Late Diagnosed Left Coronary to the Pulmonary Artery Large Fistulae: An Interesting and Incidental Cath Lab Finding

Coronary artery anomalies are congenital changes in their origin, course, and/or structure. Most of them are discovered as incidental findings during coronary angiographic studies or at autopsies. A coronary artery fistulae involve a communication between a coronary artery and a chamber of the heart or any segment of the systemic or pulmonary circulation. We present herein the case of a 67-year-old man with a recent history of exertional angina and dyspnea to usual daily activities whose coronary angiogram revealed an interesting and incidental coronary-pulmonary artery large fistulae

Classificação das fraturas tóraco-lombares baseada em investigação por imagem: avaliação de 33 casos Classification of thoracolumbar spine fractures based on a complete imaging investigation in 33 patients

As fraturas das regiões torácica e lombar da coluna vertebral constituem amplo espectro de diferentes tipos de lesões resultantes de mecanismos fisiopatológicos distintos. A fim de se reduzir as controvérsias existentes a respeito da conduta destas lesões é necessária a utilização de uma classificação que permita a sua correta caracterização. Neste estudo avaliamos retrospectivamente 33 pacientes portadores de fraturas tóraco-lombares com o objetivo de categorizar e avaliar os fatores relacionados a esta patologia. O mecanismo de trauma mais freqüente foi queda de altura, presente em 24 casos. Na maioria dos pacientes (57,6%) as fraturas localizaram-se na transição tóraco-lombar (T12-L1) e o quadro neurológico mais freqüente foi o déficit sensitivo-motor completo abaixo da lesão, em 45,45% dos casos. A apresentação neurológica foi mais grave nos pacientes com lesões torácicas em relação às lesões lombares (teste de Fischer, p=0,039). Uma correlação positiva foi observada entre a severidade do quadro neurológico e a gravidade da lesão segundo a classificação de Magerl (r de Pearson=0,85, pThe thoracolumbar spine fractures constitute a wide spectrum of resultant lesions, with distinct injury mechanisms. In order to reduce the controversies concerning about the management of these fractures, a universally accepted classification is necessary. In this study we evaluated retrospectively 33 patients with thoracolumbar spine fracture, with the goal of categorize and evaluate the factors related to this pathology. A complete radiological investigation, complaining of plain radiography, computed tomography and magnetic ressonance imaging, was used to classify these fractures. Fall was the more common mechanism, present in 24 cases. In 57.6% of the patients, the fractures located at thoracolumbar transition (T12-L1) and the more frequent neurological presentation was total deficit, present in 45.45%. The neurological presentation was more serious in patients with thoracic lesions regarding lumbar lesions (Fischer's test, p=0.039). A positive correlation was observed between severity of the neurological presentation and gravity of the lesion according to Magerl's classification (Pearson's method, r=0.85, p<0.001). In conclusion, thoracolumbar spine fractures are serious lesions considering the initial neurological presentation; a wide and accurate classification, as we used, is necessary to describe these injuries and may help resolve some of the controversies concerning the management of these lesions

Late Diagnosed Left Coronary to the Pulmonary Artery Large Fistulae: An Interesting and Incidental Cath Lab Finding

Coronary artery anomalies are congenital changes in their origin, course, and/or structure. Most of them are discovered as incidental findings during coronary angiographic studies or at autopsies. A coronary artery fistulae involve a communication between a coronary artery and a chamber of the heart or any segment of the systemic or pulmonary circulation. We present herein the case of a 67-year-old man with a recent history of exertional angina and dyspnea to usual daily activities whose coronary angiogram revealed an interesting and incidental coronary-pulmonary artery large fistulae