Secondary infection of the aorta is a sporadic and life-threatening disease. It is usually caused by infection and abscess in an adjacent structure. The most common mechanism for secondary aortic ...infection is a psoas abscess eroding the aortic wall, which rarely results in non-aneurysmal aortic rupture. Primary treatment is surgical aortic reconstruction, but the risk of emergency surgical treatment is high. Endovascular aortic stent-graft implantation can be lifesaving in this setting by stopping the bleeding. However, the crucial question of durability and late infections remains unanswered and warrants long-term antibiotic treatment and follow-up. In this report, we present a case of primary psoas abscess, which resulted in non-aneurysmal aortic rupture and its endovascular treatment.
Recent attention has focused on the clinical significance of blood pressure variability (BPV) in explaining the adverse cardiovascular consequences of hypertension. We therefore analyze the impact of ...24 h BPV on the development of future cardiovascular disease determined by The Pooled Cohort Risk Assessment Equations 10-year risk calculator.
We analyzed 250 adult patients, ages 40-80 years old. The ambulatory blood pressure monitoring was recorded automatically. We defined the mean blood pressure values, SD, and coefficient of variation (CV) of blood pressure on the basis of the recorded 24 h ambulatory blood pressure monitoring values as an indicator for BPV.Patients were divided into two groups according to their Pooled Cohort Risk Assessment Equations 10-year risk profile (<7.5 and ≥7.5%).
Besides the mean systolic blood pressure (SBP), parameters showing the BPV such as SD and CV of mean blood pressures were also significantly higher in patients with an elevated 10-year risk score compared with others. Only CV of SBP and pulse pressure showed a clear association with the 10-year risk in multivariate logistic regression analysis. The results suggested that each 1% increase in CV of SBP could lead to a 1.258-fold increase in The Pooled Cohort Risk Assessment Equations 10-year risk score.
In the present study, we found that independent of baseline SBP, increased CV of SBP within 24 h was associated with increased cardiovascular risk, as assessed by The Pooled Cohort Risk Assessment Equations 10-year risk calculator.
Acute myocarditis is a well-recognized but rare manifestation of mostly viral infections. It can present with various clinical manifestations and may mimic myocardial infarction (MI) since patients ...usually present with chest pain, and the electrocardiographic changes similar to those observed in acute ST-elevation MI. We, herein, present such an extreme case of acute myocarditis characterized by dynamic ST segment elevation with reciprocal changes in the electrocardiogram.
ECG on admission revealed sinus rhythm and minimal ST-segment elevation in leads II, aVF, I, aVL, V5, and V6 with reciprocal ST segment depression at lead V1 (A). ECG taken when the patient had chest pain showed 4–5mm ST-segment elevation in leads I, II, III, aVF, aVL, and V4–V6 with ST segment depression in right precordial leads. Posterior ECG showed that the ST-segment depression in right precordial leads was due to the reflection of ST elevation of the posterior wall (B). Coronary angiography showed normal epicardial coronary arteries (C). ECG on discharge revealed biphasic T waves in the leads I, II, aVL, V5 and V6 (D). Display omitted
Saphenous vein graft (SVG) infarctions usually occur in degenerated vein grafts filled with atherothrombotic debris. The success rate of percutaneous coronary intervention (PCI) to SVG decreases ...because of their greater content of thrombus and other material such as necrotic debris. In this case report, we present an unusual case of a patient presenting with total occlusion of an Aorta-Posterior descending (Ao-Pd) SVG during inferior acute myocardial infarction, which spontaneously recanalized over fifteen days period following failed PCI.
A 76-year-old male first admitted to our hospital with atypical chest pain. Fifteen days before admission, the patient was hospitalized for acute inferior myocardial infarction (A). The angiogram showed complete thrombotic occlusion of the SVG to tile posterior descending artery (B). Primer percutaneous coronary intervention to SVG was resulted with failure (C). Fiteen days after the initial hospitalization, control coronary angiogram showed complete patency of the previously occluded SVG (D). Display omitted
Although it is difficult to diagnose with transthoracic echocardiography, a negative right atrial echo-contrast effect might be an indicator of unroofed coronary sinus in patients with dilated right ...heart chambers and without obvious atrial and/or ventricular septal defect.
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