scholarly journals Case Report: Hematoma Formation After Spontaneous Coronary Artery Rupture

2022 ◽  
Vol 8 ◽  
Author(s):  
Weitao Liang ◽  
Honghua Yue ◽  
Tailong Zhang ◽  
Zhong Wu
Keyword(s):  
Coronary Artery ◽  
Clinical Symptoms ◽  
Preoperative Evaluation ◽  
Diagnostic Process ◽  
Hematoma Formation ◽  
Diagnostic Work ◽  
The Right ◽  
Multimodality Approach ◽  
Work Up ◽  
Coronary Artery Rupture

We report a case of hematoma formation in the right coronary artery after spontaneous rupture. A 48-year-old female patient was admitted with a suspected right cardiac mass. Despite diagnostic work-up, the dignity of the mass could not be determined. Due to acute clinical symptoms, explorative surgery was decided and performed. Hereby, the mass was partially incised, and thrombus-like tissue was detected without active bleeding. We described the challenges during the diagnostic process, and the diagnosis was finally made according to a multimodality approach. For further assessment, we reviewed related literature and highlighted the importance of coronary angiography in the preoperative evaluation of such patients. The therapy may vary according to the location and size of such lesions.

Diagnostic work-up and therapeutic implications in MINOCA: need for a personalized approach

2021 ◽  
Vol 17 (1) ◽  
pp. 149-154 ◽  
Author(s):  
Marco Giuseppe Del Buono ◽  
Rocco Antonio Montone ◽  
Giulia Iannaccone ◽  
Maria Chiara Meucci ◽  
Riccardo Rinaldi ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Coronary Artery ◽  
Obstructive Coronary Artery Disease ◽  
Benign Condition ◽  
Therapeutic Implications ◽  
Risk Of Mortality ◽  
Artery Disease ◽  
Personalized Approach ◽  
Diagnostic Work ◽  
Work Up

Myocardial infarction with non-obstructive coronary artery (MINOCA) disease represents a heterogeneous clinical conundrum accounting for about 6% of all acute myocardial infarction (MI) cases. Initially believed to be a benign condition, is now becoming clear that MINOCA is associated with a non-negligible risk of mortality, rehospitalization, disability and angina burden at follow-up, with high socioeconomic costs. To date, there are no prospective clinical trials in this population and cannot be assumed that benefits observed in patients suffering from MI with obstructive coronary artery disease may successfully translate to this syndrome. Herein, we comment on the importance of the multimodality assessment to properly identify and treat the specific causes of MINOCA, in order to improve prognosis and the quality of life in these patients.

scholarly journals Anomalous Origin of Coronary Artery from the Contralateral Aortic Sinus - Case Report

2018 ◽  
Vol 12 (2) ◽  
pp. 98-101
Author(s):  
Kajal Kumar Karmoker ◽  
Khandaker Aisha Siddika ◽  
Arif Hossain ◽  
Mohammad Adib Al Javed ◽  
Bijoy Datta
Keyword(s):  
Coronary Artery ◽  
Sudden Death ◽  
Coronary Arteries ◽  
Anomalous Origin ◽  
Complex Congenital Heart Disease ◽  
Coronary Artery Anomalies ◽  
Aortic Sinus ◽  
Diagnostic Work ◽  
Work Up ◽  
Congenital Coronary Artery Anomalies

Congenital coronary artery anomalies are rare heart defect that has been associated with myocardial ischemia and sudden death. Only 1-2% of population having variation in the origin, course or distribution of the epicardial coronary arteries. Anomalous origin of coronary arteries may be present as isolated defect or as a part of complex congenital heart disease. The clinical presentation, diagnostic work up, prognosis and treatment of these anomalies are highly variable. Most of the patients are asymptomatic but manifestation of these patients are chest pain, dyspnoea, palpitation, dizziness, ventricular fibrillation, syncope and sudden death. It is the second most common cause of sudden death in young athletes. Selective coronary angiography is the gold standard for identification of such type of anomaly. Patients of anomalous origin of coronary artery from the opposite sinus may require medical treatment, coronary angioplasty with stenting or surgical repair.University Heart Journal Vol. 12, No. 2, July 2016; 98-101

Inveterate (42-year-old) Hip Dislocation Treated with Arthroplasty. A Case Study

2017 ◽  
Vol 19 (2) ◽  
pp. 175-182
Author(s):  
Tomasz Pitera ◽  
Grzegorz Guzik ◽  
Piotr Biega
Keyword(s):  
Hip Dislocation ◽  
Treatment Method ◽  
High Energy ◽  
Road Accident ◽  
Computed Tomography Images ◽  
Appropriate Treatment ◽  
Diagnostic Work ◽  
The Right ◽  
Work Up

Dislocation of the hip usually results from a high-energy injury sustained during a road accident. Inveterate dislocations persisting for many months or years are extremely rare. Selection of an appropriate treatment method is not easy and is always associated with the risk of serious complications. The present authors hope that a description of the course of diagnostic work-up and treatment of a patient in whom a hip dislocation persisted for 42 years will prove interesting and helpful for orthopaedists who may encounter such a case in their practice. The patient sustained a dislocation of the right hip in 1974. He did not agree to undergo reduction immediately after the injury. Initially, he experienced extremely severe pain and difficulty walking, but gradually learned to walk without crutches and even took up a job. The limb was considerably shortened with only minimal movement in the hip joint. The pelvic geometry was altered and spinal scoliosis developed. In the last several years, the patient experienced a significant increase in pain and a decrease in function that prevented him from walking unassisted. Following a thorough physical examination, and based on computed tomography images, the patient was qualified for hip arthroplasty. An analysis of the available literature prompted the present authors to use a cemented implant and not to use bone grafts. Early treatment outcomes are good.

scholarly journals Esophageal Microperforation due to Calcified Mediastinal Lymph Node Leading to Tracheoesophageal Fistula

2016 ◽  
Vol 2016 ◽  
pp. 1-3
Author(s):  
Sankalp Dwivedi ◽  
E. Brooke Schrickel ◽  
Fayez Siddiqui ◽  
John O’Brien ◽  
James Kruer
Keyword(s):  
Lymph Node ◽  
Tracheoesophageal Fistula ◽  
Clinical Symptoms ◽  
Mediastinal Lymph Node ◽  
Rapid Decline ◽  
Disease Symptoms ◽  
Course Of Illness ◽  
Diagnostic Work ◽  
Subcarinal Lymph Node ◽  
Work Up

A 42-year-old male presented with worsening gastroesophageal reflux disease symptoms and cough. The clinical symptoms during the early course of illness were striking for aspiration pneumonia. He was given a prescription of proton pump inhibitors and antibiotics. Rapid decline in the clinical condition with worsening respiratory status was noted. Worsening symptoms of fever, cough, and chest pain prompted further diagnostic work-up suggesting esophageal microperforation. Esophagogram was found to be suggestive of tracheoesophageal fistula. The tracheoesophageal fistula was due to subcarinal lymph node of nontuberculous origin.

scholarly journals Influence of malformation of right coronary artery originating from the left sinus on the hemodynamic environment

2020 ◽  
Author(s):  
Mengyang Cong ◽  
Xingming Xu ◽  
Jianfeng Qiu ◽  
Shun Dai ◽  
Chuanzhi Chen ◽  
...  
Keyword(s):  
Coronary Artery ◽  
Coronary Arteries ◽  
Right Coronary Artery ◽  
Clinical Symptoms ◽  
Element Model ◽  
Cross Sectional Area ◽  
Sectional Area ◽  
Cross Sectional ◽  
The Cross ◽  
The Right

Abstract Background: The Anomalous origin of the Right Coronary Artery (RCA) from the Left Coronary artery sinus(AORL) is one of the abnormal origins of the coronary arteries. Most of these issues seldom have effects on human health, but some individuals may have symptoms such as myocardial ischaemia or even sudden death. Recently, researchers are studying AORL through clinical cases, but study based on computational fluid dynamics (CFD) is rarely seen. In this study, haemodynamic changes between normal origin of the RCA and AORL are compared according to numerical simulation results.Methods: Realistic three-dimensional models of 16 normal right coronary arteries and 26 abnormal origins of the right coronary arteries were reconstructed, respectively. The blood flow was numerically simulated using software ANSYS. This study involves one-way fluid-solid coupling finite element model in which the blood is assumed to be incompressible Newtonian fluid, and the vessel is assumed to be isotropic, linear elastic material.Results: The differences of the cross-sectional area at the inlet between the normal group and the abnormal group was significant ( P <0.0001). There were significant differences in the volumetric flow ( P <0.0001) and the pressure ( P =0.0001). There were positive correlations with the ratio of the cross-sectional area of the RCA to the inlet area of the ascending aorta (AAO) and the ratio of the inlet volumetric flow of the RCA to the volumetric flow of the AAO, in both the normal ( P =0.0001, r=0.8198) and abnormal ( P =0.0199, r=0.4925) group.Conclusion: This study shows that the cross-sectional area of the inlet of AORL may cause ischaemia symptoms, and the results may contribute to the further understanding of the clinical symptoms of AORL based on the haemodynamics.

scholarly journals Prevalence of Pediatric and Adolescent Balance Disorders: Analysis of a Mono-Institutional Series of 472 Patients

Children ◽  
2021 ◽  
Vol 8 (11) ◽  
pp. 1056
Author(s):  
Cristiano Balzanelli ◽  
Daniele Spataro ◽  
Luca Oscar Redaelli de Zinis
Keyword(s):  
Benign Paroxysmal Positional Vertigo ◽  
Clinical History ◽  
Diagnostic Process ◽  
Clinical Documentation ◽  
Vestibular Loss ◽  
Balance Disorders ◽  
Positional Vertigo ◽  
Diagnostic Work ◽  
Work Up ◽  
Paroxysmal Positional Vertigo

(1) Background: To assess the prevalence and frequency distribution of balance disorders in children and adolescents to delineate the planning of a targeted clinical and instrumental diagnostic work-up; (2) Methods: Retrospective analysis of the clinical documentation of patients under 18 years suffering from balance disorders from 2010 to 2019. Detailed collection of clinical history, accurate clinical examination, including both nystagmus and vestibulospinal signs examinations, and specific instrumental testing were the basis of the diagnostic process. (3) Results: A total of 472 participants were included in the study. Vestibular loss (26.1%) was the most frequent cause of vertigo in children, followed by vestibular migraine (21.2%) and benign paroxysmal positional vertigo (10.2%). In 1.1% of patients, the cause of vertigo remained undefined; (4) Conclusions: The diagnostic process applied was effective in understanding the cause of balance disorders in most cases and prevents more complex and expensive investigations reserved for only a few selected cases.

Two-Vessel Off-Pump Coronary Artery Bypass Grafting by Left Thoracotomy in a Complex Reoperative Case

2014 ◽  
Vol 17 (2) ◽  
pp. 77
Author(s):  
Shinya Unai ◽  
Gary Cook ◽  
Hitoshi Hirose ◽  
Nicholas Cavarocchi ◽  
John Entwistle
Keyword(s):  
Coronary Artery ◽  
Coronary Artery Bypass ◽  
Saphenous Vein Graft ◽  
Artery Bypass ◽  
Preoperative Evaluation ◽  
Descending Aorta ◽  
Left Thoracotomy ◽  
Off Pump ◽  
Triple Vessel Disease ◽  
The Right

An 83-year-old male with a history of three prior sternotomies, including coronary artery bypass surgery (CABG), presented with unstable angina. Cardiac catheterization showed left main and triple-vessel disease. The saphenous vein graft (SVG) to the right coronary artery was diseased but patent, and the SVG to the left anterior descending artery (LAD) was occluded. Preoperative evaluation showed a heavily calcified ascending aorta and minimum disease on the descending aorta. He successfully underwent a left thoracotomy 2-vessel off-pump CABG using the descending aorta for the proximal anastomosis. The left thoracotomy approach is a useful alternative to avoid complications associated with resternotomy, especially in patients with a hostile chest, although visualization of the target vessels may be limited.

scholarly journals Recurrent Kawasaki Disease: A Case Report of Three Separate Episodes at >4-Year Intervals

Children ◽  
2018 ◽  
Vol 5 (11) ◽  
pp. 155 ◽  
Author(s):  
Nikita Goswami ◽  
Katherine Marzan ◽  
Elizabeth De Oliveira ◽  
Sharon Wagner-Lees ◽  
Jacqueline Szmuszkovicz
Keyword(s):  
Coronary Artery ◽  
Kawasaki Disease ◽  
Systemic Vasculitis ◽  
High Dose ◽  
Z Score ◽  
Coronary Aneurysms ◽  
Increased Risk ◽  
The Right ◽  
Work Up ◽  
High Dose Aspirin

Kawasaki disease (KD) is a self-limited systemic vasculitis, most often occurring in children 1–5 years old. It has a 2% recurrence rate and is associated with coronary aneurysms (CA), which can develop within two weeks of onset. A 25% increased risk is noted in patients who are recalcitrant to treatment. We describe a patient with recurrence of KD three times, approximately four years apart. A 10-year-old female with two previous episodes of KD, at 11 months and five years of age), in which she met five out of five criteria for KD and had no coronary involvement, presented with 15 days of fever, conjunctivitis and mucocutaneous changes. Infectious work-up was negative, and she was diagnosed with incomplete KD meeting three out of five criteria. An echocardiogram (ECHO) on day 12 revealed dilation of the right coronary artery (RCA) and left coronary artery (LCA). Treatment with intravenous immunoglobulin (IVIG) and high-dose aspirin was started at an outside hospital. After transfer, serial ECHOs showed evolving coronary aneurysms, left anterior descending (LAD) z-score + 8.2 and RCA z-score + 4.0. She received 10 mg/kg infliximab (day 18) and began clopidogrel. A cardiac MRI (day 20) demonstrated progression of the LAD aneurysm, with a z-score + 13, and warfarin was started. To our knowledge, this is the first report of recurrent KD occurring three times at ~5 year intervals.

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