scholarly journals Hair pin bends of epicardial coronary arteries - a unique feature in multiple myocardial bridges

2019 ◽  
Vol 10 (3) ◽  
pp. 2250-2254
Author(s):  
Mohandas G.V ◽  
Sitansu k.Panda
Keyword(s):  
Coronary Artery Disease ◽  
Coronary Artery ◽  
Coronary Arteries ◽  
Unique Feature ◽  
Ischemic Heart ◽  
Myocardial Bridging ◽  
Myocardial Bridge ◽  
Anatomical Variant ◽  
Myocardial Bridges ◽  
Artery Disease

Myocardial bridge(MB) is an anatomical variant. Sometimes MB can cause compression over the coronary arteries and causes ischemic heart diseases.MB associated with bends of coronary arteries double the risk of coronary artery disease. So the present study aimed to find out the incidence of bends of the coronary artery along with the myocardial bridging. 100 heart specimens were obtained from routine dissection conducted for undergradu­ate students in the department of Anatomy IMS & SUM Hospital Bhubaneswar. After the simple dissecting procedure, epicardial coronary arteries, their branches and myocardial bridges and hairpin bends of coronary arteries were observed. Myocardial bridges present 41 (41%) over Left anterior descending artery(LAD) only.Among 41 hearts single myocardial bridge present in 37((90.25%)  hearts, double myocardial bridge were present in 3((7.31%)  hearts and triple myocardial bridges present in only one heart(2.44%). Hairpin bends of the coronary artery were present in double and triple myocardial bridged hearts only. No hairpin bends of the coronary artery was observed in the single myocardial bridge. Hair pin bends of the coronary arteries are the unique features of the myocardial bridges in multiple myocardial bridges, i.e. double and triple myocardial bridges. However, hairpin bends of coronary arteries were absent in single myocardial bridged hearts.

Gender Differences in Non-Obstructive Coronary Artery Disease

2020 ◽  
Vol 26 ◽  
Author(s):  
Maria Bergami ◽  
Marialuisa Scarpone ◽  
Edina Cenko ◽  
Elisa Varotti ◽  
Peter Louis Amaduzzi ◽  
...  
Keyword(s):  
Coronary Artery Disease ◽  
Gender Differences ◽  
Heart Disease ◽  
Coronary Artery ◽  
Ischemic Heart Disease ◽  
Coronary Arteries ◽  
Obstructive Coronary Artery Disease ◽  
Ischemic Heart ◽  
Current Evidence ◽  
Artery Disease

: Subjects affected by ischemic heart disease with non-obstructive coronary arteries constitute a population that has received increasing attention over the past two decades. Since the first studies with coronary angiography, female patients have been reported to have non-obstructive coronary artery disease more frequently than their male counterparts, both in stable and acute clinical settings. Although traditionally considered a relatively infrequent and low-risk form of myocardial ischemia, its impact on clinical practice is undeniable, especially when it comes to infarction, where the prognosis is not as benign as previously assumed. Unfortunately, despite increasing awareness, there are still several questions left unanswered regarding diagnosis, risk stratification and treatment. The purpose of this review is to provide a state of the art and an update on current evidence available on gender differences in clinical characteristics, management and prognosis of ischemic heart disease with non-obstructive coronary arteries, both in the acute and stable clinical setting.

scholarly journals Does Myocardial Bridge Appear More Frequently and Diffusely on Radial Access Coronary Angiography?

2021 ◽  
Author(s):  
oktay senoz ◽  
zeynep yapan emren
Keyword(s):  
Coronary Artery Disease ◽  
Coronary Artery ◽  
Coronary Angiography ◽  
Coronary Arteries ◽  
Clinical Laboratory ◽  
Conventional Coronary Angiography ◽  
Myocardial Bridge ◽  
Radial Access ◽  
Left Anterior Descending Artery ◽  
Artery Disease

Abstract Background: Although the incidence of myocardial bridge (MB) has been defined in different conventional coronary angiography (CCA) studies,the frequency of MB in radial access coronary angiography (RACA) is unknown.The aim of this study was to determine the incidence of MB in patients undergoing RACA.Method: A total of 2600 consecutive patients who underwent RACA were retrospectively investigated to detect the presence of MB.The clinical,laboratory, and angiographic features of the patients with MB were analyzed. Results: MB was detected at an incidence of 10.2%, in 255/2600 patients who underwent RACA.The most involved coronary artery was the left anterior descending artery (LAD) (86.9%) and the mid segment (84.9%) was the most affected section.Co-involvement of multiple coronary arteries by MB was 7.8%. Coronary artery disease (CAD) was determined in 102 (36.2%) of the coronary arteries with MB, 82.4% which were proximal to the MB.Conclusion: These data demonstrated that the incidence of MB able to be detected on RACA was much higher than reported in previous CCA studies.

scholarly journals Myocardial bridging in the course of coronary arteries and its clinical significance

2020 ◽  
Vol 11 (6) ◽  
pp. 58-62
Author(s):  
Gunjan Rai ◽  
Soumya Khanna ◽  
Royana Singh
Keyword(s):  
Coronary Artery ◽  
Sudden Death ◽  
Coronary Arteries ◽  
Arterial Disease ◽  
Myocardial Bridging ◽  
Myocardial Bridge ◽  
Diagonal Branch ◽  
Myocardial Bridges ◽  
Coronary Arterial Disease ◽  
Congenital Coronary Artery Anomalies

Background: Sudden death in young adults in absence of any risk factor related to coronary arterial disease has been reported. It could be because of some unrecognized congenital coronary artery anomalies like myocardial bridging. The clinician should keep myocardial bridging as a differential diagnosis in cases of sudden death in young individuals having no risk factors of coronary artery diseases. Aims and Objective: The present study was conducted to know the prevalence of myocardial bridge and percentage of distribution of myocardial bridges in the course of different coronary arteries of cadaveric hearts. Material and Methods: The study was conducted in the department of Anatomy, IMS, BHU Varanasi. Total numbers of 49 formalin preserved hearts were taken for the study. The hearts were meticulously dissected to see the distribution and location of myocardial bridge. Coronary arteries with myocardial bridge were photographed and data was statistically analyzed.Out of 49 hearts, 26(53.06%) showed myocardial bridging. Total numbers of bridges were found to be 34 in number. Among the 26 myocardial bridged hearts 8 hearts (30.76%) showed double myocardial bridges and 18 hearts (69.23%) showed single myocardial bridges. In hearts with double myocardial bridging, 5 of them showed myocardial bridging in the territory of both anterior interventricular artery (AIVA) and posterior interventricular artery (PIVA) and 3 showed bridging in the territory of anterior interventricular artery and its diagonal branch. Among the18 single myocardial bridging 16 were in the course of anterior interventricular artery and two showed myocardial bridging in one of the diagonal branch of AIVA. There were 24 myocardial bridges in the course of AIVA, 16 as a part of single myocardial bridged hearts and 8 as a part of double myocardial bridged heart with the percentage of distribution were 2 (8.33%)in the proximal 1/3rd,18(75%)were in middle 1/3rd and 4(16.66%) were in distal 1/3rd. Conclusion: Due to the presence of high percentage of reported myocardial bridges in cadaveric hearts, the clinicians should always screen the young individuals and athletes having myocardial ischemia for the myocardial bridges along with other etiological factors.

scholarly journals Is myocardial bridge more frequently detected on radial access coronary angiography?

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Oktay Şenöz ◽  
Zeynep Yapan Emren
Keyword(s):  
Coronary Artery Disease ◽  
Coronary Artery ◽  
Coronary Angiography ◽  
Coronary Arteries ◽  
Conventional Coronary Angiography ◽  
Myocardial Bridge ◽  
Femoral Access ◽  
Radial Access ◽  
The Difference ◽  
Artery Disease

Abstract Background Although the incidence of myocardial bridge (MB) has been defined in different femoral access conventional coronary angiography (FACCA) studies, the frequency of MB on radial access coronary angiography (RACA) is unknown. The aim of this study was to determine the difference in the incidence of MB between patients undergoing RACA and FACCA. Method A total of 2500 consecutive patients who underwent RACA and a total of 1455 consecutive patients who underwent FACCA were retrospectively investigated to detect the presence of MB. The incidences of the groups were calculated separately and compared. The clinical and angiographic features of the patients with MB were analyzed. Results MB was detected at an incidence of 10.2%, in 255/2500 patients who underwent RACA, and 1.8% in 27/1455 patients who underwent FACCA (p < 0.001). In both RACA and FACCA patients, the most involved coronary artery was the left anterior descending artery (LAD) (86.9% and 93.1%) and the mid-segment (84.9% and 88.9%) was the most affected section. Co-involvement of multiple coronary arteries by MB was 7.8% in patients who underwent RACA and 7.4% in patients who underwent FACCA. Coronary artery disease (CAD) was determined in 111 (35.7%) of the coronary arteries with MB, of which 81.9% were proximal to the MB. No significant CAD was detected in any of the vessels of 69.8% (178/255) of the patients who underwent RACA for different clinical indications. Conclusion These data demonstrated that the incidence of myocardial bridge able to be detected on RACA was much higher than FACCA.

Differentiating anginal patients with coronary artery disease from those with normal coronary arteries using psychological measures

1991 ◽  
Vol 67 (7) ◽  
pp. 645-646 ◽  
Author(s):  
James H. McCroskery ◽  
Robert E. Schell ◽  
Robert P. Sprafkin ◽  
Larry J. Lantinga ◽  
Robert A. Warner ◽  
...  
Keyword(s):  
Coronary Artery Disease ◽  
Coronary Artery ◽  
Coronary Arteries ◽  
Normal Coronary Arteries ◽  
Psychological Measures ◽  
Artery Disease

Abstract 13804: Clinical Profile and Outcomes of Myocardial Infarction With Non-obstructive Coronary Arteries in Older Adults

Circulation ◽  
2020 ◽  
Vol 142 (Suppl_3) ◽  
Author(s):  
Ara H Rostomian ◽  
Derek Q Phan ◽  
Mingsum Lee ◽  
Ray X Zadegan
Keyword(s):  
Myocardial Infarction ◽  
Coronary Artery Disease ◽  
Coronary Artery ◽  
Los Angeles ◽  
Coronary Arteries ◽  
Medical Center ◽  
Invasive Coronary Angiography ◽  
Obstructive Coronary Artery Disease ◽  
Kaiser Permanente ◽  
Artery Disease

Introduction: Myocardial Infarction with non-obstructive coronary artery disease (MINOCA) is found in 5%-6% of patients with acute myocardial infarction (AMI). As such, the diagnosis and management of AMI patients with non-obstructive coronary artery disease (NOCAD) poses a challenge as compared to patients with MI with coronary artery disease (MICAD). Hypothesis: To evaluate the characteristics and outcomes of MINOCA in older patients as compared with MICAD patients, with and without revascularization. Methods: This was a retrospective observational study of patients ≥80 years old who underwent invasive coronary angiography (ICA) for AMI between 2009-2019 at Kaiser Permanente Los Angeles Medical Center. MINOCA was defied as <50% stenosis of coronary arteries on angiography with a troponin level ≥0.05 ng/ml. Patients with MINOCA vs MICAD were compared. Multivariate logistic regression was used to identify independent predictors of MINOCA and Kaplan-Meier survival analysis was used to analyze all-cause mortality between cohorts. Results: A total of 259 patients with MINOCA (mean ± SD age 83.8±2.7 years, 68% female) and 687 patients with MICAD (84.7±3.4 years, 40% female) were analyzed. Younger age (odds ratio [OR]=1.11; 95% confidence interval [CI]=1.05-1.18), female sex (OR=3.14; CI=2.20-4.48), black race (OR=2.53; CI=1.61-3.98), no history of prior stroke (OR=1.56; CI=1.06-2.33), atrial fibrillation or flutter (OR=2.04; CI:1.38-3.02), lower troponin levels (OR=1.08; CI:1.03-1.11), and lower triglyceride levels per 10 mg/dl increments (OR=1.06; CI:1.03-1.11) increased the odds of having MINCOA as compared to MICAD. At median follow-up of 2.4 years, MINOCA was associated with a lower rate of death (44.8% vs 55.2%, p<0.01) compared to un-revascularized MICAD, but no difference (31.3% vs 40.4%, p=0.68) when compared to re-vascularized MICAD. Conclusions: Patients age ≥80 years with MINOCA have fewer traditional risk factors compared to their counterparts with MICAD and fewer deaths compared to un-revascularized MICAD, but similar mortality compared to revascularized MICAD

Abstract 342: Impact Of System And Physician Factors On The Diagnostic Yield Of Coronary Angiography In Stable Ischemic Heart Disease: A Population Based Study

2014 ◽  
Vol 7 (suppl_1) ◽  
Author(s):  
Harindra C Wijeysundera ◽  
Feng Qiu ◽  
Maria C Bennell ◽  
Madhu K Natarajan ◽  
Warren J Cantor ◽  
...  
Keyword(s):  
Coronary Artery Disease ◽  
Heart Disease ◽  
Coronary Artery ◽  
Coronary Angiography ◽  
Ischemic Heart Disease ◽  
Diagnostic Yield ◽  
Obstructive Coronary Artery Disease ◽  
Ischemic Heart ◽  
Patient Factors ◽  
Artery Disease

Background: Wide variation exists in the diagnostic yield of coronary angiography in stable ischemic heart disease (IHD). Previous work has primarily focused on patient factors for this variation. We sought to understand if system and physician factors, specifically hospital and physician type, as well as physician self-referral, have incremental impacts on the yield of coronary angiography, above and beyond that of patient factors alone. Methods: All patients who underwent a diagnostic coronary angiogram for possible stable IHD, at the 18 cardiac centers in Ontario, Canada were identified from October 1st, 2008 to September 30th, 2011. Obstructive coronary artery disease was defined as stenosis greater than 70% in the main coronary arteries or greater than 50% in the left main artery. Physicians were classified as either invasive or interventional. Hospitals were categorized into cath only, stand-alone PCI and full service centers. Multi-variable hierarchical logistic models were developed to identify system and physician level predictors of obstructive coronary artery disease, having adjusted for patient factors. Results: Our cohort consisted of 60,986 patients who underwent a diagnostic angiogram for possible stable IHD, of which 33,483 had obstructive coronary artery disease (54.9%), ranging from 41.0% to 70.2% across centers. Self-referral rates varied from 4.8% to 74.6%. Fewer self-referral patients (52.5%) had obstructive coronary artery disease compared to non-self-referral patients (56.5%), with an odds ratio (OR) of 0.89 (95% CI 0.85-0.93;p <0.001), after accounting for patient factors. Angiograms performed by interventional physicians had a higher likelihood of showing obstructive coronary artery disease (60.1% vs. 50.8%; OR 1.22; 95% CI 1.17-1.28; p<0.001). Fewer angiograms at cath only centers showed obstructive disease (45.0%) compared to full service centers (58.1%); this was of borderline significance (OR 0.59; 95% CI 0.34-1.00; p=0.05). Conclusion: Physician and system factors are important predictors of the diagnostic yield of coronary angiography in stable IHD, even after accounting for patient characteristics. Further study into the drivers of how these physician and system factors impact diagnostic yield is an important focus for quality improvement.

scholarly journals 775-5 Increased Incidence of Chlamydia Bacteria Detected within Coronary Arteries of Patients with Atherosclerotic Versus Transplant Induced Coronary Artery Disease

1995 ◽  
Vol 25 (2) ◽  
pp. 291A
Author(s):  
Joseph B. Muhlestein ◽  
Elizabeth H. Hammond ◽  
John F. Carlquist ◽  
Ellen Radicke ◽  
Matthew J. Thomson ◽  
...  
Keyword(s):  
Coronary Artery Disease ◽  
Coronary Artery ◽  
Coronary Arteries ◽  
Artery Disease
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