ABSTRACT
A 52-year-old man with a history of percutaneous coronary intervention (PCI) in the left anterior descending (LAD) coronary artery was admitted for a facilitated PCI following an anterior ST-elevation myocardial infarction treated with thrombolysis at a nearby clinic.
Subject(s)
Coronary Artery Disease , Embolism, Air , Embolism , Percutaneous Coronary Intervention , Male , Humans , Middle Aged , Percutaneous Coronary Intervention/adverse effects , Embolism, Air/diagnosis , Embolism, Air/etiology , Embolism, Air/therapy , Thrombectomy , Catheters , Coronary Angiography , Treatment OutcomeABSTRACT
A 67-year-old man with a history of smoking, hyperlipidemia, and hypertension complained of central chest pain radiating to his left arm for 2 hours and contacted the attending cardiologist. Based on medical history and symptom description, the physician urged him to undergo a complete cardiac evaluation to rule in or out an acute coronary syndrome. Interestingly, the patient insisted on sending digitally for tele-consultation a lead-I tracing recorded by his Samsung Galaxy Watch 4 (Samsung Electronics) worn on his left wrist.
Subject(s)
Acute Coronary Syndrome , Electrocardiography , Male , Humans , Aged , Chest Pain , Acute Coronary Syndrome/diagnosisABSTRACT
Transradial access may lead to anatomical and functional changes on the vessel wall due to puncture or material-associated trauma, inflammation and loss of endothelium's nitric oxide vasodilatory response. Despite the superficial and palpable radial artery course, caution and dexterity are important assets when puncturing, wiring, inserting the sheath, or maneuvering the catheters. Radial artery anatomic variations, tortuosity, and radial artery spasm are related with femoral access switch. The outer diameter of sheaths and catheters needs to match radial artery internal diameter; otherwise, friction or vascular stretch will occur, activating the surface endothelium and the coagulation cascade. Friction between the arterial wall and the equipment worsens endothelial function and precipitates patient discomfort, radial artery spasm, and ultimately, radial artery occlusion.
Subject(s)
Cardiology , Radial Artery , Humans , Radial Artery/surgery , Coronary Angiography , Spasm/etiology , CathetersABSTRACT
A 72-year-old man with chronic obstructive pulmonary disease complained of worsening dyspnea. Physical examination and several diagnostic tests led to a diagnosis of unilateral pulmonary edema, which manifests as a classic radiographic image, but is usually misdiagnosed. Low-cardiac-output state, unilateral pulmonary infiltrates, and respiratory failure sets the diagnosis. The trinity of high positive end-expiratory pressure, intra-aortic balloon pump, and continuous venovenous hemodiafiltration may be life-saving.
Subject(s)
Heart-Assist Devices , Pulmonary Edema , Aged , Cardiac Output, Low , Humans , Intensive Care Units , Intra-Aortic Balloon Pumping/methods , Male , Pulmonary Edema/diagnosis , Pulmonary Edema/etiologyABSTRACT
It is uncommon for the left anterior descending coronary artery to arise from the contralateral Valsalva sinus, and more of a rarity to see coexistent left main coronary artery anomaly. Our patient reported normal daily physical activity and denied further evaluation (stress test, scintigraphy) or cardiothoracic consultation. She continues to be symptom free at 1-month follow-up.
Subject(s)
Coronary Vessel Anomalies , Sinus of Valsalva , Coronary Angiography , Coronary Vessel Anomalies/complications , Coronary Vessel Anomalies/diagnosis , Female , Humans , Referral and Consultation , Sinus of Valsalva/abnormalities , Sinus of Valsalva/diagnostic imagingSubject(s)
COVID-19/complications , Coronary Vessel Anomalies/etiology , Cough/etiology , Vascular Diseases/congenital , COVID-19/diagnosis , COVID-19/therapy , COVID-19/virology , Coronary Vessel Anomalies/diagnostic imaging , Coronary Vessel Anomalies/drug therapy , Cough/diagnosis , Cough/virology , Female , Host-Pathogen Interactions , Humans , Middle Aged , Risk Factors , SARS-CoV-2/pathogenicity , Treatment Outcome , Vascular Diseases/diagnostic imaging , Vascular Diseases/drug therapy , Vascular Diseases/etiologyABSTRACT
Cardiac manifestations and angiographic characteristics of coronary artery disease in identical twins have been previously dealt with in a handful of case reports and series; yet, the results were highly controversial. Our rare case demonstrates striking similarities in both the timing and type of clinical manifestation, as well as in the underlying anatomy and the distribution of coronary artery disease. When premature coronary artery disease is found in one of a monozygotic twin pair, evaluating the other twin is a reasonable approach.
Subject(s)
Coronary Artery Disease/diagnosis , Diseases in Twins , Electrocardiography , Twins, Monozygotic , Coronary Angiography , Female , HumansABSTRACT
BACKGROUND: Several studies have focused on oxidative stress on diabetes mellitus (DM). Our purpose was to investigate the impact of oxidative stress on progression of diabetic retinopathy (DR) in insulin-dependent type 2 DM patients, measuring serum malondialdehyde (MDA), as well as to examine the effect of vitamin E on DR progression in the above-mentioned patients. METHODS: Participants in the study were 282 insulin-dependent type 2 DM patients with DR. All participants underwent a thorough ophthalmological examination, so as to grade DR, along with serum MDA measurement. All participants received 300mg vitamin E daily for 3 months and were examined again. Serum MDA pre- and post-intake of Vitamin E was the main outcome. RESULTS: Serum MDA was positively associated with DR stage, while there was a statistically significant difference pre- and post-intake of vitamin E in all DR stages. In a subgroup analysis of patients with proliferative DR, there was a significant difference at baseline between patients who have received prior laser photocoagulation and the treatment naïve patients, while after intake of vitamin E, no statistically significant difference was noticed. CONCLUSION: Oxidative stress has been found to play significant role in the pathogenesis and progression of DR, while vitamin E seems to reduce MDA levels and subsequent oxidative stress, suggesting that it might have protective role in DR progression.
