Frequency in the anomalous origin of the left main coronary artery with angiography in a Turkish population.

We estimated the frequency of anatomic variations in origin of the left coronary artery in a Turkish population by analyzing the angiographic data of 10,042 consecutive adult patients undergoing coronary angiography. Among 10,042 adult patients, 5 (0.04%) patients (4 men and 1 woman, age range 40-74, median 58 years old) had anomalous origin of the left main coronary artery. The left main coronary artery arose from the right coronary sinus of Valsalva in 2 (0.019%) patients (both of them had a retro-aortic course), from above the left coronary sinus of Valsalva in 2 (0.019%) patients, and from above the non-coronary (posterior)-left coronary commisure in 1 (0.009%) patient. Anomalous origin of the left main coronary artery is potentially a serious condition, as it can lead to myocardial infarction and sudden cardiac death under physical exertion. Therefore, greater effort for early detection and surgical repair of this anomaly are warranted. The angiographic recognition of anomalous origin of this vessel may prove useful for physicians dealing with diagnosis and treatment of anomalies of the left main coronary artery.</p

Coronary arterial anomalies in a large group of patients undergoing coronary angiography in southeast Turkey

Background: The prevalence of coronary artery anomalies (CAA) are reportedbetween 0.6–1.3% in the literature. CAA are usually asymptomatic incidental findings, but they may deteriorate coronary circulation, cause symptoms andlead to sudden cardiac death; especially in young athletes. Since interventionalprocedures are increasing rapidly for treatment of coronary artery disease (CAD) inthe modern era, comprehensive understanding of CAA is becoming progressively critical element in dealing with CAD.Materials and methods: We reviewed the database of the Cardiac Catheterisation Laboratory of Sani Konukoglu University Hospital in Gaziantep, Turkey. All patientswho were subjected to coronary angiography from 1998 to 2006 were included.Results: Among 53,655 coronary angiographies performed, CAA were foundin 653 patients (incidence of 1.21%); 590 (90.3%) patients had anomalies oforigin and distribution and 63 (11.7%) had coronary fistulae. Separate origins ofleft anterior descending (LAD) and left circumflex (LCX) coronary artery from theleft sinus of Valsalva was the most common anomaly (64.1%). Coronary arteriesbranching from anomalous aortic origin was the second most common anomaly(16.5%). Right coronary artery (RCA) originating from left sinus of Valsalva or leftmain coronary artery (LMCA) was observed in 55 (8.4%) patients, LCX arising fromRCA or right sinus of Valsalva (RSV) was seen in 52 (7.9%) patients and LMCA orLAD originating from RSV was seen in 14 (0.2%) patients. There were 16 (2.45%) patients with single coronary artery and 1 (0.15%) patient with LMCA originating from pulmonary artery.Conclusions: The incidence and the pattern of CAA in our patient population were similar with previous studies. Angiographic recognition of these vessels is importantbecause of their clinical significance and importance in patients undergoing coronary angioplasty or cardiac surgery

Effect of hypertension therapy with the angiotensin-converting enzyme inhibitor lisinopril on hyperandrogenism in women with polycystic ovary syndrome

Objective: To investigate the effect of an angiotensin-converting enzyme inhibitor, lisinopril, on serum androgen and sex-hormone-binding globulin (SHBG) levels in hypertensive women with polycystic ovary syndrome (PCOS)

Congenital coronary artery fistulas in Turkish patients undergoing diagnostic cardiac angiography

A coronary artery fistula is a direct communication between a coronary artery and one of the cardiac chambers or vessels around the heart. The present study was undertaken to define the incidence, clinical findings and angiographic characteristics of congenital coronary artery fistula in Turkish adults who underwent diagnostic cardiac angiography A consecutive series of 11,350 coronary angiography, performed between January 2000 and December 2001, was retrospectively examined for the presence of coronary artery fistulas. The incidence of congenital coronary artery fistulas was 0.08%. All the patients had chest pain during exertion or at rest. All the fistulas were single and most arose from the proximal left anterior descending coronary artery and drained into the pulmonary artery. All the fistulas were small. Surgical treatment was not indicated. A congenital coronary artery fistula in adults is a distinct though rare entity, variable in its incidence and commonly associated with coronary artery obstructive disease. Diagnosis is mostly incidental during routine coronary angiography

Pulmonary edema associated with Ascaris lumbricoides in a patient with mild mitral stenosis: a case report

Ascaris lumbricoides remains the most common intestinal nematode in the world. Clinical manifestations of ascaris lumbricoides are different in each stage of the infection. We presented an unusual presentation of ascaris lumbricoides

The relationship between microalbuminuria and isolated coronary artery ectasia

PubMedID: 24943979AIM: Coronary artery ectasia (CAE), is at least 1.5 fold dilatation of at least one coronary segment due to congenital or acquired causes. In this study, we aim to investigate the relation of CAE with microalbuminuria, which is a marker of endothelial dysfunction shown to be associated with increased cardiovascular mortality and morbidity. PATIENTS AND METHODS: Patients with CAE detected during routine coronary angiogram (CAG) and individuals with normal CAG findings have been included in our study. Urine albumin levels were measured by immunoturbidimetric method from samples collected in the morning. Patients with an albumin/creatinine (A/C) ratio less than 0.03 were normal and the ones between values 0.03-0.3 were considered to be microalbuminuric. Patients whose A/C ratios > 0.3 had macroalbuminuria and were excluded. RESULTS: A total of 105 patients (60 with CAE and 45 with normal CAG) were included in the study. Serum creatinine, low-density lipoprotein cholesterol and homocysteine levels were increased in the CAE group. Urine A/C ratio was 0.036 ± 0.040 in the CAE group and 0.018 ± 0.013 in the controls; the difference was statistically significant (p = 0.002). CONCLUSIONS: Blood homocysteine levels and urinary albumin levels are significantly increased in patients with CAE when compared to individuals with normal CAG. Microalbuminuria and hyperhomocysteinemia, two markers of endothelial dysfunction might be associated with pathophysiologic processes leading to CAE