Severe Coronary Artery Ectasia with ST Elevation MI: A Challenging Situation
Journal Title: Cardiology and Angiology: An International Journal - Year 2015, Vol 3, Issue 4
Abstract
Aim: To report a case of huge coronary artery ectasia presenting with acute myocardial infarction; a relatively rare finding encountered during coronary angiography. Presentation of Case: A young male presented with chest pain and profuse sweating at a local hospital. Electrocardiogram showed Infero-posterior STEMI. Patient received streptokinase. His symptoms settled however the electrocardiogram changes did not resolve. He presented at our hospital after 24 hours with chest discomfort. He was vitally stable and a murmur of MR was audible. His Troponin-I was raised and electrocardiogram showed ST elevations with Q waves. Coronary angiogram showed giant ectasia and occluded right coronary artery (RCA). Percutaneous coronary intervention of RCA was done; with TIMI II flow but still had some residual thrombus. The patient was kept on Tirofiban infusion. His CRP and homocysteine levels were raised. Dual antiplatelet, statin, ACE Inhibitor, beta blocker with vitamin B12 and folic acid supplement were continued. Discussion: Coronary artery ectasia is a form of atherosclerosis seen in 0.3–4.9% of coronary angiography procedures. It is described as dilation of the coronary arteries >1.5 times compared to adjacent normal vessel. An excessive expansive remodeling with enzymatic degradation of the extracellular matrix is considered to be the major pathophysiologic process. Clinical importance inclines on its association with acute coronary syndrome. Conclusion: A case of huge coronary artery ectasia presenting with acute myocardial infarction and successfully treated with PCI.
Authors and Affiliations
Abid Hussain Laghari, Khwaja Yousuf Hasan, Izat Shah, Khawar Abbas Kazmi
Keywords
Related Articles
- EP ID EP343953
- DOI 10.9734/CA/2015/17724
- Views 92
- Downloads 0
Carotid-radial Pulse Wave form and Velocity in Normotensive and Hypertensive Pregnant Women at University Teaching Hospital (UTH), Lusaka, Zambia
Background: Hypertensive disease in pregnancy continues to be one of the leading causes of maternal death. Pregnancy induced hypertension (PIH) is said to be accompanied by several cardiovascular pathophysiological chang...
Chasing Complications of Balloon Mitral Valvotomy
Percutaneous balloon mitral valvotomy (BMV) done for mitral stenosis (MS) though largely improved nowadays can be followed by multiple and rare procedure related complications. We present an interesting case of a 45 year...
Cavitary Pulmonary Aspergilloma after Norwood-I-Procedure - A Rare Complication after Delayed Sternal Closure in a Patient with HLHS
The presented case is the first to report on a child with hypoplastic left heart syndrome (HLHS) with invasive aspergillosis (IA) progressing to cavitary pulmonary aspergillosis after Norwood stage I procedure.
Non-linear Analysis of Heart Rate Variability Improves Differential Diagnosis between Parkinson Disease and Multiple System Atrophy
Aims: Parkinson's disease (PD) and multiple system atrophy (MSA) are neurodegenerative disorders characterized by motor "parkinsonian" symptoms and non-motor symptoms related to autonomic nervous system (ANS) dysfunction...
Congestive Heart Failure among the Libyan Population (North Africa); A Community Based Survey of Risk Factors and Complication
Congestive Heart failure (CHF) is a very common medical disorder and a major health problem in Libya. CHF is associated with an increase in the risk of stroke and hospitalization. Objectives: To estimate and describe th...