A separation between the aortic media and annulus fibrosus causes a rare cardiac abnormality called sinus of Valsalva aneurysm (SVA) that may be congenital or acquired. It is more prevalent in the right coronary sinus (65%-85%) but it has been seen rarely in non-coronary (10%-30%) or Left coronary sinus (<5%). The most common complication is rupture of the Aneurysm. We present an 80-year-old ma...

In seven patients thermodilution coronary sinus flow (TD-CSF) was higher (164 +/- 21 ml/min) during ventricular pacing than during atrial pacing (119 +/- 21 ml/min, P less than 0.005) at identical heart rate, without an increase in the determinants of myocardial oxygen consumption. To assess the possibility of right atrial admixture in coronary sinus blood during ventricular pacing we compared ...

A 50-year-old man suffering from recurrent chest pain accompanied by transient ST-segment elevation developed spasm of the left anterior descending coronary artery after receiving ergonovine maleate. During spontaneous chest pain, thermodilution coronary sinus blood flow fell from 96 ml/min to 46 ml/min, while the coronary sinus arteriovenous oxygen difference widened from 9.82 volumes percent ...

Six infants with anomalous connection of the pulmonary veins to the coronary sinus were studied with single crystal echocardiography. The posterior left atrial wall echo was identified by its continuity with the left ventricular posterior wall echo during a sweep from the left atrium to the left ventricle. In five of the six infants an echo-free space measuring 7 to 9 mm was identified behind t...

A 53 year old woman was referred for percutaneous coronary intervention because of a recent inferior myocardial infarction. During right coronary artery stent implantation, intermittent occlusion of the coronary side branch for the sinus node occurred, associated with intermittent sinus arrest and junctional escape rhythm. This led to speculation about the potential mechanisms for sinus node dy...

Sixty six year old male with history of heart failure was admitted for dysphagia, weight loss. CT scan chest revealed diffuse oesophageal wall thickening. Upper endoscopy, oesophagogram confirmed diagnosis of achalasia. TTE revealed severely reduced biventricular systolic function with LVEF 10%; PASP 75-80 mmHg. Parasternal long views showed dilated coronary sinus with a visible, mobile 2.0 cm ...

Twenty-one patients with various heart diseases undergoing the coronary sinus catheterization had myocardial blood flow studies before and during isometric handgrip exercise. At 30% of the maximal voluntary contraction (MVC), handgrip increased both coronary sinus blood flow by 19.8% and myocardial O2 consumption by 21.0% on the average as compared to those at rest. At 20% of MVC, the increase ...

Coronary artery fistula (CAF) is an abnormality in which the coronary artery has an anomalous connection with a venous structure such as the coronary sinus or atrium. CAF is usually congenital, but may be acquired. The prevalence in the general population is low with many asymptomatic and discovered incidentally. When symptomatic, CAF may present with dyspnea, decreasing functional capacity, an...

OBJECTIVE To compare the acute effects of right atrial appendage, atrial septal, coronary sinus os, and dual site pacing on the duration of atrial activation. METHODS 20 patients with a variety of cardiac conditions underwent an intracardiac electrophysiological study. Electrograms were recorded from the right atrial appendage and at multiple sites within the coronary sinus. The duration of a...

Congenital coronary sinus anomalies are rare in clinical practice, partly due to the lack of symptoms. We present a case of coronary sinus anomaly causing a right-to-left intracardiac shunt in a 46 years/old African American female with a past medical history of obstructive sleep apnea, diabetes mellitus, hypertension, coronary artery disease, and ischemic cardiomyopathy who presented with hypo...