Presented in this paper are 3 cases of hemorrhage of ascending aorta and left ventricle after open heart surgery treated by extracardial bypass in our hospital from Oct. 1994 to Dec. 1995. Remained aneurysmal wall enc...Presented in this paper are 3 cases of hemorrhage of ascending aorta and left ventricle after open heart surgery treated by extracardial bypass in our hospital from Oct. 1994 to Dec. 1995. Remained aneurysmal wall enclosing conduit graft was used as a sac bypassed to right atrium to form a extracardial left-toright shunt in order to control bleeding and the results turned out to be satisfactory. The bypass and hemodynamically ignorable shunt can close spontaneously without complications with recovery of coagulation system. The technique may find wide application in clinical practice.展开更多
BACKGROUND Wellen’s syndrome is a form of acute coronary syndrome associated with proximal left anterior descending artery(LAD)stenosis and characteristic electro-cardiograph(ECG)patterns in pain free state.The abnor...BACKGROUND Wellen’s syndrome is a form of acute coronary syndrome associated with proximal left anterior descending artery(LAD)stenosis and characteristic electro-cardiograph(ECG)patterns in pain free state.The abnormal ECG pattern is classified into type A(biphasic T waves)and type B(deeply inverted T waves),based on the T wave pattern seen in the pericodial chest leads.CASE SUMMARY We present the case of a 37-year-old male with history of type 1 diabetes mellitus(T1DM),gastroparesis,mild peripheral artery disease and right toe cellulitis on IV antibiotics who presented to the emergency department with nausea,vomiting and abdominal pain for 3 d and as a result couldn’t take his insulin.Noted to have fasting blood sugar 392 mg/dL.Admitted for diabetic gastroparesis.During the hospital course,the patient was asymptomatic and denied any chest pain.On admission,No ECG and troponin draws were performed.On day 2,the patient became hypoxic with oxygen saturation 80%on room air,intermittent mild right-sided chest pain which he attributed to vomiting from his gastroparesis.Initial ECG done was significant for Biphasic T wave changes in leads V2 and V3 and elevated high sensitivity troponin.Patient was transitioned to cardiac intensive care unit and cardiac catheterization performed with result significant for extensive coronary artery disease.CONCLUSION This case highlights an exceptional manifestation of Wellen's syndrome,wherein the right coronary artery and circumflex artery display a remarkable 100%constriction,alongside a proximal LAD stenosis of 90%-95%.Notably,this occurrence transpired in a patient grappling with extensive complications arising from T1DM.Moreover,it underscores the utmost significance of promptly recognizing the presence of Wellen's syndrome and swiftly initiating appropriate medical intervention.展开更多
The prevalence of myocardial bridging in hypertrophic cardiomyopathy （HCM） is relatively higher, and it usually occurs in the middle and distal portions of the left anterior descending artery. It is rarely reported ...The prevalence of myocardial bridging in hypertrophic cardiomyopathy （HCM） is relatively higher, and it usually occurs in the middle and distal portions of the left anterior descending artery. It is rarely reported that multiple lesions of myocardial bridging affecting not only the left anterior descending artery but also right coronary artery. We reported a 56-year-old man suffering from chest discomfort on exertion. Echocardiography and ventriculography showed hypertrophy of the apex involving the anterior and lateral wall. Coronary angiograph revealed multiple myocardial bridges affecting the left anterior descending artery and the right posterior descending artery.展开更多
文摘Presented in this paper are 3 cases of hemorrhage of ascending aorta and left ventricle after open heart surgery treated by extracardial bypass in our hospital from Oct. 1994 to Dec. 1995. Remained aneurysmal wall enclosing conduit graft was used as a sac bypassed to right atrium to form a extracardial left-toright shunt in order to control bleeding and the results turned out to be satisfactory. The bypass and hemodynamically ignorable shunt can close spontaneously without complications with recovery of coagulation system. The technique may find wide application in clinical practice.
文摘BACKGROUND Wellen’s syndrome is a form of acute coronary syndrome associated with proximal left anterior descending artery(LAD)stenosis and characteristic electro-cardiograph(ECG)patterns in pain free state.The abnormal ECG pattern is classified into type A(biphasic T waves)and type B(deeply inverted T waves),based on the T wave pattern seen in the pericodial chest leads.CASE SUMMARY We present the case of a 37-year-old male with history of type 1 diabetes mellitus(T1DM),gastroparesis,mild peripheral artery disease and right toe cellulitis on IV antibiotics who presented to the emergency department with nausea,vomiting and abdominal pain for 3 d and as a result couldn’t take his insulin.Noted to have fasting blood sugar 392 mg/dL.Admitted for diabetic gastroparesis.During the hospital course,the patient was asymptomatic and denied any chest pain.On admission,No ECG and troponin draws were performed.On day 2,the patient became hypoxic with oxygen saturation 80%on room air,intermittent mild right-sided chest pain which he attributed to vomiting from his gastroparesis.Initial ECG done was significant for Biphasic T wave changes in leads V2 and V3 and elevated high sensitivity troponin.Patient was transitioned to cardiac intensive care unit and cardiac catheterization performed with result significant for extensive coronary artery disease.CONCLUSION This case highlights an exceptional manifestation of Wellen's syndrome,wherein the right coronary artery and circumflex artery display a remarkable 100%constriction,alongside a proximal LAD stenosis of 90%-95%.Notably,this occurrence transpired in a patient grappling with extensive complications arising from T1DM.Moreover,it underscores the utmost significance of promptly recognizing the presence of Wellen's syndrome and swiftly initiating appropriate medical intervention.
文摘The prevalence of myocardial bridging in hypertrophic cardiomyopathy （HCM） is relatively higher, and it usually occurs in the middle and distal portions of the left anterior descending artery. It is rarely reported that multiple lesions of myocardial bridging affecting not only the left anterior descending artery but also right coronary artery. We reported a 56-year-old man suffering from chest discomfort on exertion. Echocardiography and ventriculography showed hypertrophy of the apex involving the anterior and lateral wall. Coronary angiograph revealed multiple myocardial bridges affecting the left anterior descending artery and the right posterior descending artery.
