An 87-year-old male with old myocardial infarction was referred to the hospital due to left femur neck fracture and intermittent dizziness. Significant 2:1 atrioventricular block was demonstrated on initial electrocar...An 87-year-old male with old myocardial infarction was referred to the hospital due to left femur neck fracture and intermittent dizziness. Significant 2:1 atrioventricular block was demonstrated on initial electrocardiogram (Figure 1). Transthoracic echocardiography showed reduced left ventricular function (LVEF = 47%) with regional wall motion abnormality of right coronary artery (RCA) and left circumflex coronary artery (LCx) artery. Coronary angiography showed patent previous proximal RCA and distal LCx stents. Temporary pacemaker was inserted initially and the patient was planned for permanent pacemaker insertion after the surgery.展开更多
Simultaneous thrombosis affecting more than one coronary artery has been reported to occur in about 4.8% of the cases at the time primary percutaneous coronary intervention （PCI）. Simultaneous multiple coronary arte...Simultaneous thrombosis affecting more than one coronary artery has been reported to occur in about 4.8% of the cases at the time primary percutaneous coronary intervention （PCI）. Simultaneous multiple coronary arteries throm-bosis is uncommon and can lead to a fatal outcome. Careful attention should be given to identification of abnormal ECG and coronary angiography （CAG） results. The affected ves- sel should be opened timely and efficiently in an effort to save the myocardium and reduce serious complications such as congestive heart failure, ventricular arrhythmia, cardiogenic shock, or sudden cardiac death.展开更多
A 65-year-old woman was presented with acute ab- dominal pain. The initial heart rate was 170 beats/min and the ECG showed supraventricular tachycardia （Figure IA）. After intra-venous adenosine administered, it reco...A 65-year-old woman was presented with acute ab- dominal pain. The initial heart rate was 170 beats/min and the ECG showed supraventricular tachycardia （Figure IA）. After intra-venous adenosine administered, it recovered to sinus rhythm and the follow-up ECG showed WPW pattern （Figure 1B）. The echocardiography revealed mitral valve prolapse of mid portion of anteromedial valve leaflet （A2） with severe mitral regurgitation （MR） （Figure 2）.展开更多
An 80-year-old woman visited emergency room because of resting chest pain for one hour. She had history of hypertension for 10 years. The blood pressure was 80/50 mmHg and the pulse rate was 51 beats/min. The electroc...An 80-year-old woman visited emergency room because of resting chest pain for one hour. She had history of hypertension for 10 years. The blood pressure was 80/50 mmHg and the pulse rate was 51 beats/min. The electrocardiogram demonstrated Junctional bradycardia and ST elevation in lead Ⅱ, Ⅲ and aVF. Chest X-ray indicated cardiomegaly （Figure 1A）. Coronary angiography revealed near total occlusion of proximal right coronary artery （RCA）. She underwent percutaneous coronary intervention （PCI） for the RCA lesion successfully. Echocardiography showed hypokinesia of RCA territory （Figure 2A）.展开更多
A 63-year-old male with old myocardial infarction was referred to cardiology department with cardiac arrest.Electrocardiogram revealed Q wave in the precordial leads demonstrating ischemia of anterior left ventricular...A 63-year-old male with old myocardial infarction was referred to cardiology department with cardiac arrest.Electrocardiogram revealed Q wave in the precordial leads demonstrating ischemia of anterior left ventricular wall.Mild pulmonary edema was documented on chest X-ray.Transthoracic echocardiography showed severely reduced left ventricular function (EF: 28%) with enlarged left atrium and ventricle.Coronary angiography was performed showing a total occlusion of the proximal portion of the left anterior descending artery (LAD)(Figure 1) with chronic total occlusion in the proximal portion of right coronary artery.Xience stent 2.75 × 23 mm (Abbott) was implanted in the proximal LAD lesion.Coronary angiography after percutaneous coronary intervention (PCI) revealed no definite coronary fistula (Figure 2).Two weeks later,follow-up coronary angiography demonstrated multiple coronary-left ventricular fistulas (Figure 3) which were absent in the previous angiography.展开更多
文摘An 87-year-old male with old myocardial infarction was referred to the hospital due to left femur neck fracture and intermittent dizziness. Significant 2:1 atrioventricular block was demonstrated on initial electrocardiogram (Figure 1). Transthoracic echocardiography showed reduced left ventricular function (LVEF = 47%) with regional wall motion abnormality of right coronary artery (RCA) and left circumflex coronary artery (LCx) artery. Coronary angiography showed patent previous proximal RCA and distal LCx stents. Temporary pacemaker was inserted initially and the patient was planned for permanent pacemaker insertion after the surgery.
文摘Simultaneous thrombosis affecting more than one coronary artery has been reported to occur in about 4.8% of the cases at the time primary percutaneous coronary intervention （PCI）. Simultaneous multiple coronary arteries throm-bosis is uncommon and can lead to a fatal outcome. Careful attention should be given to identification of abnormal ECG and coronary angiography （CAG） results. The affected ves- sel should be opened timely and efficiently in an effort to save the myocardium and reduce serious complications such as congestive heart failure, ventricular arrhythmia, cardiogenic shock, or sudden cardiac death.
文摘A 65-year-old woman was presented with acute ab- dominal pain. The initial heart rate was 170 beats/min and the ECG showed supraventricular tachycardia （Figure IA）. After intra-venous adenosine administered, it recovered to sinus rhythm and the follow-up ECG showed WPW pattern （Figure 1B）. The echocardiography revealed mitral valve prolapse of mid portion of anteromedial valve leaflet （A2） with severe mitral regurgitation （MR） （Figure 2）.
文摘An 80-year-old woman visited emergency room because of resting chest pain for one hour. She had history of hypertension for 10 years. The blood pressure was 80/50 mmHg and the pulse rate was 51 beats/min. The electrocardiogram demonstrated Junctional bradycardia and ST elevation in lead Ⅱ, Ⅲ and aVF. Chest X-ray indicated cardiomegaly （Figure 1A）. Coronary angiography revealed near total occlusion of proximal right coronary artery （RCA）. She underwent percutaneous coronary intervention （PCI） for the RCA lesion successfully. Echocardiography showed hypokinesia of RCA territory （Figure 2A）.
文摘A 63-year-old male with old myocardial infarction was referred to cardiology department with cardiac arrest.Electrocardiogram revealed Q wave in the precordial leads demonstrating ischemia of anterior left ventricular wall.Mild pulmonary edema was documented on chest X-ray.Transthoracic echocardiography showed severely reduced left ventricular function (EF: 28%) with enlarged left atrium and ventricle.Coronary angiography was performed showing a total occlusion of the proximal portion of the left anterior descending artery (LAD)(Figure 1) with chronic total occlusion in the proximal portion of right coronary artery.Xience stent 2.75 × 23 mm (Abbott) was implanted in the proximal LAD lesion.Coronary angiography after percutaneous coronary intervention (PCI) revealed no definite coronary fistula (Figure 2).Two weeks later,follow-up coronary angiography demonstrated multiple coronary-left ventricular fistulas (Figure 3) which were absent in the previous angiography.
