ABSTRACT
OBJECTIVES: 1. To study the incidence and clinical features of patients with Congenital Coronary Anomalies of Origin from Oppossite or Non-coronary Sinus; 2. To study the course of these Anomalous Coronary Artery Origins with CT Coronary Angiography. METHODS: A Cross Sectional Observation study was conducted at Department of Cardiology, in a tertiary Hospital for a period of 3 years. Patients undergoing Coronary Angiography (CAG) were screened and patients having Anomalous Coronary Origin from the Opposite or Non-Coronary Sinus of Valsalva were selected. CT Cronary Angiography was done in all such patients and the course of the anomalous artery was studied. RESULTS: During the 3 years period of study, total of 5241 CAGs were conducted of which 42 (0.8%) patients were found to have Anomalous Coronary Artery Origin as per the inclusion criteria. Out of the 42 cases, Anomalous origin of RCA from Left Corornary Cusp was the commonest with 23(0.43%) cases, followed by Anomalous Origin of LCX from Right Coronary or RCC with 17 (0.32%) cases. Other anomalies of origin were quite rare (n=2) which included Anomalous origin of Left Main from RCA (n=1) and Dual origin of LAD (n=1). CT Coronary Angiography showed that of the 23 patients with Anomalous Origin of RCA from Left side,27.4% had Inter-Arterial course and 56.1% had Retro-Aortic course. Of the 17 patients with Anomalous Origin of LCX from Right sinus, 88.23% had Retro-Aortic course. CONCLUSIONS: This study showed that anomalous origin of Coronary Artery from the opposite sinus is quite rare with RCA from Left Sinus and LCX from Right sinus comprised the vast majority of cases. Most of these anomalous Coronaries have on benign course as defined on CT Coronary Angiography. However, it is important to recognize to delineate the origin and course as it can have significant clinical, therapeutic and prognostic implications.
Subject(s)
Coronary Vessel Anomalies , Sinus of Valsalva , Computed Tomography Angiography , Coronary Angiography , Cross-Sectional Studies , Humans , PrevalenceABSTRACT
We report a 30 year female with rheumatic mitral stenosis, presenting with progressive right heart failure without overt leftheart symptoms. Rapid progression to severe right heart failure with moderate pericardial effusion prompted the diagnosis of associated restrictive cardiomyopathy. A MRI scan of the heart revealed diffuse subendocardial scarring of LV and RV explaining patient's rapid downhill course.
Subject(s)
Developing Countries , Endomyocardial Fibrosis/diagnosis , Heart Ventricles , Mitral Valve Stenosis/diagnosis , Rheumatic Heart Disease/diagnosis , Ventricular Dysfunction, Right/diagnosis , Adult , Cardiomyopathy, Restrictive/diagnosis , Diagnosis, Differential , Disease Progression , Echocardiography , Electrocardiography , Fatal Outcome , Female , Heart Ventricles/pathology , Humans , India , Magnetic Resonance Imaging, Cine , Mitral Valve/pathology , Pericardial Effusion/diagnosis , PrognosisABSTRACT
A young male presented with multiple xanthomas and xanthelesmas, progressive breathlessness and angina on exertion. Investigations confirmed diagnosis of familial hypercholesterolaemia, bicuspid aortic valve with severe aortic stenosis and significant obstructive coronary artery disease.
Subject(s)
Aortic Valve/abnormalities , Heart Valve Diseases/complications , Hyperlipoproteinemia Type II/complications , Adolescent , Aortic Valve Stenosis/etiology , Bicuspid Aortic Valve Disease , Coronary Artery Disease/diagnostic imaging , Coronary Artery Disease/etiology , Humans , Hydroxymethylglutaryl-CoA Reductase Inhibitors/therapeutic use , Hyperlipoproteinemia Type II/drug therapy , Male , RadiographySubject(s)
Tachycardia, Ventricular , Anti-Arrhythmia Agents/therapeutic use , Catheter Ablation , Death, Sudden, Cardiac/etiology , Death, Sudden, Cardiac/prevention & control , Defibrillators, Implantable , Electrocardiography , Emergency Medical Services , Forecasting , Humans , Recurrence , Risk , Tachycardia, Ventricular/diagnosis , Tachycardia, Ventricular/etiology , Tachycardia, Ventricular/physiopathology , Tachycardia, Ventricular/therapyABSTRACT
An 18-year-old girl with pre-excitation presented with a history of recurrent syncope preceded by palpitation. The accessory pathway, which had a relatively long antegrade effective refractory period of 340 ms, was mapped and successfully ablated in the left lateral region. However, after ablation, she had reproducible sustained polymorphic ventricular tachycardia, which was found to be the cause of her syncope. Thus, alternate mechanisms of tachycardia need to be considered in patients with pre-excitation when the presentation is atypical.
Subject(s)
Pre-Excitation Syndromes/complications , Pre-Excitation Syndromes/physiopathology , Syncope/etiology , Syncope/physiopathology , Adolescent , Catheter Ablation , Electrocardiography , Female , Humans , Pre-Excitation Syndromes/surgery , Syncope/surgery , Tachycardia, Ventricular/complications , Tachycardia, Ventricular/physiopathologyABSTRACT
Tetanus in lepromatous leprosy is rare and reported occasionally as case reports only. We present a case of lepromatous leprosy who succumbed to death due to rapidly progressing tetanus. The mechanism of protection from tetanus in leprosy is discussed.
