Asymptomatic spontaneous coronary artery dissection.

Spontaneous coronary artery dissection (SCAD) is a rare cause of myocardial ischemia that could present as angina, acute myocardial infarction, or even sudden death. It occurs more commonly in women and it has been associated with autoimmune and collagen vascular diseases. The management and prognosis in these patients depend on the initial clinical presentation and the extent of dissection.

The I allele of the angiotensin converting enzyme I/D polymorphism confers protection against coronary artery disease.

Background: Mutations in genes regulating lipid metabolism, vasoactivity, and coagulation are important modulators of coronary artery disease (CAD).

Objective: This study investigated the association between allelic variants of the angiotensin converting enzyme (ACE), methytetrahydrofolate reductase, plasminogen activator inhibitor-1 and factor V genes and CAD.

Methods: Clinical, biochemical, and angiographic information were collected from 300 patients who underwent cardiac catheterization and their DNA was genotyped by restriction fragment length polymorphism.

Cardiac tamponade caused by polymicrobial gram-negative organisms.

Polymicrobial gram-negative pericarditis is a rare entity. We describe the first case of suppurative pericarditis with Citrobacter diversus and Proteus mirabilis.

Comparison of the systemic levels of inflammatory markers after percutaneous coronary intervention with bare metal versus sirolimus-eluting stents.

Background: Percutaneous coronary intervention (PCI) with bare metal stent (BMS) deployment causes plaque disruption and a rise in systemic levels of C-reactive protein (CRP), interleukin (IL)-6, and monocyte chemoattractant protein (MCP)-1. Our aim is to study whether PCI with sirolimus-eluting stent (SES) use attenuates this response.

Methods: Patients with stable angina undergoing single-vessel PCI were enrolled in a randomized, open-label fashion into a BMS group or an SES group.

Split right coronary artery: its definition and its territory.

We report here, for perhaps the 1st time in the English-language literature, the extent of the territory fed by the anterior bifurcation of the (anomalous) split right coronary artery (RCA). A 64-year-old man presented with an occlusion of the anterior bifurcation of a split RCA--which resulted in an infarct that involved both the inferoseptal left ventricular wall and the anterior right ventricular free wall. Split RCA is the same anomaly as the improperly named "double right coronary artery.

A young female with an unusual cause of dyspnea.

Within the context of coronary artery anomalies, coronary fistulas are classified by termination. A coronary artery fistula (CAF) involves a sizable communication between a coronary artery and a heart chamber (coronary-cameral fistula) or a segment of the systemic or pulmonary system (coronary artery arteriovenous fistula). These are often due to deviations from normal embryological development.

Prevalence of coronary artery calcium among asymptomatic men and women in a developing country: comparison with the USA data.

Background: Coronary artery calcium score (CACS) correlates with atherosclerotic burden and predicts cardiac events. Most of the published data have been derived from the USA population.

Objective: To study the prevalence of coronary calcium in an asymptomatic population from the eastern Mediterranean region and compare it to data obtained from a large population study in the USA.

Acute myocardial infarction: clinical characteristics, management and outcome in a university medical centre in a developing Middle Eastern country.

Background: The management and outcome of acute myocardial infarction (AMI) have not been well studied in developing countries, although demographic data from the World Health Organization indicate that developing countries contribute a major share to the global burden of cardiovascular disease.

Objectives: To analyze the clinical characteristics, management and outcome of patients hospitalized with AMI in a university medical centre in a developing Middle Eastern country.

Methods: The study population comprised all patients hospitalized with AMI at the American University of Beirut between January 1, 1997, and December 30, 1998.

Analysis of referral patterns, predictive accuracy, and impact on patient management of myocardial perfusion imaging in a new nuclear cardiology laboratory.

Background: Most of the published data on myocardial perfusion imaging (MPI) come from large tertiary-referral medical centers with extensive experience in cardiac imaging as well as a large volume of procedures. Whether the results of MPI remain as reliable in new nuclear cardiology laboratories with smaller volumes of procedures is unknown. The purpose of this study was to analyze the referral patterns, predictive accuracy, and impact of MPI on clinical practice in a newly opened nuclear cardiology laboratory.