relationship between serum level of manganese and severity of coronary atherosclerosis

Trace elements such as manganese have an important role in the maintenance of the normal structure and physiology of cells. Manganese is involved in many biological processes. Therefore, an evaluation of the manganese in the atherosclerotic disease is important. In this cross sectional study, 334 subjects, without recent cardiac event and history of collagen vascular or infectious disease were investigated. All patients divided into 4 groups to evaluate severity of coronary artery disease according to Syntax scoring system. All groups were matched in cardiovascular risk factors. The serum level of manganese in normal coronary group was 1.47 +/- 0.23 micro g/L and in total atherosclerotic groups was 1.06 +/- 0.37 micro g/L. The serum level of manganese was significantly lower in total atherosclerotic groups than normal group [p=0.001] and significantly decreased with severity of atherosclerosis. The serum level of manganese was significantly lower in sever atherosclerosis patients than mild and moderate coronary artery disease groups [p=0.001]. The finding indicated that the serum level of manganese is lower in atherosclerotic patients and it decreases with severity of atherosclerosis

Spontaneous coronary artery dissection: a case report

Spontaneous coronary artery dissection [SCAD] is a rare and important cause of acute coronary syndrome and sudden cardiac death. Various etiologies are thought to be responsible for this condition, among which underlying atherosclerosis seems to be the most common. SCAD is predominant in women and is usually diagnosed via coronary artery angiography. Therapeutic interventions include medical therapy, percutaneous coronary artery intervention, and surgery based on lesion characteristics. We describe a 36-year-old woman with SCAD presenting with acute chest pain to Fatemeh-Zahra Hospital, Sari, Iran. The patient had no current atherosclerosis risk factors and had given birth 6 months previously. Coronary angiography was performed due to the persistence of the chest pain after initial management, and a spontaneous dissection of the left anterior descending artery was observed. She underwent coronary artery bypass graft and was discharged in good condition

Infective Left Atrial Dissecting Flap after Cardiac Surgery

Left atrial dissection (LatD), defined as the forced separation of the left atrial (LA) wall layers by blood, is a rare and severe complication of cardiac surgery. It is most frequently associated with atrioventricular junction injuries. We report a case of infected LatD after coronary artery bypass graft, mitral valve replacement, aortic valve replacement and ascending aortic root replacement. The patient was presented with septicemia and disseminated intravascular coagulation. To the best of our knowledge, this is the first case report of LA dissecting flap concomitant with attached infective vegetations identified by transesophageal echocardiography.