ABSTRACT
It has been reported that myocardial bridging may be associated with myocardial ischemia, myocardial infarction, vasospasm, cardiac arrhythmia and sudden death. However, the mechanism whereby ischemia occur as a consequence of myocardial bridging remains unclear. Recently we experienced a case of myocardial infarction in a patient with myocardial bridging and atrial fibrillation. A 66-year-old man presented with severe chest pain. His ECG showed ST elevation in V3-V5 and atrial fibrillation with rapid ventricular response. He underwent coronary angiography, which revealed a thrombus in the distal portion of the myocardial LAD bridge. He was treated with antiplatelet agents, heparin, tirofiban and amiodarone and beta-blocker without percutaneous coronary intervention. Five days later, his clinical condition was recovered and follow-up coronary angiography revealed markedly improved blood flow of the left anterior descending artery. The previous thrombus had disappeared.
Subject(s)
Aged , Humans , Amiodarone , Arrhythmias, Cardiac , Arteries , Atrial Fibrillation , Chest Pain , Coronary Angiography , Death, Sudden , Electrocardiography , Follow-Up Studies , Heparin , Ischemia , Myocardial Bridging , Myocardial Infarction , Myocardial Ischemia , Percutaneous Coronary Intervention , Platelet Aggregation Inhibitors , ThrombosisABSTRACT
PURPOSE: Headache is a frequent symptom in pediatric practice, but the prevalence of chronic recurrent headache was estimated in several studies with wide variations, because of inadequate expression and differences in case definition in children. Headache classification of International Headache Society is usually used in adults, but the application of it to children is uncommon, so we tried to diagnosis children with headache by using International Headache Society Classification. METHODS: We analyzed the clinical pictures, physical examinations including neurologic examination, PNS series, EEG and CT or MRI in 53 children with nonprogressing recurrent headache over than one month, who visited to pediatric department of Dong-A University hospital from January, 1995 to Feburary, 1996 and diagnosed them by using International Headache Society Classification. RESULTS: 1) The sex ratio between male and female was 1:1.2. 2) Diagnosed groups consisted of children with migraines in 22 cases(41.5%), tension-type headache in 19 cases(35.9%), coexisting migraine and tension-type headaches in 5 cases(9.4%), miscellaneous headaches not associated with structual lesion in 1 case(1.9%), headache associated with vascular disorders in 2 cases(3.8%), headache associated with nonvascular intracranial disorder in 1 case(1.9%), headache due to facial pain in 3 cases(5.6%). 3) Of 22 migraine cases, 13 cases(59.1%) had migraine with aura, 8 cases(40.9%) have migraine without aura and of 19 tension-type headache cases, 8 cases(42.1%) have episodic type, 11(57.9%) cases have chronic type. 4) Of 53 cases with recurrent headache, 3 cases(6%) had abnormal findings in CT or MRI. 5) Of 53 cases with recurrent headache, 9 cases(17%) had abnormal findings in EEG. CONCLUSIONS: International Headache Society Classifications are useful, but the diagnostic criteria are too strict for children, especially in migraine and tension type headache.
Subject(s)
Adult , Child , Female , Humans , Male , Classification , Diagnosis , Electroencephalography , Facial Pain , Headache , Magnetic Resonance Imaging , Migraine Disorders , Migraine with Aura , Migraine without Aura , Neurologic Examination , Physical Examination , Prevalence , Sex Ratio , Tension-Type HeadacheABSTRACT
BACKGROUND: It is known that dyslipidemia plays and important role in atherogenesis and progression for the disease. Recently it was reported that apolipoprotein levels are important in athcrogenesis. In Korean patients the study of the apolipoprotein levels as for the risk factor for atherogenesis is still needed. Subjects and METHODS: The 107 patients who underwent coronary angiography to differentiate chest pain syndrome were subjected to this study. Thirty-two patients who had no significant coronary artery disease served as a control group and 75 patients who had one or more coronary stenoses more than 50% narrowing by luminal diameter served as the coronary artery disease(CAD) group. Plasma levels of total cholesterol, triglycerides, high density lipoprotein cholestero(HDL-C), apolipoprotein A-1(Apo- A1) and apolipoprotein B(Apo B) were measured from venous blood after overnight fastion, and the results were compared between the groups. RESULTS: The male gender and smoking habits were more prevalent in the CAD group. Total cholesterol levels were significantly higher in the CAD group but the HDL-C level was not significantly different in two groups though the mean level of the HDL-C was some lower in the CAD group. The Apo A-1 level was lowere in the CAD group while the Apo B level was higher in teh CAD group compared to those of the control, Apo B / Apo A-1 ratio much more distinctly discriminated the two groups. CONCLUSION: Theses results suggest that the plasma Apo-A-1, Apo B levels and the ratio of Apo B / Apo A-1 can be used for risk statification of CAD.