RESUMO
Techniques for vascular intervention have been evolving in the past decades. Trans-radial artery access (TRA) has been emerging and is favorable over trans-femoral access in recent years due to the lower risk of bleeding complications, vascular injury, early mobilization, shorter hospitalization and lesser cost. TRA has its own limitations such as radial artery stenosis, dissection, spasm and crossover. When access from the conventional sites is complicated or unsuccessful, trans-ulnar artery may serve as a feasible and alternative route. Despite posing potential complications similar to TRA, trans-ulnar artery is a relatively safe approach in an experienced trans-radial operator. We, herein, present a challenging case of subclavian artery revascularization performed via retrograde trans-ulnar approach.
Assuntos
Cateterismo Periférico/métodos , Procedimentos Endovasculares/métodos , Artéria Subclávia , Síndrome do Roubo Subclávio/cirurgia , Idoso , Angiografia , Feminino , Humanos , Síndrome do Roubo Subclávio/diagnóstico , Artéria UlnarRESUMO
Wellens' syndrome represents critical occlusion of the proximal left anterior descending coronary artery. Electrocardiographic changes similar to Wellens' wave are not exceptional to acute coronary occlusion and can also be seen in cardiac and non-cardiac conditions, such as left ventricular hypertrophy, persistent juvenile T wave, bundle branch blocks, cerebral haemorrhage, pulmonary oedema, pulmonary embolism, pheochromocytoma, Takotsubo syndrome, digitalis and cocaine-induced coronary vasospasm. Cocaine-induced pseudo-Wellens' syndrome should be considered as one of the differentials, since cocaine is used frequently by young adults and can cause left anterior descending coronary vasospasm mimicking Wellens' syndrome. Initiation of the beta-blocking agent in pseudo-Wellens' syndrome as a part of acute coronary syndrome management can be disastrous. We illustrated a case of cocaine-induced pseudo-Wellens' syndrome presented with typical chest pain associated with Wellenoid ECG.
Assuntos
Bloqueio de Ramo/diagnóstico , Cocaína/efeitos adversos , Antagonistas Adrenérgicos beta/administração & dosagem , Antagonistas Adrenérgicos beta/uso terapêutico , Bloqueio de Ramo/induzido quimicamente , Bloqueio de Ramo/diagnóstico por imagem , Bloqueio de Ramo/tratamento farmacológico , Dor no Peito/etiologia , Angiografia Coronária , Diagnóstico Diferencial , Eletrocardiografia , Humanos , Masculino , Pessoa de Meia-Idade , SíndromeAssuntos
Anticoagulantes/uso terapêutico , Trombose Coronária/tratamento farmacológico , Enoxaparina/uso terapêutico , Varfarina/uso terapêutico , Fibrilação Atrial/etiologia , Trombose Coronária/complicações , Trombose Coronária/diagnóstico por imagem , Ecocardiografia Transesofagiana , Feminino , Átrios do Coração/diagnóstico por imagem , Humanos , Pessoa de Meia-IdadeRESUMO
Pericardial cysts are rare anomalies of the pericardium that are usually asymptomatic and followed by two-dimensional (2D) echocardiography. Here we report a large pericardial cyst that could not be measured accurately by 2D echocardiography but three-dimensional (3D) echocardiography enabled measurements of the cyst that correlated well with computed tomography measurements. In addition, 3D echocardiography demonstrated the mono-trabeculated nature of the cyst further suggesting the incremental value of 3D echocardiography in the evaluation of pericardial cysts. The cyst was subsequently resected surgically.
