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 Long-term results of different approaches to revascularization in non-ST-segment elevation acute coronary syndrome and multiple coronary atherosclerosis

2017 ◽  
Vol 89 (4) ◽  
pp. 29-34 ◽  
Author(s):  
V I Ganyukov ◽  
R S Tarasov ◽  
Yu N Neverova ◽  
N A Kochergin ◽  
O L Barbarash ◽  
...  
Keyword(s):  
Acute Coronary Syndrome ◽  
Coronary Artery ◽  
Medical Treatment ◽  
Coronary Atherosclerosis ◽  
Long Term Results ◽  
St Segment Elevation ◽  
Coronary Syndrome ◽  
St Segment

Aim. To assess the long-term results of different approaches to treating patients with non-ST-segment elevation acute coronary syndrome (NSTE ACS) and multivessel coronary artery disease (MVCAD). Subjects and methods. A total of 150 patients with NSTE ACS, in whom coronary angiography revealed MVCAD, were examined. The patients were divided into 3 groups according to the selected treatment policy: 1) percutaneous coronary intervention (PCI) (n=91 (60.6%)); 2) coronary artery bypass grafting (CABG) (n=40 (26.6%)); and 3) only medical treatment (n=9 (6%)). The mean follow-up was 27.6±3.5 months. Results. The medical treatment policy in this patient sample demonstrates the worst results, with the majority of cardiovascular events developing in the hospital period. PCI in patients with NSTE ACS and multiple coronary atherosclerosis has a number of objective limitations in this patient sample, leading to suboptimal treatment outcomes Conclusion. The use of CABG or PCI as a myocardial revascularization technique in patients with NSTE ACS and MVCAD is characterized by a comparable satisfactory survival in the hospital and long-term follow-up periods. 12% of patients do not receive revascularization due to the extremely high risk from any of coronary blood restoring methods, which results in very many deaths largely occurring during the hospital period.

scholarly journals MI with Non-obstructive Coronary Artery Presenting with STEMI: A Review of Incidence, Aetiology, Assessment and Treatment

2020 ◽  
Vol 15 ◽  
Author(s):  
Ying X Gue ◽  
Rahim Kanji ◽  
Sabiha Gati ◽  
Diana A Gorog
Keyword(s):  
Acute Coronary Syndrome ◽  
Coronary Artery ◽  
Correct Diagnosis ◽  
Correct Treatment ◽  
St Segment Elevation ◽  
Coronary Syndrome ◽  
Plaque Disruption ◽  
Methodical Approach ◽  
St Segment ◽  
Assessment And Treatment

MI with non-obstructive coronary artery (MINOCA) is a condition previously thought to be benign that has recently been shown to have comparable mortality to that of acute coronary syndrome with obstructive coronary disease. The heterogeneity of the underlying aetiology makes the assessment, investigation and treatment of patients with MINOCA challenging. The majority of patients with MINOCA presenting with ST-segment elevation MI generally have an underlying coronary or myocardial cause, predominantly plaque disruption or myocarditis. In order to make the correct diagnosis, in addition to the cause of the presentation, a meticulous and methodical approach is required, with targeted investigations. Stratification of patients to guide investigations that are more likely to provide the diagnosis will allow the correct treatment to be initiated promptly. In this article, the authors review the contemporary incidence, aetiology, recommended assessment and treatment of patients with MINOCA presenting with ST-segment elevation MI.

Predictors of long-term use of evidence-based therapies after non-ST-segment elevation acute coronary syndrome. The S-Témoin survey

2009 ◽  
Vol 133 (1) ◽  
pp. 32-40 ◽  
Author(s):  
Nicolas Danchin ◽  
François Diévart ◽  
Jean-François Thébaut ◽  
Olivier Grenier ◽  
Esvet Mihci ◽  
...  
Keyword(s):  
Acute Coronary Syndrome ◽  
Evidence Based ◽  
St Segment Elevation ◽  
Coronary Syndrome ◽  
St Segment ◽  
Elevation Acute Coronary Syndrome
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