scholarly journals Diagnostic Approach to Angina Pectoris

2021 ◽  
Vol 96 (3) ◽  
pp. 218-224
Author(s):  
Joon Ho Ahn ◽  
Young Joon Hong

Stable angina is a chronic, systemic disease with a wide range of associated symptoms and clinical outcomes. Prompt diagnosis can be challenging for clinicians. Typical chest pain caused by stable angina occurs when the myocardium receives inadequate oxygen, resulting in myocardial ischemia. Various diagnostic tools including non-invasive tests such as coronary computed tomographic angiography and image-based stress tests have evolved over the last decade. An important factor in the selection of the proper diagnostic test for stable angina is assessment of the pre-test probability in the event of possible coronary arterial stenosis.

2021 ◽  
Vol 12 (2) ◽  
pp. 712-716
Author(s):  
Edsel Ing ◽  
Felix Tyndel ◽  
Joyce Tang ◽  
Thomas R. Marotta

A 67-year-old woman had delayed initial diagnosis of her right low flow carotid cavernous fistula (CCF) during the coronavirus disease (COVID-19) pandemic due to difficulty detecting ocular signs via online virtual examinations. Her right eye conjunctival erythema and proptosis with medial rectus enlargement on computed tomography scan was initially misdiagnosed as euthyroid thyroid-associated orbitopathy without lid retraction. She developed vision loss, and increasing episcleral venous congestion and CCF was suspected. Computed tomographic angiography did not show an obvious fistula. Digital subtraction angiography revealed the right-sided low flow CCF, which was fed from vessels from the contralateral side.


2013 ◽  
Vol 54 (1) ◽  
pp. 89-98 ◽  
Author(s):  
Luca Saba ◽  
Matteo Atzeni ◽  
Warren Matthew Rozen ◽  
Alberto Alonso-Burgos ◽  
Raffaella Bura ◽  
...  

Preoperative imaging using a range of imaging modalities has become increasingly popular for preoperative planning in plastic surgery, in particular in perforator flap surgery. Modalities in this role include ultrasound (US), magnetic resonance angiography (MRA), and computed tomographic angiography (CTA). The evidence for the use of these techniques has been reported in only a handful of studies. In this paper we conducted a non-systematic review of the literature to establish the role for each of these modalities. The role of state-of-the-art vascular imaging as an application in perforator flap surgery is thus offered.


Author(s):  
C. K. M. Boerhout ◽  
R. G. T. Feenstra ◽  
G. A. Somsen ◽  
Y. Appelman ◽  
P. Ong ◽  
...  

AbstractPatients with new-onset stable angina constitute a substantial part of the population seen by cardiologists. Currently, the diagnostic workup of these patients depends on the pre-test probability of having obstructive coronary artery disease. It consists of either functional testing for myocardial ischaemia or anatomical testing by using coronary computed tomographic angiography (CCTA) or invasive coronary angiography. In case the pre-test probability is > 5%, the current guidelines for the management of chronic coronary syndromes do not state a clear preference for one of the noninvasive techniques. However, based on the recently published cost-effectiveness analysis of the PROMISE trial and considering the diagnostic yield in patients with angina and nonobstructive coronary artery disease, we argue a more prominent role for CCTA as a gatekeeper for patients with new-onset stable angina.


Neurosurgery ◽  
2006 ◽  
Vol 58 (4) ◽  
pp. 686-694 ◽  
Author(s):  
Peter Zampakis ◽  
Celestine Santosh ◽  
William Taylor ◽  
Evelyn Teasdale

Abstract OBJECTIVE: Accurate diagnosis and demonstration of the angioarchitecture and localization of a spinal dural arteriovenous fistula is of crucial importance before treatment. Selective spinal angiography (DSA) has been considered the standard technique, but is invasive, time-consuming, and may be falsely negative. This report evaluates the use of noninvasive vascular imaging (computed tomographic and magnetic resonance angiography [MRA]) in patients suspected to have a dural fistula with spinal drainage. METHOD: Ten consecutive patients had DSA and multidetector computed tomographic angiography (MDCTA), eight also had MRA. Nine were men with an average age of 67 years. In nine patients, the diagnosis was confirmed at surgery or intravascular treatment. Eight were proven to have a spinal dural fistula. In two, the fistula was within the cervical cranial dura. In all patients, the venous drainage involved only the spinal venous plexus. RESULTS: MDCTA identified the level of the feeding artery in nine patients. In two cases, selective DSA failed to show the abnormality found on MDCTA, but both were confirmed at surgery. MRA was diagnostic in a case in which the lesion was not accurately depicted by either MDCTA or DSA. MRA was less accurate than MDCTA in determining the level of the feeding artery. CONCLUSION: MDCTA and MRA can direct and focus DSA. MDCTA gives additional useful three-dimensional bone detail and localization information for the surgeon. It may replace DSA if surgery is the planned treatment.


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