ABSTRACT
Coronary artery ectasia (CAE) is defined as a localised or diffuse dilatation of coronary artery lumen more than 1.5 times that of an adjacent normal segment. CAE may present with or without functionally significant stenosis. Such patients may manifest with stable angina or with acute coronary syndrome. Ectasia may serve as a nidus for thrombus formation with likelihood of distal embolisation or it may lead to dissection or spasm. This condition presents a challenge for an interventionist. Should we intervene or manage it medically. We describe a case of CAE where all the vessels were diffusely ectatic with variable degree of stenosis. In brief we discuss the causes and management issues in ectasia.
Subject(s)
Acute Coronary Syndrome/diagnosis , Coronary Vessels/anatomy & histology , Dilatation, Pathologic/complications , Acute Coronary Syndrome/etiology , Adult , Coronary Angiography/methods , Coronary Vessels/diagnostic imaging , Coronary Vessels/pathology , Dilatation, Pathologic/drug therapy , Humans , Hydroxymethylglutaryl-CoA Reductase Inhibitors/administration & dosage , Hydroxymethylglutaryl-CoA Reductase Inhibitors/therapeutic use , Male , Platelet Aggregation Inhibitors/administration & dosage , Platelet Aggregation Inhibitors/therapeutic use , Thrombolytic Therapy/methods , Treatment OutcomeABSTRACT
Chronic thromboembolic pulmonary hypertension (CTEPH) is a form of pulmonary arterial hypertension (PAH) in which the pulmonary thrombus fails to resolve, resulting in occlusion and remodelling of pulmonary arteries.1 Timely diagnosis is critical since it is potentially curable by pulmonary thromboendarterectomy. Twenty five per cent of cases do not have a history of thromboembolic event. The diagnosis should be considered in the diagnostic work-up of PAH despite lack of history of episodes of thromboembolism. Here we are reporting a case of CTEPH with multiple systemic to pulmonary collaterals delineated by angiogram and CT.
Subject(s)
Angiography , Dyspnea/diagnostic imaging , Electrocardiography , Hypertension, Pulmonary/diagnostic imaging , Pulmonary Artery/diagnostic imaging , Pulmonary Embolism/diagnostic imaging , Tomography, X-Ray Computed , Adult , Anticoagulants/therapeutic use , Chronic Disease , Dyspnea/etiology , Humans , Hypertension, Pulmonary/physiopathology , Male , Pulmonary Artery/physiopathology , Pulmonary Embolism/physiopathology , Treatment Outcome , Warfarin/therapeutic useABSTRACT
Anomalous origin of the right coronary artery is an uncommon entity with a reported incidence of 0.26%. The anomalous origin is usually from the left sinus of Valsalva. Anomalous origin of the right coronary artery (RCA) from the left anterior descending (LAD) artery is a rare occurrence. Symptomatic patients with associated significant coronary artery disease (CAD) may be treated with routine interventions such as percutaneous coronary intervention or coronary artery bypass surgery. We report a case of single coronary artery with severe proximal LAD stenosis. The RCA had its origin from the mid LAD. Coronary intervention was successfully carried out on the severe stenosis at the proximal LAD artery. These cases are rare. We discuss accurate diagnosis and appropriate management in such cases.
Subject(s)
Coronary Stenosis/surgery , Coronary Vessel Anomalies/surgery , Percutaneous Coronary Intervention/methods , Aged , Coronary Angiography , Coronary Stenosis/diagnostic imaging , Coronary Vessel Anomalies/diagnostic imaging , Humans , Male , Treatment OutcomeABSTRACT
Coronary angiography and angioplasty are relatively safe procedures but not without complications. We report an interesting case of effort angina taken for angioplasty of the LCX and assessment of fractional flow reserve (FFR) for the LAD artery lesion in which the tip of the pressure wire was broken and embolised to the LCX while trying to retrieve it. This is the first case report using a hybrid technique with a slip catheter for the successful retrieval of a fractured FFR wire.
