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Query: UMLS:C0151814 (coronary occlusion)
 3,687 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Spontaneous pneumothorax is a relatively frequent acute medical problem. Acute chest pain, sudden dyspnea, and a sensation of discomfort are the usual clinical symptoms: these manifestations also occur in coronary occlusion, with which the condition my easily be misdiagnosed. This is especially true in cases of spontaneous pneumothorax of the left side because the ECG anomalies that arise could be erroneously confused with a coronary condition. The literature on the subject is reviewed and a case of left spontaneous pneumothorax is presented, pointing out the electrocardiographic disturbances: decrease of the amplitude of the QRS complex and R waves, inversion of the T wave in AVL and flattening of the T wave in most of the derivations, slight deviation of the electric axis of QRS toward the right, and phasic variation of voltage (very slight in this case). The importance of ECG studies in these cases is stressed in order to establish the differential diagnosis and avoid unnecessary delays in the application of the proper therapy.
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PMID:[Electrocardiographic disturbances in the left spontaneous pneumothorax. A case report (author's transl)]. 47 Apr 96

A 27-year-old man with mixed aortic stenosis and regurgitation formerly stabbed in the left anterior part of the chest was admitted to our department with dyspnea. Coronary arteriography, performed during cardiac catheterization, showed total occlusion of the left anterior descending coronary artery. The Authors point out the iatrogenic cause of the coronary occlusion. It was due to ligation of the artery when suturing the ventricular wound.
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PMID:Iatrogenic occlusion of the left anterior descending coronary artery. A case report. 374 Nov 57

A 27 years old man was admitted in our Institute for exertion dyspnea, palpitation and a single syncopal attack; five months before admission he was subjected to thoracotomy for pericardial and myocardial haemostatic suture because of a slash. Clinical, phonocardiographic and echocardiographic data suggested diagnosis of combined aortic stenosis and aortic regurgitation. An anterior myocardial necrosis was in ECG and VCG, Cardiac catheterization confirmed previous report. Coronary arteriography showed total occlusion of left anterior descending artery soon after the second diagonal branch. Right coronary was undamaged. Furthermore left ventricular angiocardiography showed a changed ventricular function. The Authors point out the iatrogenic cause of the coronary occlusion; it was due to the inclusion of left anterior descending artery in the surgical myocardial and pericardial haemostatic suture and/or post-traumatic fibrosis. It is necessary to watch over the patient as the changed ventricular function can develop in an aneurismatic area.
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PMID:[Iatrogenic occlusion of the anterior descending branch of the left coronary artery. Description of a case]. 728 11

Heart failure during the immediate period of an acute myocardial infarction constitutes a major insult to this pathology; since, once installed, it is associate to ventricular dysfunction and expansion of the left ventricle. It can appear either early or delayed. Subsequent to the acute insult, the myocardium is subjected to diverse changes in its anatomical conformation and to diastolic and systolic alterations, which will affect the hemodynamic constants of the patient. Changes in the parietal ventricular architecture as well as at the neurohumoral level will also occur. The clinical signs of heart failure are: dyspnea, pallor, tachycardia, diaphoresis, cold skin, oliguria, somnolence, and gallop, which can be observed at the very beginning of the coronary occlusion. Its clinical identification, through in-hospital studies supported by adequate hemodynamic monitoring, is of utter relevance since it will lead to appropriate and fast treatment. The groups of patients with acute myocardial infarction with high risk for the development of cardiac failure are: patients with extensive Q wave infarction, diabetic, patients over 65 years of age, and those with a history of previous myocardial infarction(s). The cornerstone of treatment must be focused on reducing the myocardial ischemia, which can be achieved through the use of modern therapeutics and, given the case, pharmacological agents, coronary intervention procedures, or cardiac surgery must be taken into account. At present it is known that angiotensin converting enzyme inhibitors, betablockers, inotropics, are useful to improve ventricular function in patients with acute myocardial infarction.
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PMID:[Heart failure in acute myocardial infarction]. 1200 71

A 48-year-old woman with Wolff-Parkinson-White syndrome underwent surgical division of the accessory pathway in the left lateral wall. At 6 months after the procedure, she developed dyspnea and chest oppression. Coronary angiography revealed total occlusion in the left circumflex coronary artery (segment 13) at the exact site where cryoablation had been performed. The coronary occlusion was treated with an intracoronary bolus injection of urokinase (960,000 U) and subsequent percutaneous transluminal balloon angioplasty. No significant residual stenosis remained after the balloon angioplasty, and no further evidence of myocardial ischemia was noted for 13 years to date after the procedure.
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PMID:Myocardial infarction after cryoablation surgery for Wolff-Parkinson-White syndrome. 1204 14

INTRODUCTION. Takotsubo syndrome (TTS) is a rare condition that mimics an acute myocardial infarction. It is associated with precordial pain, ST segment elevation, absence of coronary occlusion and reversible deformation of the left ventricle due to anteroapical dyskinesia that is reminiscent of a Japanese art of fishing octopuses (tako-tsubo). It is related with emotional and physical stress, and is thought to be mediated by an acute release of catecholamines. CASE REPORT. An 83-year-old woman with hypertension. She was admitted to the heart unit with a suspected acute coronary syndrome and respiratory failure, and thus required mechanical ventilation. An echocardiography scan showed severe ventricular dysfunction with apical dyskinesia. Cardiac catheterisation ruled out heart disease and a ventriculography scan revealed a bloated systolic deformation of the anterior and apical segments (TTS). Attempts to withdraw ventilation were unsuccessful and the neurology department was consulted. A directed medical history revealed that the patient had been suffering from generalised weakness, and progressive dysphagia and dyspnoea for several months. Results of an edrophonium test were positive. Single-fibre electromyography showed a pathological jitter and acetylcholine anti-receptor antibodies were positive. The patient was treated with immunoglobulins, corticoids and pyridostigmine. A control echocardiogram showed resolution of the TTS. CONCLUSIONS. TTS must be considered within the extra-neurological complications arising from myasthenic crisis. The neurologist must take this into account when faced with any symptom or sign of a potentially cardiac origin in myasthenic crisis and other neurocritical conditions.
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PMID:[Myasthenic crisis and Takotsubo syndrome: a non-chance relationship]. 2323 40

Percutaneous coronary intervention (PCI) of total chronic coronary occlusion (CTO) still remains a major challenge. The prevalence of a CTO has been reported to be up to 30% among patients with a clinical indication for coronary angiography. Progress has been made with further advanced interventional techniques and continuously sophisticated interventional tools. Nevertheless the number of interventions carried out to recanalize a CTO is less than 10% of all procedures. Benefits of a successful CTO recanalization include relief of angina pectoris and ischemia-related dyspnea, substantial improvement in left ventricular function and, avoidance of surgery treatment. A vast variety of new CTO PCI techniques and materials has been introduced into clinical practise and pushed success rates of reopening a CTO up to around 90% in experienced hands. Particulary the introduction of the retrograde technique was a milestone. New developed microcatheters and special polymer coated wires allow to recanalize via small collaterals and vessels. Other tools such as intravascular ultrasound (IVUS) and multislice computertomography (MSCT) help to identify the anatomy and the characteristic of the lesions. Any invasive cardiac center should adopt CTO PCI procedures as standard therapy.
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PMID:Chronic total coronary occlusion recanalization: Current techniques and new devices. 2837 85