ABSTRACT
We present the case of a 59-year-old African American female with end-stage renal disease (ESRD) who presented to the emergency department with chest discomfort. She had a coronary angiogram six months ago that showed no occlusive epicardial coronary artery disease. She had elevated troponin I levels and new regional wall motion abnormalities on echocardiogram. Her SARS-CoV-2 returned positive. After a multidisciplinary team approach, she underwent another coronary angiogram that showed new severe multivessel ostial lesions and a left main coronary artery aneurysm. COVID-19-related coronary artery vasculitis was suspected based on her clinical presentation, angiogram findings, and negative autoimmune workup. The patient underwent successful coronary artery bypass grafting and recovered without complications.
ABSTRACT
Screening echocardiography aids in identifying cardiac emboli causes and asymptomatic cardiac metastases in high-grade neoplasms. Conversely, cardiac MRI provides advanced tissue characterization and broader extracardiac assessment.
ABSTRACT
BACKGROUND: We report a rare case of a patient who presented with chest pain and was found to have a constellation of rare cardiac anomalies. CASE PRESENTATION: A 67-year-old patient with no past medical history presented with chest pain. He had mild troponin elevation, but no ischemic changes on ECG. He underwent a CT coronary angiogram for further evaluation. He was found to have a type 0 bicuspid aortic valve, large left sinus of Valsalva aneurysm and type R-III single coronary artery. These findings were confirmed with transesophageal echocardiogram and coronary angiogram. He underwent a successful repair of his aortic root aneurysm with a synthetic patch. CONCLUSIONS: The combination of type R-III single coronary artery, bicuspid aortic valve, and left sinus of Valsalva aneurysm congenital anomalies in one individual is extremely rare and marks our case unique. Given the size of his Sinus of Valsalva aneurysm, the patient underwent surgical repair of his aneurysm and was asymptomatic when seen in follow-up.
Subject(s)
Aortic Aneurysm/complications , Bicuspid Aortic Valve Disease/complications , Coronary Vessel Anomalies/complications , Sinus of Valsalva , Aged , Aortic Aneurysm/diagnostic imaging , Aortic Aneurysm/surgery , Bicuspid Aortic Valve Disease/diagnostic imaging , Coronary Vessel Anomalies/diagnostic imaging , Humans , Male , Sinus of Valsalva/diagnostic imaging , Sinus of Valsalva/surgery , Treatment OutcomeABSTRACT
We report a case of a 30-year-old male who presented with signs and symptoms of respiratory infection with left lower lobe consolidation and cardiomegaly on a chest radiography. The presence of cardiomegaly lead to further cardiac evaluation revealing giant coronary aneurysms. The patient was treated conservatively with Coumadin and aspirin and has done well at four years of follow-up.
ABSTRACT
Diastolic heart failure is a common form of congestive heart failure that is responsible for significant morbidity and mortality. In contrast to heart failure caused by systolic left ventricular dysfunction, diastolic heart failure is harder to diagnose and less likely to be accepted as a diagnosis. In addition, treatment strategies are much less defined than those for heart failure caused by systolic dysfunction.
Subject(s)
Diastole , Heart Failure/mortality , Heart Failure/physiopathology , Ventricular Dysfunction, Left/diagnostic imaging , Ventricular Dysfunction, Left/mortality , Adrenergic beta-Antagonists/therapeutic use , Angiotensin-Converting Enzyme Inhibitors/therapeutic use , Cardiac Output , Cardiotonic Agents/therapeutic use , Digoxin , Diuretics/therapeutic use , Drug Therapy, Combination , Echocardiography, Doppler , Female , Heart Failure/diagnostic imaging , Heart Failure/drug therapy , Humans , Male , Prognosis , Risk Assessment , Severity of Illness Index , Stroke Volume , Survival Analysis , Treatment Outcome , Ventricular Dysfunction, Left/drug therapy , Ventricular Dysfunction, Left/physiopathologyABSTRACT
Spontaneous coronary artery dissection (SCAD) should be considered as a cause of the acute coronary syndrome in young patients with few apparent risk factors for coronary artery disease, in females in the peripartum period, and in patients who are at a higher risk for this condition. SCAD can also present as sudden death and cardiogenic shock. Several mechanisms have been described in the pathophysiology of this condition. Urgent coronary angiography is indicated if SCAD is suspected. Percutaneous coronary artery stenting and coronary artery bypass grafting are the main treatment strategies.
Subject(s)
Aortic Dissection/diagnosis , Aortic Dissection/therapy , Coronary Aneurysm/diagnosis , Coronary Aneurysm/therapy , Adult , Aortic Dissection/diagnostic imaging , Aortic Dissection/pathology , Angina Pectoris , Coronary Aneurysm/diagnostic imaging , Coronary Aneurysm/pathology , Coronary Angiography , Coronary Artery Bypass , Diagnosis, Differential , Female , Humans , Male , Middle Aged , StentsABSTRACT
We report a case of the spontaneous formation of a left anterior descending artery to right ventricular fistula. The unprovoked appearance of this fistulous connection was clearly documented by serial angiography and confirmed during surgery.
