ABSTRACT
BACKGROUND AND PURPOSE: The purpose of this study was to assess angulations and vessel wall morphology that could lead to bending head loss in the RCA and LMCA arteries of patients with slow coronary flow (SCF) evaluated by MDCT coronary angiography. METHODS: The study involved 51 patients (45 males, mean age: 59.6 years) who were diagnosed with SCF by coronary angiography. Diagnosis of SCF was based on thrombolysis in myocardial infarction (TIMI) frame count. Fifty-one patients with absence of slow flow were selected as the control group. The angulations of the main coronary arteries with the aorta were measured from the axial images obtained through MDCT coronary angiography, and the findings were recorded. In addition, the coronary artery walls of these patients were evaluated. For statistical analysis, SPSS for Windows 10.0 (SPSS Inc., Chicago, IL) was used. For comparisons of the angles, either independent samples t test or the Mann-Whitney U test was used where appropriate. RESULTS: The results of the study indicated that 38 patients had SCF in the LAD. Comparisons of patients with SCF with the controls revealed that in the patients with SCF, the mean angle of the LMCA with the aorta (40.9±20.5°) was statistically significantly smaller than the mean angle of the LMCA with the aorta in the control cases (71.8±11°). In 12 patients, slow flow was detected in the RCA. Those with slow flow in the RCA had significantly smaller angles (mean: 33.2±20.4°) than the other cases (mean: 78.9±10.7°). CONCLUSION: A small angle of origin of the main coronary arteries from the aorta, measured on MDCT examinations is correlated with slow blood flow in those vessels, as calculated by the TIMI frame count in catheter coronary angiography.
Subject(s)
Coronary Angiography/methods , Coronary Stenosis/diagnostic imaging , Myocardial Perfusion Imaging/methods , Tomography, X-Ray Computed/methods , Adult , Aged , Coronary Stenosis/physiopathology , Coronary Vessels/physiopathology , Elastic Modulus , Female , Humans , Male , Middle Aged , Reproducibility of Results , Sensitivity and Specificity , Statistics as TopicABSTRACT
Pulmonary artery aneurysm (PAA) is a rare entity, isolated or idiopathic PAA is even less common. A 62-year-old woman presented with complaints of chest pain on exertion, palpitation, and dyspnea. Her blood pressure was 100/60 mmHg, and radial pulse was 100 beats/min and rhythmic. Transthoracic echocardiography demonstrated extreme dilatation of the main pulmonary artery and its branches. Systolic pulmonary artery pressure measured over the tricuspid regurgitation was 30 mmHg. Transesophageal echocardiography confirmed the presence of dilated pulmonary arteries and there was no thrombus. By multislice computed tomography, the diameters of the main, left, and right pulmonary arteries were measured as 53 mm, 42 mm, and 34 mm, respectively. No cardiac or pulmonary cause was found for the PAA.
Subject(s)
Aneurysm/surgery , Chest Pain/etiology , Aneurysm/diagnostic imaging , Aneurysm/pathology , Dilatation, Pathologic , Dyspnea/etiology , Echocardiography, Transesophageal , Female , Heart Atria/abnormalities , Humans , Middle Aged , Pulmonary Artery/diagnostic imaging , Pulmonary Artery/pathology , Tomography, X-Ray ComputedABSTRACT
A 78-year-old asymptomatic male with a history of coronary artery disease was admitted for preoperative cardiovascular evaluation before noncardiac surgery. Auscultation revealed a Grade 3 holosystolic murmur at the left parasternal area. Transthoracic echocardiography documented ventricular double rupture (VDR), consisting of ventricular septal rupture, and rupture of the apical part of the left ventricular free wall with pseudoaneurysm formation. Hospital records revealed that VDR had been noticed 7 years ago during hospitalization due to anterior myocardial infarction. However, recommended surgical repair could not be performed because of the patient's refusal.
