A Case of Spontaneous Coronary Artery Dissection Healed by Medical Treatment: Serial Findings of Coronary Angiography, Intravascular Ultrasound and Multi-Detector Computed Tomography

Spontaneous coronary artery dissection (SCAD) is an uncommon cause of acute coronary syndrome which may be related to lethal condition. Although several modalities including medical therapy have been suggested, agreement on optimal treatment has not yet been determined. We describe a case of SCAD which was presented as ST-segment elevation myocardial infarction, and treated successfully with medical treatment. Coronary angiography, intravascular ultrasound and multi-detector computed tomography showed the serial changes of this disease entity

Complications of 2-D Echocardiography Guided Transfemoral Right Ventricular Endomyocardial Biopsy

Endomyocardial biopsy (EMBx) is a useful tool for diagnosing various cardiac pathologies. However, the routine use of EMBx has not gained widespread acceptance due to the possible complications related to the EMBx. Thus, not much information is available on the complications related to the EMBx. We prospectively evaluated 90 consecutive patients who underwent 2-D echocardiography guided transfemoral right ventricular EMBx at Kyungpook National University Hospital between March 2002 and November 2005 to determine the incidence, nature and subsequent management of complications related to EMBx. The clinical diagnoses before the EMBx were arrhythmogenic right ventricular dysplasia in 54, dilated cardiomyopathy in 19, Brugada syndrome in 9, myocarditis in 6 and miscellaneous in 2 patients. The overall major complication rate was 5.6% and no procedure-related mortality occurred. Myocardial perforation (n=3), which was the most frequent complication, did not progress to cardiac tamponade requiring pericardiocentesis in any patient. Hemodynamically unstable ventricular tachycardia occurred in 1 patient. New and persistent right bundle branch block occurred in another. Our findings suggest that 2-D echocardiography guided transfemoral right ventricular EMBx is a relatively safe procedure