Transradial Renal Angioplasty and Stent Placement for Systemic Hypertension Caused by Severe Unilateral Renovascular Stenosis.

Percutaneous transluminal angioplasty and stent placement for renovascular hypertension is a recognized albeit seldom used therapy. We present a case of severe renovascular hypertension, due to renal artery atherosclerosis, treated successfully with stent placement via the radial artery access approach.

Inhaler syncope.

Syncope can result from certain activities that trigger an exaggerated physiological response in susceptible individuals; examples include cough, laugh, and micturition syncope. We report a novel cause for syncope, that due to reflex bradycardia and asystole produced by the use of asthma inhalers. We discuss the possible mechanisms for this effect and briefly review other breathing-related causes of bradycardia.

Abnormal origin of the left internal thoracic artery detected only by computed tomography.

The origins of the branches of the subclavian artery are known to be variable. We present the case of a 55-year-old man whose coronary artery bypass surgery necessitated the use of the internal thoracic artery as he lacked other suitable venous conduits. The left internal thoracic artery appeared to be absent on subselective subclavian angiography.

Benign or malignant anomaly? Very high takeoff of the left main coronary artery above the left coronary sinus.

Very high takeoff of the left main coronary artery in the absence of another coronary anomaly is a rare finding. The pathologic consequences of this anomaly are unclear, and the literature on this subject does not agree on whether the condition is dangerous. We present our findings in 2 patients who were discovered to have this anomaly upon noninvasive computed tomographic coronary angiography, and we discuss our analysis of the literature and our management of these patients.

Tumor-like coronary atheroma: a modern coronary evaluation with a historical perspective.

The concept that atherosclerotic disease could be a form of neoplasm has been proposed in the medical literature for centuries, yet few modern cardiologists or pathologists describe atherosclerotic plaques as having the appearance of tumors. Although atherosclerosis is now considered to be an inflammatory disease, parallels between the pathophysiologic courses of atherosclerosis and neoplasia have been described since the 19th century. Current research is increasingly focused on mechanisms common to both diseases.

Computed tomographic coronary angiography: experience at Baylor University Medical Center/Baylor Jack and Jane Hamilton Heart and Vascular Hospital.

Noninvasive cardiac computed tomographic imaging using multislice or electron beam technology has been shown to be highly specific and sensitive in diagnosing coronary heart disease. It is about a fifth of the cost of coronary angiography and is particularly well suited for evaluating patients with a low or low to moderate probability of having obstructive coronary atherosclerosis. In addition, it offers more information than calcium scoring: because of the intravenous contrast used, it temporarily increases the density of the lumen and allows differentiation of soft plaque from calcified plaque.