ABSTRACT
Two patients who had angiographically proven coronary artery aneurysms are presented. The clinical pictures of these patients were similar to that of patients with atherosclerotic coronary artery disease. Both had severe angina pectoris, and the second patient (case 2) had had myocardial infarction. Their coronary artery aneurysms were single, fusiform (case 1) and saccular (case 2) in shape and not associated with extensive coronary atherosclerosis. They were treated medically and did well.
Subject(s)
Coronary Aneurysm/diagnostic imaging , Coronary Angiography , Electrocardiography , Humans , Male , Middle AgedABSTRACT
To date, technical experience reported in the literature is very limited on angioplasty in patients with anomalous coronary arteries. Balloon angioplasty may be a more favorable approach for revascularization in these vessels. A major factor is selection of the guiding catheter. The authors report 4 patients with severe atherosclerotic lesions of anomalous coronary arteries who underwent coronary angioplasty of the anomalous vessel. Three patients had an anomalous circumflex artery and 1 had an anomalous right coronary artery. Angiographic and clinical success were achieved in 3 patients.
Subject(s)
Angioplasty, Balloon, Coronary , Coronary Artery Disease/complications , Coronary Artery Disease/therapy , Coronary Vessel Anomalies/complications , Adult , Angioplasty, Balloon, Coronary/instrumentation , Angioplasty, Balloon, Coronary/methods , Coronary Angiography , Coronary Artery Disease/diagnostic imaging , Coronary Vessel Anomalies/diagnostic imaging , Female , Humans , Male , Middle Aged , Treatment OutcomeABSTRACT
BACKGROUND: Restenosis after percutaneous transluminal coronary angioplasty (PTCA) is a major problem limiting the long-term efficacy of the procedure. The purpose of this study was to determine whether risk factors such as cigarette smoking, diabetes mellitus, hypertension or hypercholesterolaemia correlate with restenosis after PTCA. We also studied the relationship between a history of previous myocardial infarction and the extent of coronary artery disease (single-, two- or three-vessel) with restenosis after coronary angioplasty. METHODS: A total of 360 patients underwent successful PTCA. Follow-up coronary angiograms were performed in 181 patients after a mean +/- SD period of 6 +/- 4 months. RESULTS: The restenosis rate was 49%. We divided the patients into two groups: 89 patients with restenosis (8 women and 81 men) and 92 patients with no restenosis (14 women and 78 men). Age, sex, a history of cigarette smoking, diabetes mellitus and a history of previous myocardial infarction were not associated with restenosis. Serum levels of triglyceride were also unrelated to the restenosis rate. Restenosis was associated with hypertension, low levels of high-density-lipoprotein cholesterol, high levels of low-density-lipoprotein cholesterol and high total cholesterol levels (P < 0.001). Patients with two-vessel or multivessel disease had significantly higher restenosis rates than patients with single-vessel disease (P < 0.001). CONCLUSION: Patients with hyperlipidaemia, hypertension and multi-vessel disease appear to be higher risk of recurrent restenosis.
Subject(s)
Angioplasty, Balloon, Coronary , Coronary Disease/etiology , Coronary Disease/therapy , Adult , Aged , Cholesterol/blood , Cholesterol, LDL/blood , Coronary Angiography , Coronary Disease/diagnostic imaging , Diabetes Complications , Factor Analysis, Statistical , Female , Follow-Up Studies , Humans , Hypercholesterolemia/complications , Hypertension/complications , Lipids/blood , Male , Middle Aged , Myocardial Infarction/complications , Recurrence , Risk Factors , Smoking , Triglycerides/bloodABSTRACT
The relationship between cardioinhibitory response to the carotid sinus massage and the severity of coronary artery lesions and left ventricular impairment was investigated in 86 patients who underwent coronary angiography. The study group (Group 1) comprised 63 patients who had coronary lesions and the control group (Group 2) comprised 23 patients who had normal coronary arteries. There was no significant relationship between the severity of coronary artery lesions and the cardioinhibitory response to the carotid sinus massage in the study group. However, there was a positive correlation (r = 0.478, P < 0.01) between total left ventricular segment scores and the maximal change in RR interval (%) during the right carotid sinus massage in the study group. During the right carotid sinus massage, maximal change of RR interval (%) was significantly higher in patients who had segmental wall motion abnormalities than in patients who did not (83.0 +/- 72.4% vs. 32.9 +/- 42.5%, P < 0.01, respectively). In the patients who could have echocardiographic measurements there was negative correlation between fractional shortening value and maximal change of RR interval (%) (right massage; r = -0.482, P < 0.01, left massage; r = -0.334, P < 0.05). In conclusion, we found a significant relationship between the cardioinhibitory response to carotid sinus massage and the presence and severity of the segmental wall motion abnormalities and left ventricular impairment in patients with coronary artery disease.
Subject(s)
Carotid Sinus/physiopathology , Coronary Disease/physiopathology , Heart/physiopathology , Adult , Aged , Aged, 80 and over , Coronary Angiography , Electrocardiography , Female , Humans , Male , Massage , Middle Aged , Ventricular Function, Left/physiologyABSTRACT
Pericardial cysts are rare developmental benign intrathoracic lesions and constitute 7% of all mediastinal tumors. As many as 70% of the cysts are found in the right cardiophrenic angle. Unusual locations include the left costophrenic angle, the hilum and the superior mediastinum at the level of the aortic arch. Cysts arising inside the pericardial cavity and attached to the heart are exceedingly rare. We describe a case of multiple pericardial hydatid cysts.
