ABSTRACT
Coronary vessel anomaly is a rare disease, with an incidence of about 0.6-1.3% of patients receiving coronary angiography. The ischemia in coronary vessel anomalies is due in most cases to atherosclerosis or compression of the coronary artery by a great vessel, but occasionally spasm of a coronary vessel anomaly is responsible for the pathogenesis of chest pain and myocardial ischemia. A 64-year-old female presented with a one-year history of effort angina. The left circumflex artery originated from the proximal right coronary artery. There was no atherosclerotic lesion in the right and left coronary arteries, but a focal spasm in the right coronary artery by ergonovine. In a patient with chest pain and coronary artery anomaly, if there is no coronary atherosclerosis, abnormal course or compression, the spasm test of the coronary artery should be documented.
Subject(s)
Female , Humans , Middle Aged , Angina Pectoris, Variant , Arteries , Atherosclerosis , Chest Pain , Coronary Angiography , Coronary Artery Disease , Coronary Vessel Anomalies , Coronary Vessels , Ergonovine , Incidence , Ischemia , Myocardial Ischemia , Rare Diseases , SpasmABSTRACT
Pulmonary hypertension has variable causes. Reported causes are autoimmune diseases, liver cirrhosis with portal hypertension, HIV infection, use of anorectic drugs or oral contraceptives, sleep apnea syndrome and endocrinopathies. Primary pulmonary hypertension is a rare, progressive, and often fatal disease of unknown cause. The disease is most common in women (ratio 1.7:1) and the mean age at the time of diagnosis is the mid-30s. Variable cardiovascular manifestations are frequent in hyperthyroidism. These include sinus tachycardia, atrial dysrhythmias, decreased exercise tolerance, cardiomegaly, increased cardiac output and congestive heart failure. Herein, we report a case with hyperthyroidism and coincidental pulmonary hypertension. After successful therapy of the thyrotoxic state, the pulmonary pressure decreased markedly, indicating a possible pathogenetic link.
Subject(s)
Female , Humans , Autoimmune Diseases , Cardiac Output , Cardiomegaly , Contraceptives, Oral , Diagnosis , Exercise Tolerance , Heart Failure , HIV Infections , Hypertension , Hypertension, Portal , Hypertension, Pulmonary , Hyperthyroidism , Liver Cirrhosis , Sleep Apnea Syndromes , Tachycardia, SinusABSTRACT
Pulmonary hypertension has variable causes. Reported causes are autoimmune diseases, liver cirrhosis with portal hypertension, HIV infection, use of anorectic drugs or oral contraceptives, sleep apnea syndrome and endocrinopathies. Primary pulmonary hypertension is a rare, progressive, and often fatal disease of unknown cause. The disease is most common in women (ratio 1.7:1) and the mean age at the time of diagnosis is the mid-30s. Variable cardiovascular manifestations are frequent in hyperthyroidism. These include sinus tachycardia, atrial dysrhythmias, decreased exercise tolerance, cardiomegaly, increased cardiac output and congestive heart failure. Herein, we report a case with hyperthyroidism and coincidental pulmonary hypertension. After successful therapy of the thyrotoxic state, the pulmonary pressure decreased markedly, indicating a possible pathogenetic link.