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CoronaryArteryDisease (CAD) : High blood pressure accelerates the development of CAD by promoting the buildup of plaques in the coronaryarteries. Common medications include diuretics, ACEinhibitors, beta-blockers, and calcium channel blockers.
Heart Valve Disease If one or more heart valves are not functioning correctly, it can cause blood to flow backward, putting extra pressure on the heart, which may cause it to expand to compensate for the inefficiency. This may result in ischemia (lack of oxygen to the heart muscle), causing parts of the heart to weaken and enlarge.
Coronary angiography revealed a tortuous and extremely aneurysmal RCA, as well as multivessel coronaryarterydisease (mvCAD) involving LAD, D1, LCx, OM1. Multislice CT angiography further characterized the RCA, which extends to the coronary sinus (CS) distally forming a coronary cameral fistula (CCF).
Mean patient age was 55 yrs, 56% (n=575) were women, and comorbid conditions were frequent: hypertension (64.1%), dyslipidemia (46.1%), diabetes (25.7%), documented coronaryarterydisease (19.3%), previous revascularization (20.6%), previous myocardial infarction (10.1%). Length of stay (LOS) in the CPU to discharge was 10.4
Angiogram No obstructive epicardial coronaryarterydisease Cannot exclude non-ACS causes of troponin elevation including coronary vasospasm, stress cardiomyopathy, microvascular disease, etc. hours All Hyperacute T-wave and ST Depression is resolved. Lindahl et al. References: 1.
Hospital Course The patient was taken emergently to the cath lab which did not reveal any significant coronaryarterydisease, but she was noted to have reduced EF consistent with Takotsubo cardiomyopathy. An apical OMI has the same ultrasound findings as takotsubo, and thus mimics takotsubo. Lindahl et al. References: 1.
The patient stated he had a long history of well-controlled hypertension for which he was compliant with his ACE-inhibitor. He was taken emergently to the cardiac catheterization lab and found to have multi-vessel coronaryarterydisease with a near-occlusive culprit lesion in the RCA, possibly reperfused.
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