ABSTRACT
OBJECTIVE: To describe a single-center experience of using retrospectively gated multislice computed tomographic (MSCT) coronary angiography for imaging congenital coronary anomalies. PATIENTS AND METHODS: We retrospectively reviewed the clinical information and imaging studies for 9 patients diagnosed as having congenital coronary anomalies on invasive, selective coronary angiography between February 2001 and October 2003 at the Mayo Clinic in Jacksonville, Fla. Two experienced observers classified by consensus the origin and proximal course of the abnormal coronary arteries as seen on MSCT. RESULTS: In 1 patient, MSCT showed a normal but extremely anterior origin of the right coronary artery from the right aortic sinus of Valsalva. In the other 8 patients, the origin and course of 4 anomalous right coronary arteries, 2 anomalous left circumflex coronary arteries, and 2 single coronary arteries were recognized easily on MSCT. CONCLUSION: Similar to electron beam computed tomography and magnetic resonance imaging, widely available MSCT can characterize the proximal course of congenitally abnormal coronary arteries and thus aid in clinical decision making for patients with such anomalies.
Subject(s)
Coronary Angiography/methods , Coronary Vessel Anomalies/diagnostic imaging , Tomography, Spiral Computed/methods , Adult , Aged , Aged, 80 and over , Angina Pectoris/etiology , Cardiovascular Agents/therapeutic use , Coronary Angiography/instrumentation , Coronary Angiography/standards , Coronary Artery Bypass , Coronary Vessel Anomalies/complications , Coronary Vessel Anomalies/therapy , Dyspnea/etiology , Female , Florida , Humans , Magnetic Resonance Imaging/standards , Male , Middle Aged , Observer Variation , Patient Selection , Predictive Value of Tests , Retrospective Studies , Tomography, Spiral Computed/instrumentation , Tomography, Spiral Computed/standardsABSTRACT
We evaluated the accuracy of an electronic stethoscope in the detection of irregular cardiac rhythms. Ten patients with either normal sinus rhythm or atrial fibrillation previously documented by electrocardiogram (ECG) were recruited from a local retirement community. Six senior family medicine resident physicians were asked to assess the cardiac rhythms of the subjects as either regular or irregular, in both a telemedical and an in-person examination. An ECG was obtained simultaneously as the gold standard. Forty-five of the 60 in-person assessments were correct, as were 49 of the 60 telemedicine assessments. The difference was not significant. Physician confidence in telemedical examination did not affect the accuracy of examination. The results of this study suggest that telemedicine-directed auscultation of patients may be just as successful as inperson examination for the detection of cardiac arrhythmias.
