coronary Angiography

Objective: Invasive, selective coronary angiography is the gold standard for evaluation of coronary artery disease (CAD) and degree of stenosis. The purpose of this study was to compare 3-dimensional (3D) reconstructed 16-slice multislice computed tomographic (MSCT) angiography and selective coronary angiography in patients before elective coronary artery bypass graft (CABG) procedure. Methods: Sixteen-slice MSCT scans (Philips Mx8000 IDT) were performed in 50 patients (42 male/8 female; mean age, 64.44 8.66 years) scheduled for elective CABG procedure. Scans were retrospectively electrocardiogram-gated 3D reconstructed. The images of the coronary arteries were evaluated for stenosis by 2 independent radiologists. The results were compared with the coronary angiography findings using the American Heart Association segmental classification for coronary arteries. Results: Four patients (8%) were excluded for technical reasons. Thirty-eight patients (82.6%) had 3-vessel disease, 4 (8.7 %) had 2-vessel disease, and 4 (8.7%) had an isolated left anterior descending artery stenosis. In the proximal segments all stenoses >50% (56/56) were detected by MSCT; medial segment sensitivity was 97% (73/75), specificity 90.3%; distal segment sensitivity was 90.7% (59/65), specificity 77%. Conclusion: Accurate quantification of coronary stenosis greater than 50% in the proximal and medial segments is possible with high sensitivity and specificity using the new generation of 16-slice MSCTs. There is still a tendency to overestimate stenosis in the distal segments. MSCT seems to be an excellent diagnostic tool for screening patients with possible CAD.

scholarly journals Quantitative evaluation and comparison of coronary artery characteristics by 3D coronary volume reconstruction

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Yongcheol Kim ◽  
Jonathan James Hyett Bray ◽  
Benjamin Waterhouse ◽  
Alexander Gall ◽  
Georgia May Connolly ◽  
...  
Keyword(s):  
Coronary Artery ◽  
Coronary Angiography ◽  
Coronary Arteries ◽  
Intraclass Correlation ◽  
Quantitative Coronary Angiography ◽  
Volume Estimation ◽  
Diabetic Patients ◽  
Volume Reconstruction ◽  
3 Dimensional ◽  
Inter Observer Variability

AbstractNon-atherosclerotic abnormalities of vessel calibre, aneurysm and ectasia, are challenging to quantify and are often overlooked in qualitative reporting. Utilising a novel 3-dimensional (3D) quantitative coronary angiography (QCA) application, we have evaluated the characteristics of normal, diabetic and aneurysmal or ectatic coronary arteries. We selected 131 individuals under 50 years-of-age, who had undergone coronary angiography for suspected myocardial ischaemia between 1st January 2011 and 31st December 2015, at the Bristol Heart Institute, Bristol, UK. This included 42 patients with angiographically normal coronary arteries, 36 diabetic patients with unobstructed coronaries, and 53 patients with abnormal coronary dilatation (aneurysm and ectasia). A total of 1105 coronary segments were analysed using QAngio XA 3D (Research Edition, Medis medical imaging systems, Leiden, The Netherlands). The combined volume of the major coronary arteries was significantly different between each group (1240 ± 476 mm3 diabetic group, 1646 ± 391 mm3 normal group, and 2072 ± 687 mm3 abnormal group). Moreover, the combined coronary artery volumes correlated with patient body surface area (r = 0.483, p < 0.01). Inter-observer variability was assessed and intraclass correlation coefficient of the total coronary artery volume demonstrated a low variability of 3D QCA (r = 0.996, p < 0.001). Dedicated 3D QCA facilitates reproducible coronary artery volume estimation and allows discrimination of normal and diseased vessels.

scholarly journals Electroangiographic Correlation of Simultaneous ST-Segment Elevations of Anterior and Inferior Segment: Who Is the Culprit?

2021 ◽  
pp. 263246362110155
Author(s):  
Pankaj Jariwala ◽  
Shanehyder Zaidi ◽  
Kartik Jadhav
Keyword(s):  
Myocardial Infarction ◽  
Coronary Angiography ◽  
Coronary Arteries ◽  
Index Case ◽  
St Segment Elevation ◽  
Segment Elevation Myocardial Infarction ◽  
St Segment ◽  
Inferior Segment ◽  
The Right ◽  
Proximal Occlusion

Simultaneous ST-segment elevation (SST-SE) in anterior and inferior leads in the setting of ST-segment elevation myocardial infarction is often confounding for a cardiologist and further more challenging is the angiographic localization of the culprit vessel. SST-SE can be fatal as it jeopardizes simultaneously a larger area of myocardium. This phenomenon could be due to “one lesion, one artery,” “two lesions, one artery,” “two lesions, two arteries,” or combinations in two different coronary arteries. We have discussed an index case where we encountered a phenomenon of SST-SE and coronary angiography demonstrated “two lesions, one artery” (proximal occlusion and distal critical diffuse stenoses of the wrap-around left anterior descending [LAD] artery) and “two lesions, two (different coronary) arteries” (previously mentioned stenoses of the LAD artery and critical stenosis of the posterolateral branch of the right coronary arteries). We have also described in brief the possible causes of this phenomena and their electroangiographic correlation of the culprit vessels.

scholarly journals The interplay between myocardial bridging and coronary spasm in patients with myocardial infarction and non-obstructive coronary arteries: pathogenic and prognostic implications

2021 ◽  
Vol 10 (Supplement_1) ◽  
Author(s):  
RA Montone ◽  
F Gurgoglione ◽  
MG Del Buono ◽  
MC Meucci ◽  
G Iannaccone ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Unstable Angina ◽  
Coronary Arteries ◽  
Obstructive Coronary Artery Disease ◽  
Coronary Spasm ◽  
Interquartile Range ◽  
Myocardial Bridging ◽  
Adverse Cardiovascular Event ◽  
Provocative Test

Abstract Funding Acknowledgements Type of funding sources: None. Background Myocardial bridging (MB) is associated with endothelial dysfunction and may represent a cause of angina in patients with non-obstructive coronary artery disease (NOCAD). Purpose  Herein, we assessed the interplay between MB and coronary vasomotor disorders, evaluating also their prognostic relevance in patients with myocardial infarction and non-obstructive coronary arteries (MINOCA) or stable NOCAD. Methods We prospectively enrolled consecutive NOCAD patients undergoing intracoronary acetylcholine provocative test to assess the presence of epicardial or microvascular spasm in patients with suspected angina or MINOCA. Myocardial bridging was diagnosed by coronary angiography. The incidence of major adverse cardiac events (MACE), defined as the composite of cardiac death, non-fatal MI and rehospitalisation for unstable angina, was assessed at follow-up. We also assessed angina status using Seattle Angina Questionnaires (SAQ). Results We enrolled 310 patients (mean age 60.6 ± 11.9; 136 [43.9%] men; 169 [54.5%] stable NOCAD and 141 [45.5%] MINOCA). MB was found in 53 (17.1%) patients. MB was an independent predictor of spasm and MINOCA (p &lt; 0.05). At follow-up (median 22 months, interquartile range [13-32]), patients with MB had a higher rate of MACE and a lower SAQ score (all p &lt; 0.001) compared with patients without MB. The rate of MACE was considerably higher in patients with both spasm and MB than in the remaining patients (12/42 [28.6%] vs. 13/268 [4.8%], p &lt; 0.001). Conclusion Among patients with NOCAD coronary spasm associated with MB predicts a worse clinical presentation with MINOCA and a worse clinical outcome at medium-long term follow-up, thus identifying a high-risk subset of patients with MB with relevant therapeutic implications. MB and clinical outcomesCharacteristicsOverall population(n= 310)Presence of Myocardial bridging(n= 53)Absence of Myocardial bridging(n = 257)p valueMACE [n, (%)]25 (8.1)12 (22.6)13 (5.1)&lt;0.001CV Death [n, (%)]1 (0.3)0 (0.0)1 (0.4)0.649MI occurrence [n, (%)]6 (1.9)2 (3.8)4 (1.6)0.286Hospitalization for unstable angina [n, (%)]18 (5.8)10 (18.9)8 (3.1)&lt; 0.001Recurrent angina [n, (%)]70 (22.6)20 (37.7)50 (19.4)0.004SAQ [median (IQR)]82 [78; 88]78 [68; 84]84 [78; 88]&lt; 0.001Follow-up time [months, median (IQR)]22 [15;32]20 [15; 28]23 [15; 34]0.10CV Cardiovascular; MI: Myocardial Infarction; IQR: InterQuartile Range; MACE: Major Adverse Cardiovascular Event; SAQ: Seattle Angina Questionnaire.Abstract Figure Outcomes

scholarly journals Immunoglobulin G4-related masses surrounding coronary arteries: a case report

2021 ◽  
Vol 5 (3) ◽  
Author(s):  
Takuya Nakamura ◽  
Yutaka Goryo ◽  
Takuya Isojima ◽  
Hiroyuki Kawata
Keyword(s):  
Coronary Artery ◽  
Coronary Angiography ◽  
Cardiovascular System ◽  
Coronary Arteries ◽  
Elevated Serum ◽  
High Serum ◽  
Immunoglobulin G4 ◽  
Coronary Arteritis ◽  
Serum Igg4 ◽  
Mass Formation

Abstract Background Immunoglobulin G4 (IgG4)-related disease (IgG4-RD) is an immune-mediated fibroinflammatory condition with high serum IgG4 levels affecting various organs, such as the pancreas, lacrimal and salivary glands, thyroid, kidney, and lung. Typical cardiovascular manifestations of IgG4-RD include periaortitis, coronary arteritis, and pericarditis. However, reports of IgG4-RD associated with coronary arteritis are rare. Here, we report a case of IgG4-related masses surrounding the coronary arteries. Case summary A 59-year-old man was referred to our hospital because of mediastinal masses detected by computed tomography (CT). Coronary CT angiography revealed masses surrounding the right coronary artery and the left anterior descending coronary artery. An elevated serum level of IgG4 and histological findings led to the diagnosis of IgG4-related coronary arteritis with mass formation. Coronary angiography showed numerous feeding arteries to the masses, which were demonstrated as multiple microchannels in the intravascular ultrasound (IVUS) images. Discussion IgG4-RD involving the cardiovascular system has been reported. However, coronary artery disease associated with IgG4-RD is very rare, and the mechanism of mass formation in IgG4-related coronary arteritis is unclear. In our case, within the cardiovascular system, IgG4-RD was limited to the coronary arteries, suggesting that the affected coronary arteries may provide the necessary blood supply to the mass, thus, aiding its growth. These findings were supported by the images from coronary angiography and IVUS.

scholarly journals Three Vessel Coronary Cameral Fistulae Associated with New Onset Atrial Fibrillation and Angina Pectoris

2014 ◽  
Vol 2014 ◽  
pp. 1-3
Author(s):  
Murat Yuksel ◽  
Abdulkadir Yildiz ◽  
Mustafa Oylumlu ◽  
Nihat Polat ◽  
Halit Acet ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Coronary Artery ◽  
Coronary Angiography ◽  
Left Ventricle ◽  
Coronary Arteries ◽  
Diastolic Pressure ◽  
Left Ventricular ◽  
Ventricular Rate ◽  
Fistula Formation ◽  
New Onset

Coronary cameral fistulas are abnormal communications between a coronary artery and a heart chamber or a great vessel which are reported in less than 0.1% of patients undergoing diagnostic coronary angiography. All three major coronary arteries are even less frequently involved in fistula formation as it is the case in our patient. A 68-year-old woman was admitted to cardiology clinic with complaints of exertional dyspnea and angina for two years and a new onset palpitation. Standard 12-lead electrocardiogram revealed atrial fibrillation (AF) with a ventricular rate of 114 beat/minute and accompanying T wave abnormalities and minimal ST-depression on lateral derivations. Transthoracic echocardiographic examination was normal except for diastolic dysfunction, minimally mitral regurgitation, and mild to moderate enlargement of the left atrium. Sinus rhythm was achieved by medical cardioversion with amiodarone infusion. Coronary angiography revealed diffuse and multiple coronary-left ventricle fistulas originating from the distal segments of both left and right coronary arterial systems without any stenosis in epicardial coronary arteries. The patient’s symptoms resolved almost completely with medical therapy. High volume shunts via coronary artery to left ventricular microfistulas may lead to increased volume overload and subsequent increase in end-diastolic pressure of the left ventricle and may cause left atrial enlargement.

scholarly journals P3673Differences in mortality between patients referred to coronary angiography with stable angina or unstable angina

2017 ◽  
Vol 38 (suppl_1) ◽  
Author(s):  
K. Fladseth ◽  
A. Kristensen ◽  
J. Mannsverk ◽  
T. Trovik ◽  
H. Schirmer
Keyword(s):  
Coronary Angiography ◽  
Unstable Angina ◽  
Stable Angina
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