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Background: Ectatic coronary segments are nidi for thrombus formation due to altered flow dynamics and stasis-an important component of Virchow's triad. Ectasia accompanied by an adjacent coronary stenosis with or without a plaque event can lead to acute myocardial infarctions complicated by huge thrombus burden.
Case Summary: Here, we present a case of a young male with acute inferior wall myocardial infarction complicated by Type IV coronary artery ectasia of the right coronary artery and huge thrombus burden that was refractory to conventional methods of thrombus management like thrombo-suction and intracoronary cocktails including tenecteplase. After a stormy course of transient complete heart block and recurrent ventricular tachycardia, the thrombus was successfully extracted using a stent retriever to achieve thrombolysis in myocardial infarction (TIMI) II plus flow distally. The lesion just distal to the ectasia was stented 24 h later to achieve TIMI III flow and the patient had an uneventful recovery subsequently.
Discussion: Angiographically visible thrombus that is refractory to intracoronary medications and aspiration thrombectomy can be successfully managed using a stent retriever.
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http://dx.doi.org/10.1093/ehjcr/yty161 | DOI Listing |
J Inflamm Res
December 2024
Department of Cardiology, College of Medicine, Southwest Jiaotong University, Chengdu Cardiovascular Disease Research Institute, The Third People's Hospital of Chengdu, Chengdu, Sichuan, People's Republic of China.
Background: Increased levels of remnant cholesterol (RC) and inflammation are linked to higher risks of atherosclerotic cardiovascular disease. Whether a combination of C-reactive protein (CRP) and RC improves the predictive ability for evaluating the severity of coronary artery lesions remains unknown.
Methods: A total of 1675 patients with coronary artery disease were stratified according to the Synergy Between Percutaneous Coronary Intervention (SYNTAX) score (SYNTAX score ≤22 versus SYNTAX score >22).
Exp Ther Med
February 2025
Department of Urology, Konstantopouleio-Patision General Hospital of Nea Ionia, 14233 Nea Ionia, Greece.
A 79-year old Caucasian male with metastatic hormone refractory prostate cancer and bilateral nephrostomy was admitted to the emergency department due to 4-day bloody urethral discharge, weakness and dizziness. The patient was treated with the luteinizing hormone-releasing hormone-antagonist and abiraterone acetate plus prednisone, dabigatran 150 mg bid (for atrial fibrillation and coronary heart disease) and 5-aminosalicylic acid for the management of mild ulcerative colitis. Imaging revealed bladder overdistention and blood analysis low levels of hematocrit (HCT) and hemoglobin (HGB) (HCT, 22%; HGB, 7.
View Article and Find Full Text PDFEClinicalMedicine
January 2025
Department of Epidemiology, NHC Key Laboratory for Health Technology Assessment, Fudan University School of Public Health, 138 Yi Xue Yuan Road, Shanghai, 200032, China.
Background: Depression is a severe mental disorder commonly co-morbid with diabetes, but it remains to elucidate whether depression is associated with the risks of a wide range of vascular complications in people with type 2 diabetes mellitus (T2DM) and whether metabolic biomarkers may mediate this pathway.
Methods: We conducted this prospective analysis among the participants of the UK Biobank who were diagnosed with T2DM and free of vascular complications at baseline between March 13, 2006 and September 30, 2010. Major depressive disorder (MDD) was ascertained according to the hospital admission records and self-report of doctor-diagnosed conditions, while the presence of depressive symptoms was assessed using the Patient Health Questionnaire-2.
Cureus
November 2024
Department of Cardiology, The First Affiliated Hospital of Chongqing Medical University, Chongqing, CHN.
Background Cardiovascular diseases (CVD), including coronary artery disease, ischemic heart disease, stroke, cardiomyopathy, and atrial fibrillation and flutter, are the leading cause of mortality worldwide, resulting in significant economic and health costs. Recognizing trends and geographical differences in the global burden of CVD facilitates health authorities in particular nations to assess the disease burden and forecast future epidemiological trends. Public health authorities in each country can better understand the differences in disease data and, by learning from the experiences and practices of successful countries and considering the characteristics of their diseases, allocate health resources more rationally and formulate more targeted healthcare strategies to reduce the disease burden.
View Article and Find Full Text PDFCureus
November 2024
Family Medicine, King Abdulaziz Medical City Jeddah, Jeddah, SAU.
Diabetes mellitus, particularly Type 2 diabetes (T2DM) remains a significant concern globally with an increase in prevalence reported in recent years. If diabetes is not managed properly, it can lead to several complications including an increased risk of cardiovascular disease (CVD). Cardiovascular complications such as coronary heart disease, peripheral artery disease, and stroke are common among individuals with diabetes.
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