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Query: UMLS:C0004153 (atherosclerosis)
 77,401 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Atherosclerotic plaques tend to involve arterial localizations in which blood flow is not laminar due to arterial bends and bifurcations. A 49-year-old man was admitted to hospital with breathlessness and was subsequently diagnosed with left ventricular failure. Coronary angiography revealed three-vessel coronary artery disease and an anomalous extra left anterior descending artery taking off from the right sinus of Valsalva and spared from atherosclerosis. The absence of side branches and the relative lack of bends in arterial geometry were considered to be the cause of resistance to atherosclerosis. The present case identifies local flow conditions as an important factor determining the genesis of atherosclerosis in arterial segments.
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PMID:Providing insights into atherosclerosis: A case of multivessel coronary artery disease with an anomalous straightforward vessel spared from atherosclerosis. 2247 97

A coronary artery fistula between a coronary artery and a cardiac chamber is a rare condition. We reported a case of right coronary artery fistula to the left ventricle in a 57-year-old man who had 2-year history of chest pain and exercise dyspnea without significant coronary atherosclerosis with abnormal left ventricular size and function. It was important to recognize this anomaly and our experience showed that transcatheter occlusion of coronary artery fistula was a safe and effective procedure in the presence of symptoms of congestive heart failure, significant left-to-right shunt or refractory to medical treatment.
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PMID:Right coronary artery fistula to left ventricle treated by transcatheter coil embolization: a case report and literature review. 2268 40

An 85-year-old man with a diagnosis of idiopathic dilated cardiomyopathy presented with worsening breathlessness and reduced functional capacity. Previous angiography had demonstrated only mild, single-vessel coronary atherosclerosis. Owing to the occurrence of severe symptoms despite optimal medical therapy, cardiac resynchronisation therapy (CRT) was performed by means of biventricular pacemaker implantation. The patient was readmitted, 6 months later, with an acute ST-segment myocardial infarction. Urgent coronary angiography demonstrated severe multivessel atherosclerotic coronary artery disease, in the absence of any alteration in basal drug therapy or modifiable cardiovascular risk factor profile. Percutaneous coronary intervention was performed with good result. We postulate a potential causal association between CRT and accelerated coronary atherosclerosis, with alterations in blood flow dynamics and coagulation properties as potential mechanisms. There are no previous reports of this phenomenon in the published literature.
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PMID:Rapid progression of coronary atherosclerosis after cardiac resynchronisation therapy: cause or coincidence? 2325 39

There are a manifold number of variations and anomalies of the origin and course of coronary arteries described in the literature. The incidence of such variations in the general population is reported to range between 0.3 and 1.6 %. Although uncommon, they may be benign or produce symptoms ranging from mild dyspnea to sudden cardiac death, and have been associated with an increased risk of accelerated atherosclerosis and perfusion defects. Thus, in order to effectively utilize the increasing number of therapeutic options available for treating coronary artery diseases, an appreciation of the likely normal and variable arrangements of the coronary arteries is essential. This review will describe the normal anatomy of the coronary arteries as well as the common variations with potential clinical effects.
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PMID:The clinical anatomy of the coronary arteries. 2342 64

We present the case of a patient with initially insignificant coronary atherosclerosis with rapid progression revealed by dobutamine stress echocardiography, despite the absence of a major risk factor. A 61-year-old woman, complaining of chest pain, palpitations and dyspnoea on exertion, was referred to our department for outpatient assessment. Coronary angiography performed two months earlier revealed an insignificant stenosis of the proximal left anterior descending coronary artery. Holter monitoring revealed malignant ventricular arrhythmias during angina episodes.The results of maximal treadmill exercise testing were negative, but those of the dobutamine stress echocardiography were positive. The angiographic re-evaluation revealed a rapid progression of stenosis of the proximal left anterior descending coronary artery. Percutaneous coronary angioplasty with stenting was successfully performed.The outcome of patients with insignificant angiographic stenosis and no major risk factor is not necessarily favourable. Therefore, these patients should receive intensive therapy for the management of risk factors and careful clinical monitoring, including dobutamine stress echocardiography.
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PMID:Rapid progression of coronary artery stenosis revealed by stress echocardiography. 2370 69

Dyspnea is a subjective sensation of difficult or uncomfortable breathing caused by increased excitation of brain respiratory centres,(1) and is usually secondary to pulmonary or cardiac disease.(2) Heart failure is a serious public health problem in industrialised countries, with an increasing prevalence and incidence. It is more common in the elderly, and is usually caused by a defect in myocardial contraction, coronary atherosclerosis, or less frequently, valvular disease.(3) Aortic insufficiency (AI) is one of them. It may originate from infective endocarditis, congenital or valvular heart disease, or rheumatic fever. It may lead to a medical emergency due to the inability of the left ventricle to adapt to the rapid increase in the end-diastolic volume caused by regurgitation of blood from aorta to left ventricle. If not corrected, the AI can lead to acute cardiogenic shock.(4.)
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PMID:[Dyspnea caused by Coxiella Burnetii]. 2372 34

A 9-year-old male timneh African grey parrot (Psittacus erithacus timneh) was presented because of inability to fly and suspected trauma. The owner also had observed dyspnea, with tail bobbing and open-beak breathing. On clinical examination, a hard, painful mass was palpable in the left proximal humerus and axillary area. Radiographs revealed a radiodense soft tissue mass of the left humerus with no bony involvement, multifocal opacities in lung and air sacs, and an enlarged spleen. An asymmetric, vascularized cyst was detected in the mass by ultrasound examination. Results of biopsy of the mass revealed multifocal cysts composed of unilayer isoprismatic cells laying in vascularized connective tissue. Because of the severity of clinical signs and the poor clinical condition, the bird was euthanatized. On postmortem examination, the findings were air sac cystadenocarcinoma involving the humeral air sac with metastases in the spleen and kidneys, atherosclerosis, pneumoconiosis, and mycotic granulomatous pneumonia and airsacculitis with isolation of Aspergillus niger.
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PMID:A complicated, metastatic, humeral air sac cystadenocarcinoma in a timneh African grey parrot (Psittacus erithacus timneh). 2377 55

Takotsubo cardiomyopathy (TCM), also known as stress-induced cardiomyopathy, is a clinical syndrome of transient left ventricular (LV) apical wall motion abnormality with relative preservation of the basal heart segments in the absence of any significant atherosclerosis. Recurrence of this condition is rare. We report a postmenopausal woman, who experienced two episodes of TCM within 4 months following emotional and physical stress. In the first episode, she was admitted due to severe dyspnea, accompanied by sudden-onset, prolonged, burning chest pain and palpitation. Transthoracic echocardiography revealed akinesia of the LV, with the exception of the basal regions. Coronary angiography demonstrated no significant coronary artery disease, and follow-up echocardiography showed normalization of the LV wall motion abnormalities. In the second episode, she experienced similar symptoms and echocardiography revealed similar changes. Multi-detector computed tomography revealed normal coronary arteries. After 9 days, she was discharged in good condition; and at 3 months' follow-up, she was symptom-free with normal echocardiography.
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PMID:Recurrence of takotsubo cardiomyopathy: role of multi-detector computed tomography coronary angiography. 2439 68

Advanced atherosclerosis of the aorta can cause severe ischemia in the kidneys, refractory hypertension, and claudication. However, no previous reports have clearly associated infrarenal aortic stenosis with shortness of breath. A 77-year-old woman with hypertension and hyperlipidemia presented with exertional dyspnea. Despite extensive testing and observation, no apparent cause for this patient's dyspnea was found. Images revealed severe infrarenal aortic stenosis. After the patient underwent stenting of the aortic occlusion, she had immediate symptomatic improvement and complete resolution of her dyspnea within one month. Twelve months after vascular intervention, the patient remained asymptomatic. In view of the distinct and lasting elimination of dyspnea after angioplasty and stenting of a nearly occluded infrarenal aortic lesion, we hypothesize that infrarenal aortic stenosis might be a treatable cause of exertional dyspnea. Clinicians should consider infrarenal aortic stenosis as a possible cause of dyspnea. Treatment of the stenosis might relieve symptoms.
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PMID:Exertional dyspnea as a symptom of infrarenal aortic occlusive disease. 2495 52

Coronary cameral fistula is a rare entity and is characterized by an abnormal communication between coronary artery and a cardiac chamber. It is usually congenital and asymptomatic in majority of patients. If symptomatic the patients usually present in childhood. We present a case of 45-year-old male who presented with anginal chest pain and dyspnea on exertion for last 1 year. His exercise treadmill test was positive for ischemic changes and ECG-gated contrast enhanced CT was done for further evaluation. CT showed a large right coronary artery to right atrium fistula. It also ruled out any coronary atherosclerosis as reason for chest pain and ischemic symptoms on exercise treadmill test. The fistula was successfully closed by surgery and there was resolution of chest pain and dyspnea.
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PMID:Symptomatic Coronary Cameral Fistula. 2624 Jul 37


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