A 58-year-old female with a history of coronary artery disease (CAD) with remote percutaneous intervention (PCI) to ostial right coronary artery (RCA) with a bare-metal stent represented with unstable angina. Left heart catheterization (LHC) showed 90% stenosis of the previously stented ostial RCA with a moderate disease in the circumflex and left anterior descending arteries (LAD). LHC had also demonstrated that the previously placed ostial RCA stent, 19 years ago, was dislodged with only 3-4 mm within RCA and the remainder 10-12 mm in the ascending aorta.
View Article and Find Full Text PDFTranscatheter aortic valve replacement (TAVR) has become a mainstay of treatment in the management of severe aortic stenosis. It is a challenging procedure that requires expertise in obtaining proper access, delivery of catheters to and beyond the aortic valve, and finally accurate deployment of the aortic bioprosthesis. Patients with aortic anomalies portend an added challenge in performing TAVR procedures.
View Article and Find Full Text PDFTo help standardize the assessment of diastolic dysfunction in the United States, the American Society of Echocardiography (ASE) released criteria for the assessment of diastology in patients with normal and abnormal ejection fraction. As heart failure with preserved ejection fraction (HFpEF) is a leading cause of morbidity and mortality in cardiac patients, it is imperative to assess diastology appropriately. Echocardiography is the mainstay in the assessment of diastolic function; with the new ASE guidelines, diagnosis is simplified especially in patients that have preserved baseline ejection fraction.
View Article and Find Full Text PDFThis is an interesting cardiovascular imaging and coronary angiography case of a 67-year-old female patient who presented with chest pain, abnormal electrocardiogram (EKG), and heart failure who was subsequently found to have spontaneous coronary artery dissection (SCAD) and Takotsubo cardiomyopathy (TCM) on imaging studies. The case presentation highlights the importance of imaging studies and prompt diagnosis in these patients. This study may also highlight the need for early medical intervention in patients with suspected systolic dysfunction due to either of these pathophysiologic processes.
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