Background: Children with giant coronary artery aneurysms (CAA) after Kawasaki disease (KD) are at substantial risk of thrombosis. There are currently no evidence-based guidelines for optimal thromboprophylactic therapy in these children.. Methods: The North American Kawasaki Disease Registry was queried to identify all patients with giant CAA (maximum coronary artery z-score ,10) and their antithrombotic therapy. Freedom from thrombosis was modelled using the Kaplan-Meier method; thrombotic complication rate was calculated per patient-year/month of follow-up.. Results: n=202 patients with giant CAA were included, of whom 28 (14%) experienced either coronary artery thrombosis with or without myocardial infarction. Freedom from thrombotic complications was 92%, 85% and 79% at 3 months, 5 and 10 years after diagnosis, respectively. Non-pharmacological factors associated with increased risk of thrombotic complications included higher maximum coronary artery z-scores (HR: 1.7/+10 SD, p,0.001), ...
Spontaneous coronary artery dissection (SCAD) is a rare cause of acute coronary syndrome and sudden cardiac death with high predilection for premenopausal women. The overall incidence of SCAD in patients referred for coronary angiography has been reported to vary between 0.1% and 1%. In a series of 94 antemortem and postmortem cases the mean age for men was 46 years and the mean age for women was 39 years. In this series, the dissection of right coronary artery was more common in men while the left coronary artery system was most commonly affected in women. Although the precise etiology of SCAD remains unclear, several risk factors such as atherosclerosis, connective tissue disorder, peri-partum episode, and trauma have been postulated. Consequently, SCAD could result in a wide spectrum of presentations ranging from chest pain to extensive myocardial infarction. Notably, sudden cardiac death has been a common mode of clinical presentation in many previously reported cases. While the definitive diagnosis
Study Start Date: April 2014. Spontaneous Coronary Artery Dissection (SCAD) is an unpredictable event in which patients typically first present with a sudden, unexpected heart attack. The condition can affect all age groups and is recognised as a cause of heart attacks in young adults. Although both men and women can be affected by SCAD, the condition is more common in women, particularly during or shortly after pregnancy.. SCAD results from an acute bleed into the vessel wall of a coronary artery creating a false lumen (a lumen is the term for the inside of a blood vessel, the tube down which the blood is supposed to flow). This accumulation of blood compresses the true lumen, restricting or preventing blood flow to the heart muscle. Little is currently known about the underlying causes of SCAD and its long-term outcomes, or indeed, how best to treat it. (Picture below shows angiographs of vessel before (A) and after (B) stenting.). ...
Long term objective:Discover molecular and cellular mechanisms of SCAD and develop biomarkers to enable prediction and prevention.. The purpose of the research is to identify mutations (defects in the genetic blueprint) that cause tears in blood vessels that supply the heart. Some mutations may be inherited (passed on) from a parent without an apparent blood vessel problem while others may develop for the first time in the affected person. The study includes individuals diagnosed with spontaneous coronary artery dissection and their biological parents.. Adults with SCAD will be identified both retrospectively and prospectively.Confirmation of the diagnosis by review of coronary angiography will be required before proceeding with the informed consent process and blood or saliva sample procurement. ...
Spontaneous coronary artery dissection (SCAD) is a rare myocardial ischemic disease that threatens patients life. Various risk factors are associated with SCAD, such as smoking, severe hypertension and psychological reasons.
Spontaneous coronary artery dissection (SCAD) occurs when blood flow in the heart slows or stops because of a tear in the wall of an artery. Read about SCAD symptoms, causes and treatment, and hear from people who have experienced it.
Spontaneous Coronary Artery Dissection (SCAD) - a rare condition that can cause a heart attack. Learn more about the causes, symptoms, diagnosis and treatment from the number one heart center, Cleveland Clinic.
Find media articles, news releases and videos about the Spontaneous Coronary Artery Dissection (SCAD) Research Program at Mayo Clinic.
Many patients who experience a type of heart attack known as spontaneous coronary artery dissection may benefit most from a conservative approach to treatment, rather than more invasive procedures. A scientific statement reviewing current knowledge and best practices for SCAD treatment - put together by a collaborative working group from multiple institutions including Massachusetts General Hospital - was published today in the American Heart Association journal, Circulation.
TY - JOUR. T1 - Exertional dyspnoea due to spontaneous coronary artery dissection in a 55-year-old man. AU - Iturbe, J. M.. AU - Banerjee, S.. AU - Brilakis, E. S.. PY - 2007/10/1. Y1 - 2007/10/1. UR - http://www.scopus.com/inward/record.url?scp=34848874515&partnerID=8YFLogxK. UR - http://www.scopus.com/inward/citedby.url?scp=34848874515&partnerID=8YFLogxK. U2 - 10.1136/hrt.2006.100982. DO - 10.1136/hrt.2006.100982. M3 - Article. C2 - 17890697. AN - SCOPUS:34848874515. VL - 93. JO - Heart. JF - Heart. SN - 1355-6037. IS - 10. ER - ...
Coronary artery aneurysm is an abnormal dilatation of part of the coronary artery. Acquired causes include atherosclerosis, Kawasaki disease and coronary catheterization. It can also be congenital. It is often found coincidentally on coronary angiography. Generally, it has a good prognosis. In Kawasakis disease, untreated, there is a 1-2% death rate, from cardiac causes. Nichols L, Lagana S, Parwani A (May 2008). "Coronary artery aneurysm: a review and hypothesis regarding etiology". Arch. Pathol. Lab. Med. 132 (5): 823-8. doi:10.1043/1543-2165(2008)132[823:CAAARA]2.0.CO;2. PMID 18466032. Fukazawa R, Ikegam E, Watanabe M, et al. (May 2007). "Coronary artery aneurysm induced by Kawasaki disease in children show features typical senescence". Circ. J. 71 (5): 709-15. doi:10.1253/circj.71.709. PMID 17456996. Archived from the original (- Scholar search) on 2012-12-19. Seabra-Gomes R, Somerville J, Ross DN, Emanuel R, Parker DJ, Wong M (April 1974). "Congenital coronary artery aneurysms". Br Heart ...
Background: Drug-eluting stents (DES) may induce toxic effects on the coronary arterial wall such as aneurysm formation, incomplete stent apposition, stent thrombosis and vessel rupture based on the experimental studies. We investigated the incidence and characteristics of arteriopathy at 6 month routine angiographic follow up after DES implantation regardless of clinical events in a single center unrestricted DES registry.. Methods: A total 614 consecutive patients (pts, Male 278, mean age 63.12±10.89 years) who were treated with DES (Sirolimus-SES and/or Paclitaxel-PES) were enrolled. We performed routine angiographic follow up at 6 months regardless of clinical events and IVUS was done in case of angiographic aneurismal change at the DES implanted site was observed.. Results: Conventional coronary risk factors were not different compared with control study population. The incidence of coronary aneurysm was 3.1 % (19/614). Among the 19 coronary aneurysm patients (pts, Male 16, Age 61.68± ...
We present our recent casuistry on such an interesting issue as coronary dissections. Provide data to assist the diagnosis and treatment of this disease.
Who gets it?. Typically, it affects women below the age of 50 years of age. Women outnumber men by a ratio of 9:1. SCAD is considered a rare cause of heart attacks. It probably is responsible for about 4% of all heart attacks. In women aged 50 or less it probably accounts of 25-35% of all heart attacks. The proportion is even higher in pregnant women.. Why does it happen?. We dont know for sure. It is believed that especially in pregnancy, hormonal changes (in the third trimester and during childbirth and even in the immediate period after delivery can make the arterial walls more vulnerable and weak. What we dont know for sure is whether it is just about the pregnancy or whether the patient themselves have an underlying propensity to start off with. What we do know is that people with very tortuous coronary arteries seem to be more predisposed to SCAD.. Several conditions can cause an underlying propensity to a weaker coronary artery walls.. These include:. 1) Fibromuscular dysplasia (about ...
Pregnancy-associated hormonal and hemodynamic changes and coronary shear stress have been hypothesized as contributing to P-SCAD (12). Within the first 6 weeks of pregnancy, notable hemodynamic changes begin to occur, including expansion of blood volume, increase in red cell mass, reduction of systemic vascular resistance, and increased cardiac output (13). By the end of pregnancy, plasma volume increases by 30% to 50% for a total of 4.7 to 5.2 l (14,15). Cardiac output increases from 4 to 5 l/min at baseline to 6 to 7 l/min during the second trimester and peaks as high as 10 to 11 l/min during labor. In conjunction with active Valsalva efforts ("pushing") in the second stage of labor, these physiological adaptations may hypothetically contribute to regional demands on the coronary arteries and precipitate SCAD. Although it is possible for SCAD patients to develop subclinical coronary intramural hematomas intrapartum, leading to a SCAD MI, the highest frequency of P-SCAD did not occur during ...
SCAD is an uncommon cardiac event that occurs when a tear forms in one or more of the coronary arteries near the heart. Find out more & meet survivors here.
This is a widget area - If you go to "Appearance" in your WP-Admin you can change the content of this box in "Widgets", or you can remove this box completely under "Theme Options" ...
There was a record 245+ registered participants including 35 survivors who came from across the US and a survivor from Canada. Over $35,000 was raised for research. Participants enjoyed a warm up led by Michelle Short from the Oceanside Jazzercise Center. Matt Baylow, meteorologist from CBS News 8 San Diego was our emcee and reminded everyone to wear sunscreen even though it was overcast. Prior to the start of the 5K, survivors were acknowledged by the rest of the participants. As participants crossed the finish line they received a participation medal and enjoyed a complimentary lunch plus other refreshments. There was a silent auction as well as booths with information from various sponsors and supporters. A special thank you to survivors Raylene Davis, Ellen Robin (committee lead), Karin Kiefer, Erin Balogh, Marti Snyder, Tanya Gray, Wini Simon, Caroline Knaplund, who spent many hours planning this very successful event.. SCADaddle for Research SCADaddle for Research West Coast Sponsors were ...
A 41-year-old Caucasian female with a history of hypertension presented with exertional chest pain. Her vital signs were stable on admission and physical examination was unremarkable. An Electrocardiogram (EKG) revealed inferior ST segment elevations consistent with acute myocardial infarction and cardiac enzymes were elevated. She was started on heparin, and underwent immediate cardiac catheterization.
Case Reports in Cardiology is a peer-reviewed, Open Access journal that publishes case reports related to hypertension, arrhythmia, congestive heart failure, valvular heart disease, vascular disease, congenital heart disease and cardiomyopathy.
Kawasaki disease is an acute febrile illness that usually occurs in children younger than 5 years of age. The use of intravenous immunoglobulin (IVIG) within the first 10 days of illness has been shown to reduce the incidence of coronary artery aneurysms significantly. The relative roles of repeated doses of intravenous immunoglobulin (IVIG) are controversial in refractory Kawasaki disease (KD). Most experts recommend the second retreatment with IVIG, 2 g/kg in refractory KD. However, the dose-response effect of the third or fourth IVIG was uncertain. Although there have been a significant number of reports on new therapeutic options for refractory KD, such as steroid, infliximab, methotrexate, and other immunosuppressants, their effectiveness in reducing the prevalence of coronary artery aneurysms was unproven. We present here KD patient with small coronary artery aneurysm who is resistant to the third IVIG and steroid pulse therapy but showed improvement immediately after the infusion of the
Aneurysmal coronary artery disease is characterised by abnormal dilatation of a localised or diffuse segment of the coronary artery tree. Before the advent of coronary angiography, all reported cases were based on postmortem findings. The largest angiographic series is the Coronary artery surgery study (CASS) registry where 4.9% of 20 087 patients were observed at angiography to have coronary artery aneurysms.1 In this series, a coronary artery aneurysm was defined as a dilatation with a diameter of ⩾ 1.5 times the adjacent normal coronary artery. Ninety per cent of these were associated with atherosclerotic coronary artery disease, where vessel ectasia and poststenotic dilatations are not an infrequent finding. Tunick et al in their series,2 used the term "discrete aneurysm" to mean a localised spherical or saccular shaped dilatation of ⩾ 1.5 times. They excluded fusiform aneurysms as they felt that these may be confused with vessel ectasia. In their series of 8422 patients an incidence of ...
Spontaneous coronary artery dissection (SCAD) is a rare but often fatal cause of ischaemic heart disease occurring predominantly in young or middle aged, otherwise healthy subjects. Although about 250 cases of SCAD have been reported in the literature, to the best of our knowledge, spontaneous three vessel coronary dissection associated with typical effort angina has never been reported. This case illustrates coronary angiography and intravascular ultrasound images in a patient with SCAD involving all three vessels and treated by stenting.. A 57 year old man presented with exertional chest pain. His risk factors included smoking, hypertension, and hyperlipidaemia. ECG showed an abnormal Q wave in lead III and 1 mm ST depression in III, aVF. Technetium-99m sestamibi SPECT image showed a moderate fixed defect in the inferior wall and a reversible defect in the anterior wall. Selective coronary angiography revealed SCAD involving all three vessels. Right coronary angiogram showed linear dissection ...
In adults, CAA is predominantly atherosclerotic in origin however, other causes include Kawasaki disease, autoimmune disease, trauma, infection, dissection, congenital malformation and angioplasty [1, 24]. Recently, with the advent of implantation of drug eluting stents there are increasing reports suggesting stents causing coronary aneurysm months or years after the procedure [1, 14, 22, 24]. The proposed pathogenesis of stent-related aneurysm formation is multi-factorial. The drug-eluting stent contains immunosuppressant such as Sirolimus, which inhibits inflammation, or chemotherapeutic agents like Paclitaxel, which is an anti-inflammatory agent and inhibits cell proliferation. In due course of time, once drug is eluted, the polymer in which the drug is embedded may elicit a hypersensitivity reaction and vasculitis and results in weakening of vessel wall and subsequent dilatation [1, 14, 22, 24]. Mechanical damage to the arterial wall during balloon angioplasty and stent placement or ...
Fingerprint Dive into the research topics of Nationwide survey of coronary aneurysms with diameter ,6 mm in Kawasaki disease in Korea. Together they form a unique fingerprint. ...
Ischemic heart disease (IHD) may coexist with aorto-iliac occlusive disease, and concomitant revascularization procedures may be required. This study reports our experience with ascending aorta to left femoral bypass grafting (Ao-ltFG) to prepare for intra-aortic balloon pumping (IABP). A 73-year-old man with chest pain was admitted to our hospital. Coronary angiography revealed coronary aneurysm and IHD. Enhanced computed tomography showed coronary aneurysm, complete left subclavian artery occlusion and bilateral external iliac artery occlusion. We planned a two-stage operation. In the first operation, we chose coronary artery bypass grafting, excision of the coronary aneurysm and simultaneously Ao-ltFG to prepare for IABP. In the second operation, we chose axillo-axillo bypass grafting and Ao-ltFG to right femoral artery bypass grafting. Although in the operative findings no coronary aneurysm was recognized, we performed the other operations and the postoperative course was uneventful without ...
Spontaneous coronary artery dissection (SCAD) which was first described by Pretty in 1931 is rare but significant cause of myocardial infarction and sudden cardiac death. The incidence of this condition in general population is between 0.28% and 1.1%, however in pregnant population it accounts for 27% of all MI cases.1 Mode of presentation is variable and can range from asymptomatic pathology to MI and sudden cardiac death. In the past, sudden cardiac death was the most common presentation with 70% of diagnoses was made at the time of autopsy. 36 years old G3P1+1 at 38 weeks of gestation admitted to delivery suite with spontaneous labour and delivered a live male baby. Two hours after delivery, she started complaining of central chest pain which was radiating to back and left arm along with vomiting. She was haemodynamically stable with normal oxygen saturation. Immediate blood gases, chest x-ray and troponin levels were all normal. However ECG demonstrated inferior ST segment elevation. A Tran ...
TY - JOUR. T1 - Eosinophilic arteritis with coronary aneurysms and stenoses. AU - Poommipanit, Paul B.. AU - Lensky, Mark. AU - Tobis, Jonathan. PY - 2005/5/1. Y1 - 2005/5/1. UR - http://www.scopus.com/inward/record.url?scp=18244375810&partnerID=8YFLogxK. UR - http://www.scopus.com/inward/citedby.url?scp=18244375810&partnerID=8YFLogxK. M3 - Article. C2 - 15879607. AN - SCOPUS:18244375810. VL - 17. SP - 266. EP - 269. JO - Journal of Invasive Cardiology. JF - Journal of Invasive Cardiology. SN - 1042-3931. IS - 5. ER - ...
TIRADO, Gabriel I et al. Utilization of Two Internal Thoracic Arteries in a 9 Year-old Boy with Kawasaki Disease. Rev. argent. cardiol. [online]. 2008, vol.76, n.1, pp.64-66. ISSN 1850-3748.. Kawasaki disease is an acute febrile condition affecting children. Morbidity and mortality are related with the existence of coronary aneurysms. This case report is about a 9 year-old boy presenting with a diagnosis of giant main left coronary artery aneurysm and multiple median aneurysms of the right coronary artery. The boy underwent coronary artery by pass surgery graft with two internal thoracic arteries. After 60 months of follow-up, the patient was free of symptoms and the current myocardial perfusion SPECT was negative for ischemia at rest or during exercise. Sternal and thoracic growth has been normal.. Palabras clave : Kawasaki Disease; Coronary Aneurysm; Surgery; Coronary Vessels. ...
Background-Transforming growth factor (TGF)-β is a multifunctional peptide that is important in T-cell activation and cardiovascular remodeling, both of which are important features of Kawasaki disease (KD). We postulated that variation in TGF-β signaling might be important in KD susceptibility and disease outcome. Methods and Results - We investigated genetic variation in 15 genes belonging to the TGF-β pathway in a total of 771 KD subjects of mainly European descent from the United States, the United Kingdom, Australia, and the Netherlands. We analyzed transcript abundance patterns using microarray and reverse transcriptase-polymerase chain reaction for these same genes, and measured TGF-β2 protein levels in plasma. Genetic variants in TGFB2, TGFBR2, and SMAD3 and their haplotypes were consistently and reproducibly associated with KD susceptability, coronary artery aneurysm formation, aortic root dilatation, and intravenous immunoglobulin treatment response in different cohorts. A SMAD3 ...
Coronary artery aneurysms are the dilation of the coronary arteries that supply the heart tissue with blood and nutrients. The dilation exceeds 1.5 times the normal artery size. Complications can occur if these aneurysms rupture. Here is the latest research on coronary artery aneurysms. ...
Cardiovascular disease is the leading cause of death in women accounting for 1 in every 4 female deaths. Pathophysiology of ischemic heart disease in women includes epicardial coronary artery, endothelial dysfunction, coronary vasospasm, plaque erosion and spontaneous coronary artery dissection. Angina is the most common presentation of stable ischemic heart disease (SIHD) in women. Risk factors for SIHD include traditional risks such as older age, obesity (body mass index [BMI] ,25 kg/m2), smoking, hypertension, dyslipidemia, cerebrovascular and peripheral vascular disease, sedentary lifestyle, family history of premature coronary artery disease, metabolic syndrome and diabetes mellitus, and nontraditional risk factors, such as gestational diabetes, insulin resistance/polycystic ovarian disease, pregnancy-induced hypertension, pre-eclampsia, eclampsia, menopause, mental stress and autoimmune diseases ...
We thank Dr. Alfonso and colleagues for their kind letter in response to our paper (1). We agree that revascularization for patients with spontaneous coronary artery dissection (SCAD) is challenging and often terminates with suboptimal results, and thus we have adhered to a conservative approach unless patients have ongoing or recurrent ischemia. Indeed, repeat angiography in a subset of patients treated conservatively invariably demonstrated spontaneous healing of dissections (1). Our cohort included all nonatherosclerotic SCAD cases identified and evaluated in our center (no patient was excluded). We recently reported good long-term outcomes in our expanded cohort of 86 SCAD patients at the 2013 American College of Cardiology meeting, despite our low revascularization rate (2). Our results, together with your reported cohort of 45 SCAD patients in Spain (3), confirm that the natural history of SCAD is such that the vast majority heals spontaneously. Thus, clinicians should avoid intervention ...
Did you know that 90 percent of spontaneous coronary artery dissections - which involve a tear in an artery in the heart - occur in women? Or that the standard therapy for heart failure is less effective in women than in men? These cardiovascular differences among the sexes are fairly well known in the clinical and research communities. Why they exist, however, is not. And thats what a group of experts at the Frankel Cardiovascular Center at Michigan Medicine is trying to find out.. In honor of Heart Month, heres a closer look at M-BRISC, the Michigan Biological Research Initiative on Sex Differences in Cardiovascular Disease.. A unique approach. M-BRISC was created thanks to a generous, anonymous gift to the Frankel Cardiovascular Center. The initiative brings together collaborators from across the university to increase investigation designed to understand the mechanisms of cardiovascular disease that differentially affect women and factors underlying the health of women.. "What sets us ...
This case report is on a 69-year old male patient treated with cephalosporins because of suspected myocarditis due to borreliosis. Using transthoracic echocardiography a big aneurysm of the proximal part of the left coronary artery was detected. Coronary angiography revealed an aneurysm 1.2 cm in di …
Coronary artery bypass grafting (CABG) was performed under mild hypothermia, extracorporeal circulation, and aortic clamping. The internal thoracic artery was anastomosed in the distal portion of the LAD coronary artery, a dissection-free segment, and the great saphenous vein was anastomosed in a large-caliber 2nd diagonal branch, whose origin was in the false lumen. Cardiopulmonary bypass and cross-clamping times were 35 and 26 minutes, respectively.. Although conservative management has generally been associated with favorable outcomes, it is also associated with small hazard of dissection progression and the consequent need for intervention[9]. Thus, the decision for revascularization, with PCI or CABG, should rely on clinical status, hemodynamic instability, and angiographic characteristics.. Comparing conservative versus aggressive management, Shamloo et al.[10] described that 21.2% of conservatively managed patients eventually required surgical or catheter-based interventions, but only ...
Kawasaki disease is an acute vasculitis affecting predominantly children. The disease leads to coronary artery ectasia and damage which further result in ischaemic heart disease, being the most common cause of myocardial infarction in childhood. The aetiology and guidelines for the definitive...
Aneurysms of the left main coronary artery are rare with an incidence of 0.1% in large angiographic series. The majority are atherosclerotic in origin. Other causes include connective tissue disorders, trauma, vasculitis, congenital, mycotic and idiopathic. The primary complication is myocardial ischemia or infarction, with rupture being rare. Treatment options include anticoagulation, custom made covered stents, reconstruction, resection, and exclusion with bypass. A 66 year-old man was referred for evaluation of a 2 × 2 centimeter saccular aneurysm originating from the distal left main coronary artery. There was associated calcification and mild stenosis of the LM. The workup was prompted by a non-ST elevation myocardial infarction suffered following a laparotomy for a ruptured appendix. The past medical history was pertinent for hypertension, hyperlipidemia, and a left carotid endarterectomy. Cardiopulmonary bypass with hyperkalemic cardioplegic arrest was utilized. The aneurysm was exposed in the
A 55 year old man presented with a 2 year history of angina of effort complicated by two myocardial infarctions. Coronary angiography confirmed fusiform aneurysm of the right coronary artery and disease of the left anterior descending coronary artery
It is clinical condition which is characterized by abnormal dilation of a part of the coronary artery. It can be occur due to coronary angiography. Some of..
Biscione, C., Mariano, E., Sergi, D., Tarsia, G., Viceconte, N., Bernardo, V., et al. (2012). Large coronary aneurysm following laser angioplasty of the left anterior descending coronary artery. JOURNAL OF CARDIOVASCULAR MEDICINE, 13(5), 334-335 ...
Today, SUSE is pleased to announce SUSE CaaS Platform 4 as part of a larger SUSE Application Delivery Solutions update, that also includes SUSE Cloud Application Platform 1.5.. SUSE CaaS Platform 4 raises the bar for robust Kubernetes platform operations with enhancements that expand platform scalability options, strengthen application security, and make it easier to keep pace with technology advancements. Integrating the latest releases of Kubernetes and SUSE Linux Enterprise, SUSE CaaS Platform 4 continues to provide industry leading application delivery capabilities as an enterprise-ready solution.. SUSE CaaS Platform 4 is also the first enterprise-grade Kubernetes Platform to integrate Cilium, an open source CNI Plugin for Kubernetes that leverages a powerful Linux Kernel technology called BPF, as default, resulting in advanced networking and security capabilities.. With SUSE CaaS Platform 4 you can:. Strengthen application security at scale with high performance packet filtering and network ...
Pro-life groups joining CGL in the boycott to date are: Life Issues Institute, American Life League, Colorado Right to Life, American Right to Life, Sound Choice Pharmaceutical Institute, ALL Arizona, Central Nebraskans for Life, Pro-Life Waco, Houston Coalition for Life, Mother and Unborn Baby Fox Valley, Womankind, Billboards for Life, Movement for a Better America, Defenders of the Unborn, Focus Pregnancy Help Center, Idaho Chooses Life, EMC Frontline Pregnancy Centers of NY, Four Seasons for Life, CREDO, Life Choices, STOPP Dallas, CA Right To Life, Human Life Alliance, International Right to Life Federation, Operation Rescue, Pro-Life Nation, LifeNews.com, and Marys Outreach for Women ...
Chronic active Epstein-Barr virus infection (CAEBV) is a nonfamilial syndrome that shows a specific immunodeficiency for the Epstein-Barr virus (EBV). Prolonged fever, hepatosplenomegaly, lymphadenopathy, and liver dysfunction were seen in CAEBV, but
OBJECTIVES: To determine whether coronary artery lesions (ectasia and aneurysm) are commonly observed on the initial echocardiogram of patients with acute Kawasaki syndrome, whether coronary artery ectasia and/or aneurysms occur more frequently in patients with incomplete Kawasaki syndrome than in those patients with complete findings, and whether earlier diagnosis and treatment of Kawasaki syndrome are associated with less frequent occurrence of coronary artery ectasia and/or aneurysm.. DESIGN: A retrospective medical record review.. SETTING: A tertiary care pediatric hospital.. PARTICIPANTS: One hundred patients treated for Kawasaki syndrome between July 1, 1998, and June 30, 2003, who were identified by a medical record search.. MAIN OUTCOME MEASURE: Prevalence of coronary artery lesions (ectasia and aneurysm) on the initial and subsequent echocardiograms.. RESULTS: Forty-four percent of patients had a coronary artery lesion (31% with ectasia, 13% with aneurysm) on the initial echocardiogram. ...
A clinically significant cardiac injury occurs in 5% to 15% of patients with severe blunt chest trauma [1, 2, 3, 4]. Coronary artery dissection has a very low incidence. Coronary artery dissection due to blunt chest trauma is even less common and a life-threatening complication [5]. A traumatic dissection is most commonly seen in the LAD (76%), followed by the RCA (12%) and circumflex artery (6%) [6]. The mechanism is poorly understood, but the vulnerable anatomic position of the heart is probably the explanation why the LAD is most affected. The RCA is likely to be most vulnerable at its origin due to acceleration/deceleration injuries [7].. Christensen et al. reviewed 76 published cases of post-traumatic myocardial infarctions [8]. In almost 90% of the cases, the myocardial infarctions were due to motor vehicle collisions or high-velocity trauma. In about 70% of these cases, the infarction was caused by occlusion or dissection of a coronary artery. The presentation or recognition of a ...
8 mm). Saccular and fusiform aneurysms usually develop between 18 and 25 days after the onset of illness. Even when treated with high-dose IVIG regimens within the first 10 days of illness, 5% of children with Kawasaki disease develop at the least transient coronary artery dilation and 1% develop giant aneurysms. Death can occur due either to myocardial infarction secondary to blood clot formation in a coronary artery aneurysm or to rupture of a large coronary artery aneurysm. Death is most common two to 12 weeks after the onset of illness. Many risk factors predicting coronary artery aneurysms have been identified, including persistent fever after IVIG therapy, low hemoglobin concentrations, low albumin concentrations, high white-blood-cell count, high band count, high CRP concentrations, male sex, and age less than one year. Coronary artery lesions resulting from Kawasaki disease change dynamically with time. Resolution one to two years after the onset of the disease has been observed in half ...
BACKGROUND: Myocardial fibrosis and perfusion abnormalities can occur in patients with Kawasaki disease (KD). We explored using the new three-dimensional speckle tracking echocardiography (3DSTE) the left ventricular (LV) mechanics in adolescents and young adults with a history of KD.. METHODS: Twenty-five KD patients (18 males) aged 17.0 ± 5.2 years, 14 with (group I) and 11 without (group II) coronary aneurysms, were studied. The 3D volume datasets were acquired for quantification of LV global 3D strain, global and regional area strain, systolic dyssynchrony index (SDI), twist, twist gradient (twist/LV length), and ejection fraction.. RESULTS: The results were compared with those of 14 age-matched controls. Of the 14 group I patients, 6 had left, 2 had right, and 6 had both left and right coronary aneurysms. Compared with controls, group I patients had significantly lower LV systolic global 3D strain (43.7 ± 7.3% vs. 50.4 ± 6.6%, P = 0.02), twist (8.7 ± 1.3° vs. 11.4 ± 2.0°, P , 0.001), ...
This report describes a 48-year-old woman with Parkinson"s disease who developed coronary artery dissection. We believe that dissection in this patient was probably caused by treatment with the anti-Parkinsonian drug pergolide.. ...
Kawasaki disease is a leading cause of acquired heart disease among children in the United States and other developed countries. Most children who contract this illness are less than two years old, and 80 percent of affected children are younger than five years of age. A generalized vasculitis of unknown etiology, Kawasaki disease can cause coronary artery abnormalities, including coronary aneurysms. From 20 to 25 percent of untreated children develop coronary artery abnormalities, which may resolve or persist. These abnormalities are of particular concern because they can lead to thrombosis, evolve into segmental stenosis or, rarely, rupture. The principal cause of death from Kawasaki disease is myocardial infarction. The cause of the disease remains unknown, but epidemiologic investigations and the clinical presentation suggest a microbial agent. Diagnostic criteria, including fever and other principal features, have been established. In the acute phase of the disease, treatment with acetylsalicylic