coronary aneurysm
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Author(s):  
Marco Gemelli ◽  
Ettorino Di Tommaso ◽  
Vito D. Bruno ◽  
Gianni D. Angelini

Author(s):  
Houman Hashemian ◽  
Yasaman Ashjari ◽  
Esfandiar Nazari

Kawasaki disease (KD) is the most common cause of acquired heart disease today. An important and enduring complication of KD is a coronary aneurysm, whose early diagnosis and treatment can reduce the risk from 25% to 3%. Diagnosis of this disease is mainly clinical, although leukocytosis, increased erythrocyte sedimentation rate, and echocardiography are helpful in diagnosis. The cause of KD remains unknown, but the most common hypothesis is an abnormal immune response that is likely caused by an infectious agent, possibly in a favorable genetic background, and leads to vasculitis of the middle arteries, especially coronary arteries of the heart. Numerous infectious agents have been suggested in this regard. Co-infection with KD can also delay diagnosis. In this article, we introduce five years and seven months child who developed Kawasaki disease within a few days of the onset of Epstein-Barr virus infection.


2021 ◽  
Vol 25 (12) ◽  
pp. 922-923
Author(s):  
Stefania Cherubini ◽  
◽  
Alessandro Sciahbas ◽  
Maria Cera ◽  
Silvio Fedele ◽  
...  

2021 ◽  
Vol 18 (2) ◽  
pp. 11-14
Author(s):  
Satish Kumar Singh ◽  
Kiran Prasad Acharya ◽  
Chandra Mani Adhikari ◽  
Rikesh Tamrakar ◽  
Sanjay Singh KC ◽  
...  

Background and Aims:  Coronary artery Ectasia is a relatively uncommon problem encountered during coronary angiography with the prevalence ranging from 1.2% to 4.9%.  Coronary artery Ectasia and aneurysm both denote an arterial segment the dimension of which is larger than normal arterial segment, both have diameter greater than 1.5 times of normal.  The length of dilate segment is greater than its width in Ectasia while less in aneurysm. There is an overlap between risk factors of coronary artery Ectasia and atherosclerosis. The clinical relevance in general, and the appropriate medical management of coronary artery Ectasia specifically, is ill defined, as no randomised prospective studies exists. The study was conducted with an aim to estimate the prevalence of coronary artery Ectasia and aneurysm as well as to study the angiographic characteristics of coronary artery Ectasia and aneurysm undergoing in adult patients’ coronary angiography in tertiary cardiac centre of Nepal. Methods: A retrospective study was conducted in Shahid Gangalal national heart centre, Nepal analysing the angiographic records from cardiac catheterization lab.  A total of 447 patients who underwent coronary angiography and meet the inclusion criteria from July, 2019 to December, 2019 were included in the study. Any angiographic evidence of coronary Ectasia and aneurysm, coronary artery involved and it’s extent were analysed and recorded in the proforma. In addition, any associated evidence of coronary artery disease was analysed and recorded in the proforma. Results: The findings of our study revealed the overall prevalence of coronary artery Ectasia (CAE) and Coronary artery Aneurysm as 2.6%. Coronary ectasia was most prevalent in left anterior descending (LAD) artery (83.3%), followed by RCA and left main in 66.7% and 16.7% respectively.   In contrast, Coronary aneurysm was mostly seen in RCA (66.7%) followed by LCX (33.3%). In addition, the study also showed the frequency of localised Ectasia as 50 % and the association of significant coronary artery disease with coronary artery Ectasia in 66.67%. Conclusion: CAE and aneurysm are rare phenomenon encountered in routine coronary angiography, with LAD and RCA being most commonly involved in CAE and coronary aneurysm respectively.   CAE and aneurysm have significant association with the coronary artery disease.


Author(s):  
Stefano Maffè ◽  
Paola Paffoni ◽  
Luca Bergamasco ◽  
Eleonora Prenna ◽  
Giulia Careri ◽  
...  

Giant coronary artery aneurysm is an uncommon disease, treated with surgical intervention or percutaneous coil embolization. A thrombosed aneurysm can cause extrinsic compression on the cardiac chambers, with potential hemodynamic effects and may cause problems when we need to implant a cardiac device. We present a case of difficult pacemaker implantation in a patient with 3 syncopes, first-degree AV block and complete left bundle branch block on electrocardiogram. The patient presented a giant aneurysm of the right coronary artery (85 x 90 mm), thrombosed, with right atrial compression. The pacemaker implantation was hampered by the difficulty of passing the lead through the compressed right atrium; indeed, only with   simultaneous echocardiographic and fluoroscopic guidance, was it possible to complete the procedure. This case demonstrates the utility of echocardiogram, in particular settings, in cardiac stimulation procedures.


Circulation ◽  
2021 ◽  
Vol 144 (Suppl_2) ◽  
Author(s):  
Danielle Sganga ◽  
Shiraz A Maskatia

Case Presentation: A 10 year old male with prior COVID-19 exposure presented with 7 days of fever, rash, cough, vomiting, and hypotension. Laboratory evaluation was notable for SARS-CoV2 antibodies, elevated cardiac enzymes, BNP, and inflammatory markers. Initial echocardiogram showed normal cardiac function and a small LAD coronary aneurysm. He was diagnosed with Multisystemic Inflammatory Syndrome in Children (MIS-C) and given methylprednisolone and IVIG. Within 24 hours, he developed severe LV dysfunction and progressive cardiorespiratory failure requiring VA-ECMO cannulation and anticoagulation with bivalirudin. Cardiac biopsy demonstrated lymphocytic infiltration consistent with myocarditis. On VA-ECMO, he had transient periods of complete AV block. With immunomodulator treatment (anakinra, infliximab) and 5 days of plasmapheresis, inflammatory symptoms and cardiac function improved. He weaned off ECMO, and anticoagulation was transitioned to enoxaparin. He had left sided weakness 5 days later, and brain MRI revealed an MCA infarct. Ten days later, he had focal right sided weakness and repeat MRI showed multiple hemorrhagic cortical lesions, thought to be thromboembolic with hemorrhagic conversion secondary to an exaggerated inflammatory response to an MSSA bacteremia in the setting of MIS-C. Enoxaparin was discontinued. After continued recovery and a slow anakinra and steroid wean, he has normal coronary arteries, cardiac function, and baseline ECG but requires ongoing neurorehabilitation. Discussion: COVID-19 infection in children is often mild, but MIS-C is an evolving entity that can present with a wide range of features and severity. This case highlights two concepts. While first degree AV block is often reported in MIS-C, there is potential for progression to advanced AV block. Close telemetry monitoring is critical, especially if there is evidence of myocarditis. MIS-C shares features with Kawasaki disease, with a notable difference being a higher likelihood of shock and cardiac dysfunction in MIS-C. In MIS-C patients with cardiovascular collapse requiring ECMO, there is a risk for stroke. There should be a low threshold for neuroimaging and multidisciplinary effort to guide anticoagulation in these complex cases.


2021 ◽  
Vol 63 (11) ◽  
pp. 1405-1407
Author(s):  
Akiyuki Kotoku ◽  
Kentaro Aso ◽  
Takayuki Yamada ◽  
Naoki Shimizu ◽  
Hidefumi Mimura

2021 ◽  
Author(s):  
Yan Jin ◽  
Mengfei Zhang ◽  
Juan He

Abstract Background: Coronary artery fistula is a rare coronary anomaly which is defined as a communication between coronary artery and other heart chambers or vascular structures. The coronary artery which supply the fistula with blood can dilated, as a consequence, coronary aneurysm developed. Case introduction: Coronary artery fistula is frequently asymptomatic in its early stage, here we report a 26-year-old woman with left coronary artery fistula and left coronary artery aneurysm who presented in our hospital with dyspnea, fatigue and palpitation. The orifice of fistula was closed by continuous suture via right atriotomy. The wall of the aneurysm and enlarged LCA were partially resected along its longitudinal axis so that we can reduce the diameter of LCA to approximately normal.Conclusion: This technique provides a safe method for surgical repair of the giant coronary artery aneurysm with CAF.


Author(s):  
Alberto Barioli ◽  
Nicola Pellizzari ◽  
Luca Favero ◽  
Carlo Cernetti

Abstract Background The optimal treatment of aneurysmal or ectatic culprit vessels in the setting of acute myocardial infarction is still matter of debate, as revascularization with either percutaneous intervention or surgery is associated with low procedural success and poor outcomes. Case Summary We report the case of a 55-year-old male patient, admitted for inferior ST-elevation myocardial infarction, who underwent successful percutaneous implantation of a micro-mesh self-expanding nitinol carotid stent in a right coronary aneurysm with IVUS-measured diameter of 9 mm and massive thrombus apposition. Discussion The technical characteristics of the micro-mesh self-expanding nitinol carotid stent allow for adequate plaque coverage and good apposition even in large vessels, making this device particularly suitable for the treatment of coronary lesions with high thrombus burden, when severe coronary ectasia or aneurysms are present.


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