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1.
Am J Case Rep ; 22: e931561, 2021 Sep 01.
Artigo em Inglês | MEDLINE | ID: mdl-34465715

RESUMO

BACKGROUND Coronary artery anomalies (CAAs) are rare congenital malformations with different clinical presentations and pathophysiological mechanisms. These anomalies are frequently the cause of sudden death in young patients. Most CAAs are incidental findings owing to the lack of symptoms; however, they may be associated with acute coronary syndrome in rare cases. CASE REPORT We describe the case of a 47-year-old man who presented with a 1-day history of progressive typical chest pain and elevated troponin levels. The patient underwent a coronary angiography, which unveiled the anomalous origin of the left main coronary artery arising from the right coronary artery, with an interarterial course between the ascending aorta and the pulmonary artery, without coronary artery disease. Coronary computed tomography angiography confirmed the CAA and its relationship with the symptoms. An uneventful coronary artery bypass graft was undertaken, and at the 1-year follow-up, the patient was asymptomatic, with a normal stress test. CONCLUSIONS This case depicts the presentation of atypical acute coronary syndrome in a young patient with a rare CAA. In such patients, coronary angiography and coronary computed tomography angiography are essential tools to confirm the diagnosis and to determine treatment. Although controversial, in young individuals presenting CAA with an interarterial course, such as the left main coronary artery arising from the right coronary artery, coronary artery bypass graft may be an important treatment option to avoid sudden death in the future.


Assuntos
Síndrome Coronariana Aguda , Doença da Artéria Coronariana , Anomalias dos Vasos Coronários , Síndrome Coronariana Aguda/diagnóstico , Síndrome Coronariana Aguda/etiologia , Angiografia Coronária , Anomalias dos Vasos Coronários/diagnóstico , Anomalias dos Vasos Coronários/diagnóstico por imagem , Humanos , Masculino , Pessoa de Meia-Idade
2.
Rev Assoc Med Bras (1992) ; 67(3): 418-425, 2021 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-34468608

RESUMO

OBJECTIVE: The aim of this study is to evaluate the myocardium structure in patients with chest pain who were determined to have moderate and/or high risk for cardiac ischemic heart disease (IHD) but who had normal findings on conventional coronary angiography by using native cardiac magnetic resonance imaging (CMRI) T1 mapping and comparing with healthy volunteers. METHODS: A total of 50 patients and 30 healthy volunteers who underwent CMRI were included in our prospective study. Patients whose clinical findings were compatible with stable angina pectoris, with moderate and/or high risk for IHD, but whose conventional coronary angiography was normal, were our patient group. Native T1 values were measured for 17 myocardial segments (segmented based on American Heart Association recommendations) by two radiologists independently. The data obtained were statistically compared with the sample t-test. RESULTS: Myocardial native T1 values were found to be significantly prolonged in the patient group compared with the control group (p<0.05). Inter-observer reliability for native T1 value measurements of groups was high for both patient and control groups (α = 0.92 for the patient group and 0.96 for the control group). CONCLUSION: Findings suggestive of ischemia were detected by T1 mapping in the myocardium of our patients. For this reason, it is recommended that this patient group should be included in early diagnosis and close follow-up assessments for IHD.


Assuntos
Imagem Cinética por Ressonância Magnética , Miocárdio , Angiografia Coronária , Humanos , Isquemia , Estudos Prospectivos , Reprodutibilidade dos Testes , Estados Unidos
3.
Rev Med Chil ; 149(3): 469-471, 2021 Mar.
Artigo em Espanhol | MEDLINE | ID: mdl-34479327

RESUMO

Spontaneous coronary artery dissection is an uncommon cause of acute coronary syndrome that predominantly affects women without cardiovascular risk factors. In transplant patients, spontaneous coronary artery dissection is an extremely rare condition, having been described in only three patients, in whom vascular damage secondary to the use of anticalcineurinics is postulated as a probable mechanism. We report a spontaneous coronary dissection in a female who received a heart transplant at 34 years of age. The diagnosis was made in a follow-up coronary angiography three years after transplantation, supplemented with optical coherence tomography. A percutaneous coronary revascularization of the involved artery was performed, with good immediate results and at one year of follow-up.


Assuntos
Anomalias dos Vasos Coronários , Transplante de Coração , Doenças Vasculares , Angiografia Coronária , Anomalias dos Vasos Coronários/diagnóstico por imagem , Dissecação , Feminino , Transplante de Coração/efeitos adversos , Humanos , Doenças Vasculares/diagnóstico por imagem , Doenças Vasculares/etiologia
4.
Rev Med Chil ; 149(3): 472-475, 2021 Mar.
Artigo em Espanhol | MEDLINE | ID: mdl-34479328

RESUMO

We report a 51-year-old asymptomatic male, with type II diabetes, referred to our outpatient clinic due to ST and T alterations on the precordial leads on the electrocardiogram. The echocardiogram showed apical akinesia and left ventricular hypertrophy. There were no angiographic lesions in the coronary angiography. In the left ventriculography, a hyperdynamic left ventricle with suspected left ventricular hypertrophy and an apical aneurysm were found. The cardiac magnetic resonance confirmed those findings, without late gadolinium enhancement. According to the European Cardiology Society Risk Score, the patient had a low sudden death risk. However, this score does not consider the presence of an aneurysm as risk factor for sudden death, but it is considered in the 2017 ACC/AHA Heart Rhythm Society Guidelines, as a major risk factor. Therefore a defibrillator was implanted, and he was discharged on permanent oral anticoagulation.


Assuntos
Cardiomiopatia Hipertrófica , Diabetes Mellitus Tipo 2 , Aneurisma Cardíaco , Cardiomiopatia Hipertrófica/complicações , Cardiomiopatia Hipertrófica/diagnóstico por imagem , Meios de Contraste , Angiografia Coronária , Eletrocardiografia , Gadolínio , Aneurisma Cardíaco/complicações , Aneurisma Cardíaco/diagnóstico por imagem , Humanos , Masculino , Pessoa de Meia-Idade
5.
Am J Case Rep ; 22: e932786, 2021 Sep 05.
Artigo em Inglês | MEDLINE | ID: mdl-34482358

RESUMO

BACKGROUND Giant coronary artery aneurysm (GCAA) is a rare disease, with an incidence of 0.02% in the general population. GCAA is defined as when the diameter of the coronary artery is more than 4 times the adjacent part or more than 8 mm. There are several causes of GCAA, with atherosclerosis being the most common. Patients with giant coronary artery aneurysms can be asymptomatic or develop chest pain, dyspnea, and palpitations. Complications of GCCA include myocardial infarction, thrombosis, and sudden death, so early treatment is necessary to prevent mortality. There is no standard surgical approach for a giant coronary artery aneurysm. CASE REPORT A 64-year-old man with hypertension, opium addiction, morbid obesity (body weight 151 kg and BMI 46), and benign prostate hyperplasia presented with a giant coronary aneurysm in coronary angiography. The patient underwent cardiac surgery, and a 42-mm coronary aneurysm was detected. The aneurysm had many orifices that opened to the left main coronary artery, left circumflex artery, LAD, the diagonal branch of the LAD, and the septal branch of the LAD. Aneurysmectomy and coronary artery bypass graft were successfully performed. CONCLUSIONS Giant coronary artery aneurysms are rare. Patients with giant coronary artery aneurysms may experience sudden death due to myocardial infarction and other cardiovascular complications due to ischemia. Because it is rare, there is no standard surgical approach for a giant coronary artery aneurysm. Further studies need to focus on standardized surgical management of patients with giant coronary artery aneurysms.


Assuntos
Aneurisma Coronário , Obesidade Mórbida , Dor no Peito/etiologia , Aneurisma Coronário/complicações , Aneurisma Coronário/diagnóstico , Aneurisma Coronário/cirurgia , Angiografia Coronária , Dispneia/etiologia , Humanos , Masculino , Pessoa de Meia-Idade , Obesidade Mórbida/complicações
8.
Arq Bras Cardiol ; 117(2): 281-287, 2021 08.
Artigo em Inglês, Português | MEDLINE | ID: mdl-34495219

RESUMO

BACKGROUND: GRACE, TIMI and HEART scores have been previously validated to predict serious untoward events among patients with non-ST elevation acute coronary syndrome (Non-ST ACS). However, the ability of these scores to discriminate the angiographic complexity of coronary artery disease has not been clearly established. OBJECTIVES: We sought to evaluate the correlation between clinical scores (TIMI, GRACE and HEART) and the anatomical complexity assessed by SYNTAX score, among non-ST ACS patients undergoing cinecoronariography. METHODS: Transversal cohort encompassing patients with diagnosis of Non-ST ACS referred to invasive stratification in our single center, between July 2018 and February 2019. Association between the scores was established by the Pearson's linear correlation test while the accuracy of the clinical scores versus SYNTAX score was determined with the ROC curve. RESULTS: A total of 138 patients were enrolled. Median GRACE, TIMI and HEART scores were 97, 3 and 5, respectively, whereas the median SYNTAX was 8. There was a positive correlation between the SYNTAX and the HEART (ρ =0.29; p<0.01) and GRACE (ρ =0.18; p<0.01) scores, but the correlation with TIMI reached no statistical significance (ρ =0.15; p=0.08). The HEART score was also the one with the highest area under the curve to predict a SYNTAX ≥32 [HEART = 0.81 (IC95% 0.7-0.91). HEART> 4 presented 100% sensitivity, with 50% specificity; and GRACE> 139 showed 55% sensitivity and 97% specificity for high SYNTAX. CONCLUSION: The clinical scores presented a positive, although modest, association with the SYNTAX score. The combined use of HEART and GRACE offers good accuracy for detecting angiographic complexity.


Assuntos
Síndrome Coronariana Aguda , Síndrome Coronariana Aguda/diagnóstico por imagem , Angiografia Coronária , Humanos , Prognóstico , Medição de Risco , Fatores de Risco
10.
J Int Med Res ; 49(8): 3000605211033177, 2021 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-34382462

RESUMO

Contrast-induced nephropathy (CIN) is the impairment of kidney function defined as a serum creatinine increase of 25% or 44 µmol/L compared with baseline, usually occurring 24 to 48 hours after the use of intravenous contrast. Important risk factors for CIN include female sex, advanced age (>65 years), type 2 diabetes (T2D), kidney disease, advanced heart failure, and intravascular volume depletion. We herein present a male patient with T2D, moderately reduced renal function, no albuminuria, and a positive echocardiography stress test. He underwent percutaneous coronary intervention (PCI), and two drug-eluting stents (in the left anterior descending coronary artery) and three bare-metal stents (in the right coronary artery) were implanted. Despite adequate rehydration (0.9% intravenous NaCl with 8.4% sodium bicarbonate) before and after the procedures, he developed irreversible kidney injury after coronary angiography and PCI. This case report demonstrates the unpredictable clinical course of CIN. Patients with T2D are at high risk for the occurrence of CIN, so careful clinical assessment is recommended with global renal functional reserve evaluation.


Assuntos
Doença da Artéria Coronariana , Diabetes Mellitus Tipo 2 , Nefropatias , Intervenção Coronária Percutânea , Idoso , Meios de Contraste/efeitos adversos , Angiografia Coronária , Doença da Artéria Coronariana/complicações , Doença da Artéria Coronariana/diagnóstico por imagem , Creatinina , Diabetes Mellitus Tipo 2/complicações , Diabetes Mellitus Tipo 2/tratamento farmacológico , Feminino , Humanos , Masculino , Estudos Retrospectivos , Fatores de Risco
11.
Kardiologiia ; 61(7): 28-35, 2021 Jul 31.
Artigo em Russo, Inglês | MEDLINE | ID: mdl-34397339

RESUMO

Aim      To create a three-dimensional mathematical model of coronary flow in patients with ischemic heart disease based on findings of computed tomography angiography (CTA) with subsequent calculation of the fractional flow reserve (FFRCTA) and comparison of estimated FFRCTA with FFR reference values measured by coronary angiography (CAG).Material and methods  The study included 10 patients with borderline stenosis (50-75 %) as determined by CTA performed with a 640­slice CT-scanner. Based on CTA findings, three-dimensional mathematical models were constructed for further calculation of FFRCTA. Later, an invasive measurement of FFR (FFRINV) was performed for all patients. FFR values <0.8 indicated the hemodynamic significance of stenosis.Results FFRCTA and FFRINV values differed insignificantly in most cases (n=9) and exceeded 5% in only one case. The regression analysis showed a close correlation between estimated and invasively measured FFR values.Conclusion      Preliminary results showed a good consistency of calculated and measured FFR values. Therefore, further development of the method for mathematical modeling of three-dimensional blood flow by CTA findings is promising. Noninvasive evaluation of FFR is particularly relevant for analysis of hemodynamic significance of borderline (50-75 %) coronary stenoses.


Assuntos
Doença da Artéria Coronariana , Estenose Coronária , Reserva Fracionada de Fluxo Miocárdico , Angiografia por Tomografia Computadorizada , Computadores , Angiografia Coronária , Doença da Artéria Coronariana/diagnóstico , Estenose Coronária/diagnóstico por imagem , Hemodinâmica , Humanos , Valor Preditivo dos Testes , Tomografia Computadorizada por Raios X
12.
Kardiologiia ; 61(7): 36-43, 2021 Jul 31.
Artigo em Russo, Inglês | MEDLINE | ID: mdl-34397340

RESUMO

Aim      To study the effect of residual coronary injury after a percutaneous coronary intervention (PCI), as evaluated with the SYNTAX scale (residual SYNTAX score, RSS), on the mid-term prognosis for patients with non-ST elevation acute myocardial infarction (NSTEMI) and also to determine threshold RSS values for patients at high and low risk of adverse cardiac events.Material and methods  A single-center, retrospective study was performed. From 421 patients with NSTEMI after PCI with stenting, 169 patients were selected who originally had multivessel coronary disease and who had undergone a repeated inpatient examination, including mid-term (11.7±3.0 mos.) coronary angiography. The endpoints were recurrent clinical manifestations of angina, repeat revascularization (RR), unstable angina (UA), recurrent acute myocardial infarction (AMI), cardiac death, and also a composite endpoint (major adverse cardiac events, MACE) that included UA, recurrent AMI, and cardiac death. After revealing a significant direct correlation between RSS and the probability of recurrent AMI, UA, MACE, or RR (p <0.05) using the ROC analysis, we have established threshold RSS values that divided patients into groups with high and low risk of the cardiac events listed above.Results For a significantly high risk of recurrent AMI (area under the curve, AUC 0.79±0.05; 95 % confidence interval, CI 0.68-0.89; р=0.048), the threshold RSS score was 8 (sensitivity 100 %, specificity 70.9 %). For UA and MACE, the RSS scores were both 3 (AUC 0.68±0.5; 95 % CI 0.58-0.79; p=0.005 and AUC 0.71±0.05; 95 % CI 0.61-0.8; p=0.001, respectively). The probability of UA during the observation period with RSS >3 was 4.07 times higher and that of MACE was 5.23 times higher than with RSS<3 (95 % CI 1.44-11.49; р=0.01 and 95 % CI 1.88-14.53; р=0.001, respectively).Conclusion      The study demonstrated a significant, direct correlation between the RSS and the risk of adverse cardiac events in patients with NSTEMI during one year of observation. Specific threshold values were obtained, which may help in choosing both the extent of revascularization and the tactics for postoperative management of patients.


Assuntos
Doença da Artéria Coronariana , Infarto do Miocárdio , Intervenção Coronária Percutânea , Angiografia Coronária , Doença da Artéria Coronariana/diagnóstico , Vasos Coronários/diagnóstico por imagem , Humanos , Infarto do Miocárdio/diagnóstico , Prognóstico , Estudos Retrospectivos , Fatores de Risco , Resultado do Tratamento
13.
Am J Case Rep ; 22: e932248, 2021 Aug 26.
Artigo em Inglês | MEDLINE | ID: mdl-34437516

RESUMO

BACKGROUND While most coronary congenital anomalies are uncommon, comprising less than 2% of the general population, a single coronary artery is an especially rare finding within this broader category. It involves a lone vessel forming a single ostium from the aortic trunk. This vessel is then the source through which cardiac blood supply originates. Such congenital coronary artery anomalies are rare but can have clinically relevant consequences such as sudden death and other cardiac complications. Nonetheless, they are usually incidental findings and can be asymptomatic. This report discusses the case of a female patient found to have an absence of the right coronary artery, with the left circumflex supplying the right coronary artery territory. CASE REPORT We report a rare case of a 66-year-old woman who presented with substernal chest pain and shortness of breath. Vital signs, laboratory work-up, and resting electrocardiogram did not reveal an underlying etiology. However, an exercise stress test was positive. Left heart catheterization was performed and revealed a dominant left circumflex artery supplying the entire right coronary territory. Further imaging revealed the absence of a separate right coronary artery ostium. The patient was treated with a beta-blocker, high-intensity statin, and a nitrate. CONCLUSIONS Single left coronary artery, especially with the absence of the right coronary artery, is particularly rare, but can have significant clinical implications. Prompt diagnosis is important but challenging considering the variable presentation of this condition. It is important to review diagnostic modalities available and the treatment for patients.


Assuntos
Anomalias dos Vasos Coronários , Idoso , Dor no Peito , Angiografia Coronária , Anomalias dos Vasos Coronários/diagnóstico , Anomalias dos Vasos Coronários/diagnóstico por imagem , Eletrocardiografia , Feminino , Humanos
14.
Kyobu Geka ; 74(9): 705-708, 2021 Sep.
Artigo em Japonês | MEDLINE | ID: mdl-34446627

RESUMO

Giant coronary aneurysm is rare, but a life-threatening disease. We report a 67-year-old man with 39 mm coronary aneurysm. He was presented to our facility with acute coronary syndrome complicated by cardiogenic shock. Angiography demonstrated giant coronary aneurysm and occlusion of the right coronary artery. After cardiopulmonary resuscitation and cardiopulmonary support (PCPS), emergent excision of aneurysm and coronary artery bypass grafting was performed. The postoperative course was good without complications. Most giant coronary artery aneurysms are asymptomatic but some patients present with angina pectoris, sudden death, fistula formation, pericardial tamponade, compression of surrounding structures, or congestive heart failure. But once complications, such as thrombosis, distal embolization, fistula formation or rupture occurred, it is difficult to save life without aggressive surgery. At present, there are no specific guidelines for the treatment of giant coronary aneurysm. Surgical correction is a preferred approach for the treatment of giant coronary artery aneurysms.


Assuntos
Aneurisma Coronário , Parada Cardíaca , Infarto do Miocárdio , Idoso , Aneurisma Coronário/complicações , Aneurisma Coronário/diagnóstico por imagem , Aneurisma Coronário/cirurgia , Angiografia Coronária , Vasos Coronários , Parada Cardíaca/etiologia , Humanos , Masculino
15.
S D Med ; 74(6): 248-249, 2021 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-34449162

RESUMO

Coronary vasospasm is an underdiagnosed cause of myocardial infarction in the absence of obstructive coronary artery disease. Systemic inflammation is one of several triggers associated with coronary vasospasm. We report the case of a 47-year woman incidentally found to be COVID-positive (RT-PCR) during evaluation of constitutional symptoms and breast cellulitis. Later in the hospitalization, she developed sudden-onset typical angina at rest; 12 lead EKG showed inferolateral ST-elevations. Urgent coronary angiogram showed nitrate-responsive subtotal focal occlusions in the right coronary and circumflex arteries. In the absence of sepsis, it is difficult to attribute coronary vasospasm solely to cellulitis. Focal coronary artery spasm mimicking ST-elevation myocardial infarction successfully managed solely with intracoronary nitroglycerine in an incidentally COVID-positive patient adds to the diverse manifestations of COVID infection. The exact mechanism of focal, as opposed to diffuse coronary vasospasm is unclear.


Assuntos
COVID-19 , Vasoespasmo Coronário , Infarto do Miocárdio , Infarto do Miocárdio com Supradesnível do Segmento ST , Angiografia Coronária , Vasoespasmo Coronário/complicações , Vasoespasmo Coronário/diagnóstico , Feminino , Humanos , Infarto do Miocárdio/diagnóstico , SARS-CoV-2 , Infarto do Miocárdio com Supradesnível do Segmento ST/complicações , Infarto do Miocárdio com Supradesnível do Segmento ST/diagnóstico
16.
Medicine (Baltimore) ; 100(32): e26947, 2021 Aug 13.
Artigo em Inglês | MEDLINE | ID: mdl-34397947

RESUMO

ABSTRACT: Because of a paucity of published data, we compared the 2-year major clinical outcomes between pre-percutaneous coronary intervention (pre-PCI) thrombolysis in myocardial infarction (TIMI) flow grade 0/1 (pre-TIMI flow grade [pre-TIMI] 0/1) group and pre-PCI TIMI flow grade 2/3 (pre-TIMI 2/3) group in patients with non-ST-segment elevation myocardial infarction (NSTEMI) who underwent successful implantation of newer-generation drug-eluting stent.A total of 7506 NSTEMI patients were divided into 2 groups: pre-TIMI 0/1 group (n = 3157) and pre-TIMI 2/3 group (n = 4349). The primary outcome was major adverse cardiac events defined as all-cause death, recurrent myocardial infarction, or any repeat revascularization. The secondary outcome was stent thrombosis (ST).After propensity score-matched (PSM) analysis, 2 PSM groups (2473 pairs, n = 4946, C-statistic = 0.684) were generated. Major adverse cardiac events (hazard ration [HR], 1.294; 95% confidence interval [CI]: 1.065-1.572; P = .009), all-cause death (HR, 1.559, P = .003), cardiac death (HR: 1.641, P = .005), and all-cause death or MI (HR: 1.531, P = .001) rates were significantly higher in the pre-TIMI 0/1 group than in the pre-TIMI 2/3 group. Moreover, these differences were more prominent during the first 1 month after the index PCI. However, the cumulative incidences of recurrent myocardial infarction, any revascularization, and ST were similar between the 2 groups.Among a contemporary cohort of NSTEMI, these data suggest that the presence of a pre-PCI patency of the infarct-related artery showed better mortality reduction capacity than those with a lack of patency.


Assuntos
Circulação Coronária/fisiologia , Stents Farmacológicos , Infarto do Miocárdio sem Supradesnível do Segmento ST/fisiopatologia , Intervenção Coronária Percutânea/métodos , Pontuação de Propensão , Fluxo Sanguíneo Regional/fisiologia , Sistema de Registros , Idoso , Angiografia Coronária , Feminino , Seguimentos , Humanos , Masculino , Pessoa de Meia-Idade , Infarto do Miocárdio sem Supradesnível do Segmento ST/diagnóstico , Infarto do Miocárdio sem Supradesnível do Segmento ST/cirurgia , Estudos Prospectivos , República da Coreia/epidemiologia , Resultado do Tratamento
17.
Cardiovasc Ultrasound ; 19(1): 31, 2021 Aug 24.
Artigo em Inglês | MEDLINE | ID: mdl-34429107

RESUMO

BACKGROUND: Cardiovascular complications of severe acute respiratory distress syndrome coronavirus 2 (SARS-CoV2) are known to be associated with poor outcome. A small number of case series and reports have described cases of myocarditis and ischaemic events, however, knowledge on the aetiology of acute cardiac failure in SARS-CoV2 remains limited. We describe the occurrence and risk stratification imaging correlates of 'takotsubo' stress cardiomyopathy presenting in a patient with Coronavirus Disease 2019 (COVID-19) in the intensive care unit. An intubated 53-year old patient with COVID19 suffered acute haemodynamic collapse in the intensive care unit, and was thus investigated with transthoracic echocardiography (TTE), 12-lead electrocardiograms (ECG) and serial troponins and blood tests, and eventually coronary angiography due to clinical suspicion of ischaemic aetiology. Echocardiography revealed a reduced ejection fraction, with evident extensive apical akinesia spanning multiple coronary territories. Troponins and NT-proBNP were elevated, and ECG revealed ST elevation: coronary angiography was thus performed. This revealed no significant coronary stenosis. Repeat echocardiography performed within the following week revealed a substantial recovery of ejection fraction and wall motion abnormalities. Despite requirement of a prolonged ICU stay, the patient now remains clinically stable, and is on spontaneous breathing. CONCLUSION: This case report presents a case of takotsubo stress cardiomyopathy occurring in a critically unwell patient with COVID19 in the intensive care setting. Stress cardiomyopathy may be an acute cardiovascular complication of COVID-19 infection. In the COVID19 critical care setting, urgent bedside echocardiography is an important tool for initial clinical assessment of patients suffering haemodynamic compromise.


Assuntos
COVID-19/epidemiologia , Angiografia Coronária/métodos , Ecocardiografia/métodos , Eletrocardiografia/métodos , Cardiomiopatia de Takotsubo/diagnóstico , Comorbidade , Feminino , Humanos , Pessoa de Meia-Idade , Pandemias , Cardiomiopatia de Takotsubo/epidemiologia
18.
Pol Merkur Lekarski ; 49(292): 278-282, 2021 Aug 16.
Artigo em Inglês | MEDLINE | ID: mdl-34464368

RESUMO

Epidemiological data on serum vitamin D levels in the population of Polish patients with angiographically confirmed coronary artery disease are limited. AIM: The aim of the study was to prospectively assess the concentrations of vitamin D in a group of patients from the Cardiological Department in Bielanski Hospital in Warsaw referred for coronary angiography due to suspected coronary artery disease. MATERIALS AND METHODS: The study included a total of 1,043 qualified patients (374 women and 669 men, age: 66,9±11,0 years) who underwent coronary angiography between the years of 2013 and 2017. Plasma 25(OH)D concentrations were assessed by electrochemiluminescence. RESULTS: The median 25(OH)D concentration in the study group was 15.2 ng/ml (range: 4.0 - 55.0 ng/ml). Optimal 25(OH)D concentrations (ie., equal to or greater than 30 ng/ml) were found in 64 patients (6%). Severe deficiencies (less than 10 ng/ml) were found in 229 patients (22%). Moderate deficiencies (concentration equal to or greater than 10 ng/ml and less than 20 ng/ml) and mild deficiencies (concentration equal to or greater than 20 ng/ml and less than 30 ng/ml) were observed in 525 (50%) and 225 patients (22%), respectively. CONCLUSIONS: Vitamin D deficiency was found in 94% of residents of central Poland with angiographically confirmed coronary artery disease. 22% of patients had a severe vitamin D deficiency. Due to the documented effects of vitamin D on the cardiovascular system and the fact that cardiovascular disease (including coronary artery disease) is still the most common cause of death in developed countries, prophylactic and therapeutic strategies should be considered to combat 25(OH)D deficiency in this group of Polish patients.


Assuntos
Doença da Artéria Coronariana , Deficiência de Vitamina D , Idoso , Angiografia Coronária , Doença da Artéria Coronariana/diagnóstico por imagem , Doença da Artéria Coronariana/epidemiologia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Polônia/epidemiologia , Vitamina D , Deficiência de Vitamina D/epidemiologia
19.
Pan Afr Med J ; 39: 45, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34422168

RESUMO

Anomalous connection of the coronary arteries (ANOCOR) is a rare angiographic finding; although most ANOCORs are benign some are a risky condition that can lead to sudden death. Knowing their particularities is important to know how to manage them. With an angiographic prevalence averaging 1%, proximal anomalous connection of the Coronary arteries (ANOCOR) represents a diverse entity. The challenge is to distinguish the benign ANOCOR to reassure the patient from the high risk ANOCOR that may need surgical repair. We present a case of a 52-years-old man admitted to our cath lab for urgent coronary angiography after a non ST segment elevation myocardial infarction. At coronary angiography we found ectopic left anterior descending and circumflex arteries with a culprit lesion on the right non ectopic coronary artery. A computed tomography (CT) scan showed benign ectopic courses of the left anterior descending and circumflex arteries. No surgical repair was indicated.


Assuntos
Angiografia Coronária , Anomalias dos Vasos Coronários/diagnóstico por imagem , Infarto do Miocárdio sem Supradesnível do Segmento ST/diagnóstico por imagem , Humanos , Masculino , Pessoa de Meia-Idade , Tomografia Computadorizada por Raios X
20.
J Int Med Res ; 49(8): 3000605211034997, 2021 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-34344220

RESUMO

Takotsubo syndrome is a condition that mimics acute coronary syndrome. The exact pathogenesis of the condition is unclear but it tends to occur more frequently in elderly women and a large proportion of cases have acute, former, or chronic neurologic or psychiatric disorders. Here we describe a 55-year-old female patient, who was brought to the emergency department presenting with a new-onset manic episode characterized by grandiosity, distractibility, decreased need for sleep, and increased goal-directed behaviours. She experienced chest pain approximately two days later, and non-ST elevation myocardial infarction was observed. The emergent coronary angiogram showed patent coronary arteries, and a diagnosis of Takotsubo syndrome was made. We suggest clinical multidisciplinary vigilance for somatic complaints, especially cardiac ones, in people with psychiatric disorders in order to make timely therapeutic interventions.


Assuntos
Síndrome Coronariana Aguda , Cardiomiopatia de Takotsubo , Síndrome Coronariana Aguda/diagnóstico , Idoso , Angiografia Coronária , Serviço Hospitalar de Emergência , Feminino , Humanos , Mania , Pessoa de Meia-Idade , Cardiomiopatia de Takotsubo/diagnóstico por imagem
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