Computed tomography angiographic demonstration of an unexpected left main coronary artery dissection in a patient with polycystic kidney disease.

We report an unusual case of spontaneous coronary artery dissection in a 59-year-old patient with autosomal dominant polycystic kidney disease who presented with mild intermittent chest discomfort during hiking. Coronary computed tomography angiography revealed an unexpected dissection flap in the left main coronary artery extending to the proximal part of the left anterior descending artery. After transcatheter placement of a coronary stent, the patient had no recurrent discomfort even during heavy exercise.

Intrapericardial paraganglioma with intratumoral coronary arterial aneurysm and an arteriovenous fistula.

The authors present the case of a 55-year-old woman with a nonfunctioning intrapericardial paraganglioma. The tumor was incidentally found during transthoracic echocardiography that was performed because an enlarged cardiac silhouette had been noted on a chest x-ray. Transesophageal echocardiography further elucidated that the left circumflex coronary artery branched and traversed into the intrapericardial mass.

31P MR spectroscopic assessment of muscle in patients with myasthenia gravis before and after thymectomy: initial experience.

Purpose: To prospectively assess muscle metabolism in myasthenia gravis (MG) patients before and after thymectomy by using phosphorus 31 (31P) magnetic resonance (MR) spectroscopy.

Materials And Methods: With institutional review board approval and informed consent, resting and dynamic (31)P MR spectroscopy were performed in 14 healthy volunteers (five men, nine women; mean age, 33 years; range, 23-48 years) and 16 MG patients (six men, 10 women; mean age, 37 years; range 18-50 years) before and after thymectomy. Patients were stratified into groups according to the modified Osserman classification: mild-MG group (classes I-IIA) and moderate-to-severe-MG group (classes IIB-IV).