Diagnosing spontaneous coronary artery dissection in women: A call for early coronary angiography

There is a unique cohort of patients, predominantly women, that experience chest pain or acute coronary syndromes in the absence of significant epicardial coronary artery disease. These individuals present with signs and symptoms consistent with ischemia and undergo a diagnostic evaluation with the objective of identifying atherosclerotic coronary disease as the causal factor. When these studies find no or insignificant (
Source: Trends in Cardiovascular Medicine - Category: Cardiology Authors: Tags: Editorial Source Type: research

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We describe the case of a 39-year-old male, who presented to our emergency department after a one-day history of headache and vomiting, with associated sudden onset posterior neck pain and cerebellar signs following a massage. Computed tomography angiogram and brain demonstrated bilateral vertebral artery dissection and cerebellar stroke. He was admitted to hospital for monitoring and conservative management with antiplatelet therapy, resulting in a good outcome. This is the first reported case of bilateral vertebral artery dissection and stroke to be associated with massage. This case also suggests, unlike many reports in...
Source: New Zealand Medical Journal - Category: General Medicine Tags: N Z Med J Source Type: research
Authors: Han Z, Xu X, Lin Y Abstract A 67-year-old man was admitted to our hospital due to chest tightness induced by activity that had started about 2 months earlier. To clarify the causes of chest pain in this patient, cardiac magnetic resonance imaging was performed, resulting in a diagnosis of ventricular apical hypertrophic cardiomyopathy with intramyocardial calcification. PMID: 32240101 [PubMed - in process]
Source: The Journal of Invasive Cardiology - Category: Cardiology Tags: J Invasive Cardiol Source Type: research
A 49-year-old man was referred to our hospital for epigastric pain. Dynamic computed tomography showed a heterogeneously enhanced pancreatic head mass measuring 12 cm in diameter with hypervascular lesions (Fig 1). In addition, an irregular aneurysm was found in the branch from the superior mesenteric artery to the pancreatic head (Fig 2). Fluid retention owing to pancreatitis was observed in the left side of the pancreas. Selective angiography of the superior mesenteric artery confirmed an aneurysm of the inferior pancreaticoduodenal artery (IPDA).
Source: Surgery - Category: Surgery Authors: Source Type: research
Evaluation of chest pain (CP) in the emergency department (ED) frequently employs a non-invasive strategy, including coronary computed tomography angiography (CCTA), stress echocardiography (SE) or myocardial perfusion imaging (MPI). We sought to report the real-world experience of utilizing CCTA, compared to SE and MPI at an urban hospital ED. We conducted a retrospective cohort study of consecutively enrolled patients presenting with CP who had normal or non-diagnostic ECGs, negative initial troponin-T, at least intermediate risk based on modified Diamond-Forrester criteria (mDF), and who underwent CCTA, SE, or MPI based...
Source: The American Journal of Cardiology - Category: Cardiology Authors: Source Type: research
Condition:   Loin Pain-Hematuria Syndrome Interventions:   Device: Symplicity Spyral™ multi electrode renal denervation system;   Diagnostic Test: Renal angiogram Sponsors:   Saskatchewan Health Authority - Regina Area;   University of Saskatchewan Not yet recruiting
Source: ClinicalTrials.gov - Category: Research Source Type: clinical trials
AbstractSpontaneous renal artery dissection (SRAD) is a rare entity causing muscle spasm due to acute low back pain, back pain, or flank pain symptoms or misleading clinical diagnosis such as renal colic. A 25-year-old Syrian male refugee presented to the emergency department with sudden onset of left-sided flank pain in the evening. Physical examination results were normal except left-sided costovertebral angle sensitivity. Abdominal, pelvic and thoracic contrast computed tomography angiography (CTA) was performed to evaluate aortic dissection, which was our urgent preliminary diagnosis. Left renal artery dissection was d...
Source: CEN Case Reports - Category: Urology & Nephrology Source Type: research
We describe a 43-year-old woman presenting with an asymptomatic LRVT complicating NCS. She was referred to our hospital for investigation of dysfunctional uterine bleeding, and detailed examination revealed endometrial cancer. Computed tomography angiography (CTA) and Doppler ultrasonography revealed compression of the LRV between the aorta and the SMA, as well as an LRVT. CTA performed 4  months after the administration of an anticoagulant showed complete disappearance of the LRVT. We have also included a review of published reports describing LRVT complicating NCS and discussed the clinical features of such a presentation.
Source: CEN Case Reports - Category: Urology & Nephrology Source Type: research
CONCLUSION: This specific technique for dAVF characterisation has not been previously reported, although trans-venous angiography has been used to some effect. In view of diagnostic and therapeutic technical difficulties that are often faced in such patients, this technique may be a useful alternative that is not only helpful in accurate diagnosis but helps in providing an invaluable guide for the surgical approach. ADVANCES IN KNOWLEDGE: This case highlights the difficulties that one may be faced within cases of tortuous vasculature and the obese patient population. With this in mind we demonstrate how a unique hybri...
Source: The British Journal of Radiology - Category: Radiology Authors: Tags: Br J Radiol Source Type: research
We present a case of a 52-year-old woman accessed to the emergency department for chest and right upper limb pain that increased in the last days. She underwent a computed tomography angiogram showing interruption of the aortic arch, distal to left subclavian artery origin, large bilateral collateral vessels connecting subclavian arteries to descending aorta with multiple voluminous aneurysms, a bicuspid aortic valve, dilatated tubular segment of ascending thoracic aorta, and a suspected atrial septal defect. A nonsystematic literature review regarding these conditions has been performed.
Source: Indian Journal of Radiology and Imaging - Category: Radiology Authors: Source Type: research
Written by Pendell Meyers, case submitted by Tom FieroA man in his 30s walked into the ED complaining of chest pain. His triage ECG was done at 11:30 (no prior was available):What do you think?Sinus tachycardiaNormal QRS complex pattern, with borderline low voltageVery slight STE in leads V2-V5Proportionally large and fat T-waves in V4-5 with straightening of the ST segmentsT-waves also concerning in II, III, aVF, with inappropriately negative T-waves in aVLUsing the LAD OMI vs. BER formula:3 Variable: 27.34 (positive for OMI, using STE60V3=1.5mm, QTc=444, RWV4=2.0mm)4 Variable: 23.01 (positive for OMI, using QRS amplitude...
Source: Dr. Smith's ECG Blog - Category: Cardiology Authors: Source Type: blogs
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