Search results for "Artery"

Das »Nußknacker-Syndrom« der Vena renalis (Arteria-mesenterica-superior-Syndrom) als Ursache gastrointestinaler Beschwerden

2008

History and clinical findings Since the age of 19 a now 22-year-old man had complained of intermittent abdominal pain, irregular stools and paroxysmal tachycardia. The only preceding illness had been a single episode of iron-deficiency anemia. A laparoscopy, done 8 months after the onset of symptoms, had revealed an inflamed Meckel's diverticulum which was surgically removed. After transient improvement the symptoms recurred 5 months postoperatively. On admission to clarify the cause of the symptoms he had discrete abdominal pain on pressure, but physical examination was otherwise unremarkable. Investigations Routine biochemical tests and endoscopy were normal. Abdominal computed tomography…

A late diagnosis of aortic coarctation began as an acute coronary syndrome

2014

Abstract Aortic coarctation accounts the 5%–10% of congenital heart disease. It is usually diagnosed during childhood but the postductal form is most common in adults and may be diagnosed incidentally in the context of investigation for hypertension. The age of correction is the most important factor for the relief of hypertension and long-term survival. We describe a case of a 63-year-old man, came to our emergency room for acute coronary syndrome. Cardiac catheterization with right femoral artery access was performed but for many difficulties during the introduction of catheters was therefore performed aortography that showed an interruption "a cul de sac" at the level of the descending t…

Further evaluation of plasma sphingomyelin levels as a risk factor for coronary artery disease

2006

Abstract Background Sphingomyelin (SM) is the major phospholipid in cell membranes and in lipoproteins. In human plasma, SM is mainly found in atherogenic lipoproteins; thus, high levels of SM may promote atherogenesis. Methods We investigated in a median follow up of 6.0 years the association of SM with the incidence of a combined endpoint (myocardial infarction and cardiovascular death) in stable and unstable patients, and its relation to other marker of atherosclerosis in 1,102 patients with angiographically documented CAD and 444 healthy controls. Results and discussion Logistic regression analysis showed that SM categorized by median was associated with an elevated risk for CAD (HR 3.2…

Predicting mortality with cardiac troponins: recent insights from meta-analyses.

2019

Abstract The introduction of cardiac troponin (cTn) testing in clinical practice has been one of the most important breakthroughs that have occurred in the recent history of laboratory medicine. Although it is now uncontestable that cTn values are essential for diagnosing acute coronary syndrome (ACS), solid evidence is also emerging that assessment of either cardiac troponin I (cTnI) or T (cTnT) may provide valuable prognostic information in the general healthy population, as well as in patients with a vast array of cardiac and extra-cardiac diseases. We have hence performed a critical review of the scientific literature for identifying meta-analyses which have investigated the potential c…

Acute Coronary Syndrome in the Older Patient

2021

Coronary artery disease is one of the leading causes of morbidity and mortality, and its prevalence increases with age. The growing number of older patients and their differential characteristics make its management a challenge in clinical practice. The aim of this review is to summarize the state-of-the-art in diagnosis and treatment of acute coronary syndromes in this subgroup of patients. This comprises peculiarities of ST-segment elevation myocardial infarction (STEMI) management, updated evidence of non-STEMI therapeutic strategies, individualization of antiplatelet treatment (weighting ischemic and hemorrhagic risks), as well as assessment of geriatric conditions and ethical issues in…

Coronary Revascularization and Long-Term Survivorship in Chronic Coronary Syndrome

2021

Ischemic heart disease (IHD) persists as the leading cause of death in the Western world. In recent decades, great headway has been made in reducing mortality due to IHD, based around secondary prevention. The advent of coronary revascularization techniques, first coronary artery bypass grafting (CABG) surgery in the 1960s and then percutaneous coronary intervention (PCI) in the 1970s, has represented one of the major breakthroughs in medicine during the last century. The benefit provided by these techniques, especially PCI, has been crucial in lowering mortality rates in acute coronary syndrome (ACS). However, in the setting where IHD is most prevalent, namely chronic coronary syndrome (CC…

Non-invasive visualisation of coronary atherosclerosis: state-of-art.

2007

Coronary artery disease remains the leading cause of death in the Western world. Non-invasive coronary artery imaging challenges any diagnostic modality because the coronary arteries are small and tortuous, whereas cardiac contraction and respiration cause motion artifacts. Therefore, non-invasive coronary imaging requires high spatial and temporal resolution. This review discusses the feasible applications in coronary imaging of magnetic resonance imaging and multi-slice computed tomography (MSCT), which are currently the only non-invasive diagnostic modalities for direct coronary atherosclerosis imaging. Particular attention and focus is devoted to the potential indications and clinical i…

The effect of off-pump coronary artery bypass on mortality after acute coronary syndrome: A meta-analysis

2012

Background Patients requiring surgical revascularisation for acute coronary syndrome (ACS) form a clinically heterogeneous group ranging from haemodynamic stability to cardiogenic shock. Whilst 'off-pump' revascularisation (OPCAB) is often considered, patient selection and operative timing remain controversial. This study aims to identify whether OPCAB may confer a mortality benefit over ONCAB in revascularisation for ACS. Secondly, we review the impact of OPCAB on completeness of revascularisation (CR) and long-term re-intervention. Methods A systematic literature review identified 9 studies (1 randomised controlled trial) of which 8 fulfilled criteria for meta-analysis. Outcomes for a tot…

Up-and-Coming Markers: Myeloperoxidase, a Novel Biomarker Test for Heart Failure and Acute Coronary Syndrome Application?

2008

Myeloperoxidase (MPO) is a mammalian enzyme responsible for generation of hypochlorite. The advantage of myeloperoxidase for use as a biomarker in the setting of heart failure and acute coronary syndrome is the early increase of MPO concentration in response to the acute event. In the setting of heart failure the reported independency of coronary artery disease and general inflammation, as indicated by MPO concentration in comparison to other inflammatory markers or in subgroups of patients with ischemic and non-ischemic cardiomyopathy, has to be highlighted. In terms of ACS, inclusion of MPO into a multiple marker strategy might add to enhance diagnosis and therapy decision making. Therefo…

Psoriasis and acute coronary syndrome risk

2019