Prominent J wave (Osborn wave) with coincidental hypothermia in a 64-year-old woman

WOS: 000227407000028PubMed: 1590283

Myocardial ischemia caused by a coronary anomaly left anterior descending coronary artery arising from right sinus of Valsalva

We present the case of a patient in anomalous origin of the left anterior descending coronary artery that caused myocardial ischemia and led to positive myocardial scintigraphic results. Coronary angiography showed that the left anterior descending coronary artery arose from the right coronary ostium-an anomaly that has been associated with chest discomfort-without atherosclerotic lesions. Left circumflex artery and the diagonal branches were arising from the left main coronary artery and the whole coronary tree were free of atherosclerosis. © 2006 Elsevier Ireland Ltd. All rights reserved

Unique spontaneous unhealed chronic multivessel coronary artery dissection in an elderly man - A case report and review of the literature

WOS: 000229048900015PubMed: 15889203Spontaneous coronary artery dissection (SCAD) is relatively uncommon. It often occurs in healthy, middle-aged women without overt risk factors for atherosclerosis and is associated with the peripartum period. The pattern and severity of presentation are variable. There are only 5 reports in the literature about multivessel involvement. The etiopathogenesis of SCAD is unclear. Treatment strategy is not standard but is usually tailored to clinical features. Longterm survival of patients with SCAD who have had no problem at the initial event is good. The authors report the first case of unhealed chronic multivessel SCAD in the literature

Assessment of P-wave duration and dispersion in patients with isolated coronary artery ectasia

Introduction: Coronary artery ectasia (CAE) is defined as localized or diffuse dilatation of the epicardial coronary arteries. We sought to determine whether isolated CAE may alter P-wave duration and dispersion (PD). Methods: The study population consisted of 26 patients (mean age: 61.6 ± 11.0 years) with isolated CAE (group 1) and sex- and age-matched 26 control subjects (group 2). Both groups underwent a standard 12-lead surface electrocardiogram recorded at 50 mm/s. Maximal (Pmax) and minimal P-wave durations (Pmin) are measured. PD was defined as the difference between Pmax and Pmin. Results: In group 1, Pmax (114.2 ± 10.4 ms vs 104.8 ± 10.6 ms, p < 0.002) and PD (34.0 ± 12.7 ms vs 24 ± 10.6, p < 0.004) were significantly higher than those of group 2. Moreover a significant correlation was found between Pmax and PD with ectatic segment number (r = 0.625, r = 0.626, respectively; p = <0.001); and Pmax and PD with ectatic vessel number (r = 0.698, r = 0.704 respectively; p = <0.0001). Conclusion: Isolated CAE and the degree of the ectasia were found to be associated with prolonged Pmax and PD. © 2007 Elsevier Ireland Ltd. All rights reserved

Isolated noncompaction of left ventricular myocardium in an elderly man

[No abstract available

Prominent J wave (Osborn wave) with coincidental hypothermia: In a 64-year-old woman

[No abstract available

Prediction of subclinical left ventricular dysfunction with strain rate imaging in patients with mild to moderate rheumatic mitral stenosis

Background: Left ventricular (LV) long-axis function evaluated by Doppler tissue echocardiography-derived strain rate (SR) imaging has been shown to be a useful index of LV systolic function; however, it has not been evaluated in patients with mitral stenosis (MS). We examined the LV long-axis function of patients with pure MS and normal global systolic function as assessed by LV ejection fraction

Retroperitoneal hematoma following tirofiban and enoxaparin coadministration in a patient with acute coronary syndrome

[No abstract available

P-wave duration and dispersion in patients with coronary slow flow and its relationship with Thrombolysis in Myocardial Infarction frame count

Aim: P-wave dispersion (PD), and duration has been reported to be associated with inhomogeneous and discontinuous propagation of sinus impulses. The aim of this study was to investigate the PD in patients with coronary slow flow (CSF) phenomenon. Methods: Study population included 48 patients with angiographically proven normal coronary arteries and slow coronary flow in all 3 coronary vessels (group I, 36 men; mean age, 54 ± 9 years) and 32 subjects with angiographically proven normal coronary arteries without associated slow coronary flow (group II, 24 men, mean age, 53 ± 10 years). Coronary flow rates of all patients and control subjects were documented by Thrombolysis In Myocardial Infarction (TIMI) frame count. All patients in group I had TIMI frame counts greater than 2 SD above those of control subjects (group II). The mean TIMI frame count for each patient and control subject was calculated by adding the TIMI frame counts for each major epicardial coronary artery and then dividing the obtained value into 3. The maximum and minimum P-wave duration (Pmax and Pmin) and PD were measured from the 12-lead surface electrocardiogram. Echocardiographic examination was also performed. Results: There was no statistically significant difference between the 2 groups with respect to age, sex, hypertension, diabetes mellitus, hyperlipidemia, and cigarette smoking (P > .05). P-wave dispersion and Pmax of patients with CSF were found to be significantly higher than those of control subjects (39.4 ± 17 vs 21.2 ± 10 milliseconds and 121.6 ± 17.1 vs 104.3 ± 10.4 milliseconds, respectively; P < .0001). Moreover, we found a significant positive correlation between both Pmax and PD with mean TIMI frame count (r = 0.836 and r = 0.806, respectively; P < .0001). Conclusions: P-wave dispersion and P-wave duration both were found to be greater in patients with CSF than in controls. © 2008 Elsevier Inc. All rights reserved

Long-term prognostic value of stress-redistribution-reinjection Tl-201 imaging in patients with severe left ventricular dysfunction and coronary artery bypass surgery

WOS: 000176545900007PubMed: 12108908Objectives: This study sought to evaluate the long-term prognostic significance of stress-redistribution-reinjection Tl-201 imaging in patients with severe left ventricular (LV) dysfunction and coronary artery bypass surgery. Background: Preoperative stress-redistribution-reinjection TI-201 imaging detects viable but asynergic segments which show functional improvement postoperatively and is considered as a valuable noninvasive method in selection of patients with severe LV dysfunction for revascularization. The long-term prognostic value of the reinjection technique remains unclear. Methods: Fifty-two patients with severe LV dysfunction (mean ejection fraction (EF) 0.32 +/- 0.03) who underwent coronary artery bypass surgery in 1993-1994 were included in the study. Patients had follow-up 49 :1: 12 months. LV function was assessed by two-dimensional echocardiography. Perfusion was assessed by TI-201 SPECT imaging and was graded on a four-point scale (0 = normal, 3 = absent uptake) using the 20 segment model. Perfusion index was derived by adding the score of all segments and dividing these by 20. Patients were divided into two groups. Group A comprised patients with seven and more dysfunctional viable myocardial segments. Group B included patients with less than seven dysfunctional but viable segments. Results: Mean EF increased from 0.32 +/- 0.03 to 0.46 +/- 0.04. Mean perfusion index did not show a significant difference as a whole during follow-up compared to the early postoperative values (0.9 +/- 0.4 and 1.1 +/- 0.4, p = NS). When adequacy of revascularization was considered, the predictive value of a positive preoperative viability test for functional improvement was 82%. Nineteen cardiac events occurred in group B patients and six in group A patients: six deaths (four from cardiac and two from noncardiac causes), 13 myocardial infarctions (MI). Multivariate Cox survival analysis identified the number of viable segments detected preoperatively (chi(2) = 7.2, p = 0.002), postoperative improvement in Tl-uptake (chi(2) = 6.6, p = 0.01) and functional improvement (chi(2) = 5.3, p = 0.03) postoperatively as independent predictors of cardiac events. Preoperative EF and functional capacity were not associated with cardiac events in long-term prognosis. Conclusion: These data suggest that preoperative stress-redistribution-reinjection TI-201 imaging, specifically the number of viable segments detected preoperatively and postoperative improvement in TI-201 uptake provide important long-term prognostic information in patients with severe LV dysfunction who had coronary artery bypass surgery