The International Journal of Cardiovascular Imaging

Rigatelli, Gianluca; Cardaioli, Paolo; Giordan, Massimo; Roncon, Loris; Faggian, Giuseppe; Rigatelli, Giorgio; Zonzin, Pietro

doi: 10.1007/s10554-005-9065-4pmid: 16525753

Endovascular treatment of PVD in patients scheduled for urgent coronary surgery may be effective, relatively safe and lasting in spite of low dose antiplatelet regimen.

Alizadeh Dehnavi, Reza; Wall, Ernst; Smits, Pieter

doi: 10.1007/s10554-005-9040-0pmid: 16270223

Transient left ventricular apical ballooning is an acute cardiac syndrome characterised by an abrupt onset of chest pain and is usually associated with anterior electrocardiographic changes. The observed apical ballooning of the left ventricle is usually reversible and develops in the absence of significant atherosclerotic coronary artery disease. Here we present (to our knowledge) the first case of this syndrome in a negroid patient.

Acar, Gurkan; Dogan, Abdullah; Altınbas, Ahmet; Turker, Yasin

doi: 10.1007/s10554-005-9074-3pmid: 16502322

Protein C and protein S deficiencies may uncommonly be responsible for coronary arterial thrombosis. We report a young woman with recurrent acute stent thrombosis due to the deficiency of protein C and S. After coronary stenting, stent thrombosis occurred two times despite aggressive antiplatelet therapy, including aspirin, clopidogrel and glycoprotein IIb/IIIa inhibitor. This report suggests that the deficiency of protein C and S should be born in mind in a young patient with recurrent thrombotic events, and that anticoagulants in addition to antiplatelet agents considered in the presence of their deficiency.

Gur, Mustafa; Yilmaz, Remzi; Demirbag, Recep

doi: 10.1007/s10554-005-9042-ypmid: 16518672

Intercoronary communication is an exceptionally rare congenital malformation. A 43-year-old male was admitted to our cardiology department with symptomatic stable angina. ECG and echocardiography was normal. Exercise electrocardiography showed ST depression in inferior leads. No atherosclerotic plaque in the coronary arteries was detected on coronary angiography. However, a unidirectional intercoronary communication between the circumflex and right coronary arteries, which was leading a coronary steal from right to left, was observed. Although intercoronary communication is generally not related with ischemia, ischemic symptoms and exercise ECG changes of this case suggested that unidirectional flow might cause myocardial ischemia via coronary steal. Consequently, intercoronary communication, a very rare coronary anomaly and a cause of ischemia, is discussed in this case report.

Bitigen, Atila; Karavelioglu, Yusuf; Kaynak, Evren; Yilmaz, Mehmet

doi: 10.1007/s10554-005-9050-ypmid: 16518669

Myocardial infarction (MI) due to acute obstruction of the left main coronary artery (LMCA) occlusion is a medical emergency, requiring early and prompt diagnosis and revascularization, and unless it is treated, it will frequently result in cardiogenic shock, which has a high fatality rate. Our case focused on a patient, who was transferred to our hospital relatively late due to peculiar ECG. He had acute MI, and was in cardiogenic shock. ECG is the easiest diagnostic method in the early diagnosis of the acute coronary syndromes and in deciding on the early invasive intervention in the high risk group. Before he was sent to us, the patient had an ECG showing right bundle branch block (RBBB) and a AVR ST segment elevation. At the time of the urgent coronary angiography, it was noticed that the LMCA was totally occluded. This case has been presented in order to emphasize that peculiar changes might bring about devastating consequences as in our rare case, showing acute left main coronary artery occlusion, and ST segment elevation only in the AVR on the 12-lead ECG along with upward deflection of ST segment vector might be critical for accurate diagnosis.

Giordan, Massimo; Rigatelli, Gianluca; Cardaioli, Paolo; Di Marco, Francesca

doi: 10.1007/s10554-005-9049-4pmid: 16538434

Acute and reversible left ventricular apical wall motion abnormalities presenting with chest pain, electrocardiographic (EKG) changes and cardiac markers release, in the absence of coronary artery stenosis, have already been identified as a possible distinct clinical entity: the so-called Tako-Tsubo syndrome. A 65-year-old man with history of hypertension, hypercholesterolemia and smoking, was admitted at the emergency room of a secondary referral institution with a severe and prolonged (45 min) chest pain, irradiated to the left arm, associated with neurovegetative syndrome. The clinical presentation suggested an acute myocardial infarction (AMI). Interestingly no coronary artery stenoses or vasospasm reaction to administration of acetylcholine could be detected. A slow flow phenomenon was present. The left ventricle angiography confirmed a mild depression of left ventricle systolic function (EF 45%), with akinesia of antero-lateral wall and the typical apical ballooning-like profile. At 3-month follow-up, the patient continued to be asymptomatic and the echocardiogram showed a progressive normalization of left ventricle segmental motion and ejection fraction with a complete restoration only after 6 months. At 1 year the coronary angiography confirmed the absence of coronary stenosis, with complete regression of the ventricular apical ballooning at left ventricle catheterization. At two-year follow-up the patient is still asymptomatic. A slow resolution of the syndrome should be included in the diagnostic criteria for apical ballooning.

Stypmann, Jörg; Engelen, Markus; Epping, Constanze; Rijen, Harold; Milberg, Peter; Bruch, Christian; Breithardt, Günter; Tiemann, Klaus; Eckardt, Lars

doi: 10.1007/s10554-005-9052-9pmid: 16518668

Rafeiyian, Sima; Looti-Shahrokh, Bahram; Motamedi, Mohammad-Reza; Karkhaneh-Yousefi, Zohreh; Mojtahedzadeh, Saied; Kouhi, Ali

doi: 10.1007/s10554-005-9061-8pmid: 16518664

In this study we found out normal values for systolic and diastolic indices of pulse TDI imaging of tricuspid valve in Iranian healthy children. This can be a basis for RV function studies in different congenital cardiac disease.

Canturk, Ferhan; Yazici, Mustafa; Alayli, Gamze; Menekse, Elif; Demircan, Sabri; Ibrahimli, Firdovsi; Menekse, Serdar

doi: 10.1007/s10554-005-9059-2pmid: 16518665

Structural myocardial abnormalities may cause impaired left ventricular relaxation in RA patients and these changes are correlated with the duration of the disease. Our findings demonstrate that combined use of propagation velocity and intraventricular dispersion of E wave velocity can help the early determination of diastolic functions in the patients with RA.

Meijers, Björn; Schalla, Simon; Eerens, Filip; Suylen, Robert-J.; Broers, Bernard; Cheriex, Emile; Smedema, Jan-P.

doi: 10.1007/s10554-005-9067-2pmid: 16502021

Although acute pericarditis is a common and usual benign disorder, sometimes evolution to constrictive pericarditis may occur. We present a case of constrictive pericarditis late after coronary bypass grafting, complicated by right sided heart failure. Edema formation was aggravated due to protein-losing enteropathy, resulting in hypoalbuminemia. Imaging of constrictive pericarditis was done by ultrasound as well as simultaneous pressure recording of the right and left ventricle. Imaging of intestinal protein loss was possible using intravenous Technetium-99m-labelled human serum albumin.