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IntroductionBasilar‐tip aneurysm (BTA) is the most common aneurysm found in the posterior circulation, representing 5–8% of total intracranial aneurysms. Coil embolization (CE) is safer and more efficacious in the treatment of BTAs compared to open surgery but has increased rate of recanalization. vs. 10.7%).
CT angiogram chest: no aortic dissection or pulmonary embolism. Repeat CT angio chest (not CT coronary, unclear what protocol) showed possible LAD aneurysm and thrombus. No further troponins were measured. Serial chest xrays: progressive bilateral pulmonary edema. No further cath details available.
Mid cavity obstruction in HCM is associated with apical aneurysm, systemic embolism, and arrhythmias. Evaluation of diastolic characteristics of LV and LV and coronary anatomy evaluation are other diagnostic uses of cath in HCM. LVOTO is due to septal hypertrophy, SAM, and anterior displacement of mitral valve apparatus.
His initial high sensitivity troponin I returned at 1300 ng/L and given that his cardiac workup was otherwise unremarkable, a CT was obtained to evaluate for pulmonary embolism and aortic aneurysm or dissection but this too was unrevealing. Another EKG was also obtained. ECG at time 82 minutes: What do you think?
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