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＂Malignant＂ right coronary artery presenting as an ST-segment elevation myocardial infarction -a case report

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Journal of Geriatric Cardiology 2018年第6期15卷 467-468页

作者： Cherisse Baldeo Karan Seegobin Dmitry Yaranov Fabiana Rollini Department of Internal Medicine University of Florida Jacksonville Florida USA Department of Cardiology University of Florida Jacksonville Florida USA

ST elevation on ECG in the setting of mesenteric ischemia has been reported.[1] From three prior reports, only one had a true ST elevation myocardial infarction （STEMI） coexisting with mesenteric ischemia. In patients with a strong cardiac history, distinguishing between these two conditions can be challenging. We present the case of a 79-year-old Caucasian female presented with 3-h history acute-onset epigastric pain. Medical history was significant for ischemic heart disease with prior coronary artery bypass grafts.

关键词： Anomalous Myocardial infarction right coronary artery

Urgent Off-Pump Revascularisation in ACS and Cardiogenic Shock with Anomalous Origin of right coronary artery from Left Anterior Descending artery: A Case Report

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World Journal of Cardiovascular Diseases 2021年第8期11卷 372-377页

作者： Surabhi Puri Somya Puri Deepak Puri Department of Community Medicine AIIMS New Delhi India Maharishi Markandeshwar Medical College and Hospital Solan India Department of CTVS Max Superspeciality Hospital Mohali India

A 55-year-old female known case of essential hypertension and diabetes was brought to the Emergency Department in a drowsy state with cardiogenic shock. At presentation systolic BP was 70 mm Hg, pulse rate was 44/min and random blood sugar was 239 mg/dl. Troponin I was 8.07. Electrocardiography showed junctional rhythm and bradycardia. Ejection Fraction (LVEF) was 15% - 20%. coronary angiography was done which revealed single vessel disease in LAD with anomalous origin of RCA from midsegment of LAD. Patient was immediately taken up for Off-pump Coronary Artery Bypass Grafting (OPCAB). Right saphenous vein graft was harvested and anastomosed proximally to aorta and distally to LAD on beating heart using Medtronic Octopus heart stabilizer and coronary shunts. Wound closed in layers after achieving complete hemostasis. Patient was taken off ventilatory support on first post-operative day and discharged in a stable condition on fourth post-operative day. Post-operative Echocardiography showed LVEF increased from 15% - 20% at time of admission to 38% and 52% after 3 months and 12 months of surgery respectively.

关键词： right coronary artery Anomalous Origin Left coronary artery

Delayed right coronary ostial obstruction after J-valve deployment in transcatheter aortic valve implantation: A case report

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World Journal of Clinical Cases 2020年第4期8卷 815-819页

作者： Zhao Xu Hong Yu Peng Liang Department of Anesthesiology West China Hospital Sichuan University and The Research Units of West China (2018RU012) Chinese Academy of Medical Sciences

BACKGROUND Aortic stenosis is the most common valve disease in *** aortic valve implantation(TAVI)is being increasingly applied for intermediate-to lowrisk ***,we describe an uncommon complication of delayed right coronary obstruction in a transapical TAVI *** SUMMARY A 73-year-old woman with a EuroSCORE II of 1.21%underwent transapical TAVI because of severe aortic *** surgical procedure was ***,during routine monitoring after valve placement,the patient had a sudden onset of slow heart rate,the systolic blood pressure dropped sharply from 115 to 60 mmHg,and the central venous pressure abruptly increased from 10 to 33 *** patient had a poor response to vasoactive *** echocardiography revealed poor myocardial contractility,and electrocardiography showed a significant depression of *** angiography was performed immediately,which suggested complete obstruction of the right coronary *** emergency protocol was *** bypass was established *** aortic biological valve replacement under cardiopulmonary bypass was *** Perioperative monitoring,early recognition,and diagnosis of obstruction of coronary arteries in TAVI are *** echocardiography is a useful diagnostic and monitoring tool in this *** protocols should be established during TAVI.

关键词： Transcatheter aortic valve implantation right coronary artery Obstruction Complication Management Case report

Ops!... Where is my left main？

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Journal of Geriatric Cardiology 2018年第9期15卷 609-610页

作者： Gianluca Rigatelli Mario Lupia Marco Zuin Cardiovascular Diagnosis and Endoluminal hlterventions Unit Rovigo General Hospital Rovigo Italy Vascular Surgery Padua University School of Medicine. Padua Italy Section of Internal and Cardiopuhnonary Medicine Department of Medical Science University of Ferrara Ferrara Italy

coronary artery anomalies can reach easily nowadays elderly age, causing troubles at both diagnostic and thera- peutic levels. A 80-year-old hypertensive man underwent coronary artery angiography because of a doubtful... 详细信息

关键词： Angiography Left main right coronary artery

Variant of Wellen’s syndrome in type 1 diabetic patient: A case report

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World Journal of Cardiology 2023年第9期15卷 462-468页

作者： Mukosolu Florence Obi Manjari Sharma Vikhyath Namireddy Paul Gargiulo Chelsea Noel Cho Hyun Blossom De Gale Internal Medicine Wyckoff Heights Medical CenterBrooklynNY 11237United States Clinical Rotations St Georges UniversitySchool of MedicineTrue Blue 96038Grenada

BACKGROUND Wellen’s syndrome is a form of acute coronary syndrome associated with proximal left anterior descending artery(LAD)stenosis and characteristic electro-cardiograph(ECG)patterns in pain free *** abnormal ECG pattern is classified into type A(biphasic T waves)and type B(deeply inverted T waves),based on the T wave pattern seen in the pericodial chest *** SUMMARY We present the case of a 37-year-old male with history of type 1 diabetes mellitus(T1DM),gastroparesis,mild peripheral artery disease and right toe cellulitis on IV antibiotics who presented to the emergency department with nausea,vomiting and abdominal pain for 3 d and as a result couldn’t take his *** to have fasting blood sugar 392 mg/*** for diabetic *** the hospital course,the patient was asymptomatic and denied any chest *** admission,No ECG and troponin draws were *** day 2,the patient became hypoxic with oxygen saturation 80%on room air,intermittent mild right-sided chest pain which he attributed to vomiting from his *** ECG done was significant for Biphasic T wave changes in leads V2 and V3 and elevated high sensitivity *** was transitioned to cardiac intensive care unit and cardiac catheterization performed with result significant for extensive coronary artery *** This case highlights an exceptional manifestation of Wellen's syndrome,wherein the right coronary artery and circumflex artery display a remarkable 100%constriction,alongside a proximal LAD stenosis of 90%-95%.Notably,this occurrence transpired in a patient grappling with extensive complications arising from ***,it underscores the utmost significance of promptly recognizing the presence of Wellen's syndrome and swiftly initiating appropriate medical intervention.

关键词： Wellens’s syndrome Biphasic T waves Deeply inverted T waves Precordial leads Left anterior descending artery Pseudo-normalization right coronary artery Left circumflex artery Case report