RESUMEN
BACKGROUND: We report a rare case of a patient who presented with chest pain and was found to have a constellation of rare cardiac anomalies. CASE PRESENTATION: A 67-year-old patient with no past medical history presented with chest pain. He had mild troponin elevation, but no ischemic changes on ECG. He underwent a CT coronary angiogram for further evaluation. He was found to have a type 0 bicuspid aortic valve, large left sinus of Valsalva aneurysm and type R-III single coronary artery. These findings were confirmed with transesophageal echocardiogram and coronary angiogram. He underwent a successful repair of his aortic root aneurysm with a synthetic patch. CONCLUSIONS: The combination of type R-III single coronary artery, bicuspid aortic valve, and left sinus of Valsalva aneurysm congenital anomalies in one individual is extremely rare and marks our case unique. Given the size of his Sinus of Valsalva aneurysm, the patient underwent surgical repair of his aneurysm and was asymptomatic when seen in follow-up.
Asunto(s)
Aneurisma de la Aorta/complicaciones , Enfermedad de la Válvula Aórtica Bicúspide/complicaciones , Anomalías de los Vasos Coronarios/complicaciones , Seno Aórtico , Anciano , Aneurisma de la Aorta/diagnóstico por imagen , Aneurisma de la Aorta/cirugía , Enfermedad de la Válvula Aórtica Bicúspide/diagnóstico por imagen , Anomalías de los Vasos Coronarios/diagnóstico por imagen , Humanos , Masculino , Seno Aórtico/diagnóstico por imagen , Seno Aórtico/cirugía , Resultado del TratamientoRESUMEN
Diastolic heart failure is a common form of congestive heart failure that is responsible for significant morbidity and mortality. In contrast to heart failure caused by systolic left ventricular dysfunction, diastolic heart failure is harder to diagnose and less likely to be accepted as a diagnosis. In addition, treatment strategies are much less defined than those for heart failure caused by systolic dysfunction.
Asunto(s)
Diástole , Insuficiencia Cardíaca/mortalidad , Insuficiencia Cardíaca/fisiopatología , Disfunción Ventricular Izquierda/diagnóstico por imagen , Disfunción Ventricular Izquierda/mortalidad , Antagonistas Adrenérgicos beta/uso terapéutico , Inhibidores de la Enzima Convertidora de Angiotensina/uso terapéutico , Gasto Cardíaco , Cardiotónicos/uso terapéutico , Digoxina , Diuréticos/uso terapéutico , Quimioterapia Combinada , Ecocardiografía Doppler , Femenino , Insuficiencia Cardíaca/diagnóstico por imagen , Insuficiencia Cardíaca/tratamiento farmacológico , Humanos , Masculino , Pronóstico , Medición de Riesgo , Índice de Severidad de la Enfermedad , Volumen Sistólico , Análisis de Supervivencia , Resultado del Tratamiento , Disfunción Ventricular Izquierda/tratamiento farmacológico , Disfunción Ventricular Izquierda/fisiopatologíaRESUMEN
We report a case of the spontaneous formation of a left anterior descending artery to right ventricular fistula. The unprovoked appearance of this fistulous connection was clearly documented by serial angiography and confirmed during surgery.
Asunto(s)
Vasos Coronarios/patología , Fístula/patología , Miocardio/patología , Anciano , Angiografía Coronaria , Puente de Arteria Coronaria , Vasos Coronarios/cirugía , Fístula/diagnóstico por imagen , Fístula/cirugía , Ventrículos Cardíacos/patología , Humanos , MasculinoRESUMEN
Spontaneous coronary artery dissection (SCAD) should be considered as a cause of the acute coronary syndrome in young patients with few apparent risk factors for coronary artery disease, in females in the peripartum period, and in patients who are at a higher risk for this condition. SCAD can also present as sudden death and cardiogenic shock. Several mechanisms have been described in the pathophysiology of this condition. Urgent coronary angiography is indicated if SCAD is suspected. Percutaneous coronary artery stenting and coronary artery bypass grafting are the main treatment strategies.