Myocardial blood flow was evaluated in 31 subjects with not only visual but also, for the first time, circumferential profile analysis of rubidium 82 (82Rb) images acquired with positron emission tomography. Fifteen were control subjects and 16 subjects had significant coronary artery disease, defined as 50% or greater diameter stenosis in a major coronary artery or a first-order branch. Simultaneous 82Rb images at three myocardial levels were obtained before and after intravenous dipyridamole plus handgrip stress. In patients with significant coronary artery disease, visual analysis correctly identified significant disease in 26 (76%) of 34 arteries and its absence in 12 (86%) of 14 normal arteries. According to circumferential profile analysis, these numbers were 91% and 86%, respectively. Thus circumferential analysis of 82Rb images, obtained before and after intravenous dipyridamole plus handgrip stress, yielded improved sensitivity and comparable specificity compared with visual analysis.
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http://dx.doi.org/10.1016/0002-8703(92)90502-m | DOI Listing |
Tex Heart Inst J
January 2025
Center for Women's Heart and Vascular Health, The Texas Heart Institute, Houston, Texas.
Myocardial bridging is a frequent anomaly of the heart in humans and other animals. A myocardial bridge is typically characterized by the systolic narrowing seen with traditional catheter angiography, but this abnormality is not by itself a sign of ischemia or the need for intervention. In particular, transient spontaneous angina must be corroborated by reproducible narrowing during acetylcholine testing; this narrowing occurs during resting conditions and is responsive to nitroglycerin administration.
View Article and Find Full Text PDFJACC Case Rep
January 2025
Department of Cardiology, University of Giessen, Giessen, Germany.
We report a case of spontaneous coronary dissection (SCAD) in a 32-year-old pregnant patient during the seventh month of her second pregnancy. A 32-year-old pregnant woman in the 28th week of gestation was referred to our intensive care unit because of angina as well as elevated troponin levels. The initial electrocardiogram and transthoracic echocardiogram (TTE) were normal.
View Article and Find Full Text PDFJACC Case Rep
January 2025
Department of Interventional Cardiology, Vall d'Hebron Hospital, Barcelona, Spain.
Percutaneous coronary intervention (PCI) in pediatric patients is rare, especially in cases of chronic total occlusion (CTO) of the left main coronary artery (LMCA), with scarce evidence. These are associated with poorer prognostic outcomes, highlighting the need for timely intervention. In addition, its unique and entirely different pathophysiology compared to that well-studied in adults makes it a clinically challenging scenario for diagnosis, treatment, and follow-up.
View Article and Find Full Text PDFJACC Case Rep
January 2025
Icahn School of Medicine Mount Sinai, New York, New York, USA.
Takotsubo syndrome or broken-heart syndrome is a rare form of nonischemic cardiomyopathy characterized by regional systolic dysfunction of the left ventricle without evidence of coronary artery disease or acute plaque rupture. This transient impairment in myocardial contractility leads to symptoms and signs that can mimic a myocardial infarction. We present a case of Takotsubo syndrome in a 47-year-old premenopausal woman with complex congenital heart disease who initially presented with acute onset of shortness of breath and chest tightness after a verbal altercation.
View Article and Find Full Text PDFJACC Case Rep
January 2025
Center for Coronary Artery Disease, Minneapolis Heart Institute Foundation, Minneapolis, Minnesota, USA.
Coronary computed tomography angiography (CTA) analysis can help in the planning of percutaneous coronary intervention (PCI). Fractional flow reserve derived from coronary CTA (FFR), coronary CTA-derived regional myocardial mass, and FFR virtual PCI planner can facilitate decisions concerning sheath and guide catheter selection, stent lengths on the basis of predicted post-PCI FFR, optimal fluoroscopic angles, evaluation of provisional vs 2-stent bifurcation PCI techniques, and assessment of the magnitude of jeopardized myocardial mass in cases with side branch compromise. This case series illustrates the emerging opportunities for coronary CTA-based planning of bifurcation PCI.
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