2 research outputs found
An unusual case of aorta-right atrial tunnel with windsock aneurysm : imaging, diagnosis and treatment
The first successfully diagnosed and treated case of aorta–
right atrial tunnel was reported by Coto et al. in 1980. The
most common cause of aorta–right atrial tunnel is a ruptured
aneurysm of the sinus of Valsalva. Sinus of Valsalva aneurysms
had been reported as early as 1840 by Thurnam; these
were diagnosed at autopsy. With the advances in radiology,
many cases of aorta–right atrial tunnel have been reported
since then, each with its own subtle variations.
We report on a unique case of aorta–right atrial tunnel
with a windsock aneurysm in the right atrium. A 55-yearold
male presented with abdominal pain and the chest X-ray
revealed cardiomegaly. On further investigation with echocardiography
and computed tomography angiography, there
was an incidental aorta–right atrial tunnel with a windsock
aneurysm in the right atrium. He was treated successfully
with surgery. A similar case has been reported only once
before by Iyisoy et al. in 2014.http://www.cvja.co.zaam2017Radiolog
Resource and infrastructure-appropriate management of ST-segment elevation myocardial infarction in low- And middle-income countries
The 143 low- and middle-income countries (LMICs) of the world constitute 80% of the world's population or roughly 5.86 billion people with much variation in geography, culture, literacy, financial resources, access to health care, insurance penetration, and healthcare regulation. Unfortunately, their burden of cardiovascular disease in general and acute ST-segment-elevation myocardial infarction (STEMI) in particular is increasing at an unprecedented rate. Compounding the problem, outcomes remain suboptimal because of a lack of awareness and a severe paucity of resources. Guideline-based treatment has dramatically improved the outcomes of STEMI in high-income countries. However, no such focused recommendations exist for LMICs, and the unique challenges in LMICs make directly implementing Western guidelines unfeasible. Thus, structured solutions tailored to their individual, local needs, and resources are a vital need. With this in mind, a multicountry collaboration of investigators interested in LMIC STEMI care have tried to create a consensus document that extracts transferable elements from Western guidelines and couples them with local realities gathered from expert experience. It outlines general operating principles for LMICs focused best practices and is intended to create the broad outlines of implementable, resource-appropriate paradigms for management of STEMI in LMICs. Although this document is focused primarily on governments and organizations involved with improvement in STEMI care in LMICs, it also provides some specific targeted information for the frontline clinicians to allow standardized care pathways and improved outcomes