Cleft anterior mitral leaflet with supravalvular aortic stenosis a rare association

A 20 year old female was referred to us for evaluation of effort dyspnoea of NYHA class II with feeble left common carotid, left brachial and left radial artery as compared to other sides. Detail evaluation with two dimensional [2D] transthoracic echocardiographic, 2D transesophageal echocardiography and multidetector computed tomography [MDCT] delineated Cleft AML and diffuse type of supravalvular aortic stenosis. To the best of our knowledge, no such case have been described in the literature where these anomalies co-existed in the same patient

Incidental spontaneous coronary dissection: an interventionist's dilemma

Spontaneous coronary artery dissection [SCAD] is an uncommon entity, frequently presenting as ST-elevation myocardial infarction [MI] or sudden cardiac death. It is usually reported in association with pregnancy and has a high mortality. We present here a case of asymptomatic dissection of the right coronary artery, incidentally detected, in a young normotensive male when coronary angiography was done following acute anterior wall MI. This patient had none of the risk factors to which SCAD is generally ascribed. While management of the infarct-related artery was clear-cut, whether or not to intervene for this nonocclusive dissection was a difficult decision. A conservative approach was finally adopted for the spontaneous dissection and the patient is faring well till date