RESUMO
The degree of left main coronary artery (LM) lesions is one of the main factors that predetermine the survival rate of patients with coronary heart disease. Below is a description of a clinical case of a successful stenting in a young 35 year old patient with a severe LM obstruction and an underlying acute coronary syndrome (ACS). Urgent stenting in such clinical situations have been found to be very effective and safe as demonstrated below in the following case study.
Assuntos
Síndrome Coronariana Aguda/diagnóstico , Vasos Coronários/fisiopatologia , Infarto do Miocárdio com Supradesnível do Segmento ST/diagnóstico , Síndrome Coronariana Aguda/fisiopatologia , Síndrome Coronariana Aguda/terapia , Adulto , Angioplastia Coronária com Balão , Humanos , Masculino , Infarto do Miocárdio com Supradesnível do Segmento ST/fisiopatologia , Infarto do Miocárdio com Supradesnível do Segmento ST/terapia , Choque Cardiogênico/diagnóstico , Choque Cardiogênico/fisiopatologia , Choque Cardiogênico/terapia , StentsRESUMO
Structural heart anomalies (SHA) are congenital abnormalities of cardiovascular system, characterized by various anatomical departures of heart and great vessels from normal conditions. SHA are a part of connective tissue dysplasia syndrome (CTDS), one of the most common congenital autosomal-dominant diseases in people of young and middle age. The most common SHA are a mitral valve prolapse, abnormal chords of left ventricle and their combinations. The clinical significance of these anomalies depends on a degree of severity and impact on intracardial hemodynamics, as described in the article. The most prognostically dangerous are multiple abnormal chords of left ventricle, which can be a sign of serious hereditary disease - a left ventricular non-compaction.
Assuntos
Cardiopatias Congênitas/patologia , Cordas Tendinosas/anormalidades , Cardiopatias Congênitas/genética , Cardiopatias Congênitas/terapia , Ventrículos do Coração/anormalidades , Humanos , Prolapso da Valva Mitral/genética , Prolapso da Valva Mitral/patologia , Prolapso da Valva Mitral/terapiaRESUMO
INTRODUCTION: myxomatous degeneration (MD) of valve leaflets and other structures of the valve apparatus and the degree of its severity in particular is of great prognostic significance as this determines the risk of complications development as well as the prognosis. The aim of the paper was to assess heart rhythm and heart conduction disorders in adolescents with primary mitral valve prolapse (MVP) and myxomatous valve degeneration of various degrees. MATERIALS AND METHODS: complete physical examination of 145 adolescents aged 12-16 with MVP was carried out. Patients were divided into four groups according to the degree of myxomatous degeneration (MD): group 1 - 29 patients without MD; group 2 - 43 patients with MD and 3-4 mm leaflets thickness; group 3 - patients with MD and 5-6 mm leaflets thickness; group 4 - patients with MD and 7-8 mm leaflets thickness. Our own methods used to determine the degree of MD are presented in the paper. RESULTS: in general, significant increase in the total number of both ventricular and supraventricular arrhythmias was observed in all patients with myxomatous degeneration when compared with the group of patients with no MD. While in patients from group 2 the number of ventricular premature beats was 6.5 times higher than in group 1, it was 10 times higher in group 3 and 20 times higher in group 4. The same significant changes (p < 0.05) were seen in extrasystoles in Lown's grading (increase from grade I to grade IV), the episodes of ventricular tachycardia (VT) and their number, mean heart rate as well as maximal duration of ventricular tachycardia episodes. CONCLUSIONS: thus, the presence of MD of mitral valve leaflets in MVP and its degree of severity in particular, were found to be the major risk factor in arrhythmia development.
