RESUMO
This case report describes the occurrence of multiple coronary artery fistulae emptying into the left ventricle and includes a small communication into the left atrium. The initial diagnosis of a coronary artery fistula was made by standard and nonstandard transthoracic two-dimensional echocardiogram and Doppler interrogation. Later, multiple coronary fistulae communicating through a sinusoid and draining into the left-sided chambers were confirmed by angiography.
Assuntos
Fístula Arteriovenosa/diagnóstico , Anomalias dos Vasos Coronários/diagnóstico , Fístula Arteriovenosa/complicações , Débito Cardíaco Elevado/diagnóstico , Débito Cardíaco Elevado/etiologia , Angiografia Coronária , Anomalias dos Vasos Coronários/complicações , Ecocardiografia Doppler , Átrios do Coração/anormalidades , Átrios do Coração/diagnóstico por imagem , Insuficiência Cardíaca/diagnóstico , Insuficiência Cardíaca/etiologia , Ventrículos do Coração/anormalidades , Ventrículos do Coração/diagnóstico por imagem , Humanos , Masculino , Pessoa de Meia-Idade , Disfunção Ventricular Esquerda/diagnóstico , Disfunção Ventricular Esquerda/etiologiaRESUMO
The predictors of troponin release after percutaneous coronary intervention were prospectively assessed in 405 consecutive patients. Troponin release occurred frequently (27%) and was associated with complications during the procedure, including sapheneous vein graft interventions, multistent use, glycoprotein IIb/IIIa use, and a history of hypercholesterolemia.
Assuntos
Angioplastia Coronária com Balão , Infarto do Miocárdio/sangue , Infarto do Miocárdio/terapia , Troponina/sangue , Biomarcadores/sangue , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Infarto do Miocárdio/mortalidade , Período Pós-Operatório , Valor Preditivo dos Testes , Prognóstico , Estudos ProspectivosRESUMO
The clinical applicability of a method for quantifying pericardial effusion (PE) was studied. The pericardial and cardiac volumes were determined from border tracings of 2-dimensional echocardiograms fitted with 3-dimensional disk models. The PE volume was the difference between pericardial and cardiac volumes. A phantom study included 54 cases with different volumes and viewing geometry showed a correlation coefficient r = 0.98 and an accuracy of +/- 6%. A clinical study included 20 cases showing that the estimated PE volume correlated well with that drained surgically (between 100 mL and 1200 mL): y = 0.81 x + 120 mL; r = 0.91, P <.0001. The percent error, determined by the standard error of the estimate (114 mL) over mean (548 mL), was 20%. Intraobserver variability was 4% and interobserver variability 6%. The 3-dimensional disk method provides a quick and convenient way to quantify PE from 2-dimensional echocardiograms with acceptable accuracy and reproducibility.
Assuntos
Interpretação de Imagem Assistida por Computador , Derrame Pericárdico/diagnóstico por imagem , Volume Cardíaco , Humanos , Variações Dependentes do Observador , Imagens de Fantasmas , Análise de Regressão , Estudos Retrospectivos , UltrassonografiaAssuntos
Angina Pectoris Variante/patologia , Arritmias Cardíacas/complicações , Infarto do Miocárdio/patologia , Índice de Gravidade de Doença , Troponina I/sangue , Angina Pectoris Variante/sangue , Angina Pectoris Variante/diagnóstico por imagem , Biomarcadores/sangue , Angiografia Coronária , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Infarto do Miocárdio/sangue , Infarto do Miocárdio/complicações , Infarto do Miocárdio/diagnóstico por imagem , Estudos Prospectivos , Análise de Regressão , Sensibilidade e EspecificidadeRESUMO
To evaluate the sensitivity of the serum cardiac troponin I level in detecting stress test-induced myocardial ischemia, the authors conducted a prospective study including patients admitted for chest pain to the telemetry floor of Our Lady of Mercy Medical Center at Bronx, NY. Consecutive 134 telemetry patients that agreed to participate in this study were included. All of these patients had a nuclear stress test and were divided into various groups based on the prestress test probability of having coronary artery disease. To assess serum cardiac troponin I levels, blood samples were drawn before and after stress testing and compared with the stress test results. Overall, 30 patients (22%) had reversible perfusion defects on stress images, and none (0%) had increased serum cardiac troponin I levels. One patient of 18 patients (6%) in group C with negative stress test results had an elevated serum cardiac troponin I level after the stress test, but none of group A or group B patients had elevated troponin I levels. These data show that serum cardiac troponin I levels do not increase with stress test-induced myocardial ischemia.