We report the case of a 72-year-old man with a congenital coronary fistula between the right coronary artery (RCA) and the main pulmonary artery (PA) associated with coronary atherosclerosis. He remained asymptomatic until 72 years of age, when myocardial ischemia developed. Myocardial revascularization was performed using four saphenous vein grafts. In addition, the coronary fistula was dissec...

Intracranial atherosclerotic disease was very common among stroke patients of Asians, Blacks, and Hispanics ancestry. Furthermore, stroke patients with intracranial atherosclerosis (ICAS) have higher recurrence rate of cerebral ischemia and death than those without ICAS. However, the natural history of intracranial atherosclerotic disease is still in controversy. Most of the studies were retros...

Congenital anomalies of the coronary arteries are relatively rare. Mostly asymptomatic, however, some can cause problems, as heart failure, myocardial ischemia, and ventricular arrhythmia, and are associated with risk of complications, such as endocarditis and coronary rupture or sudden death. A case of a 69-year-old man with complaints of tiredness, dyspnea, and palpitation due to coronary art...

Coronary heart disease (CHD) is highly prevalent in patients with diabetes mellitus (DM), and remains the single most common cause of death among this population. Regrettably, a significant percentage of diabetics fail to perceive the classic symptoms associated with myocardial ischemia. Among asymptomatic diabetics, the prevalence of abnormal cardiac testing appears to be high, raging between ...

This study tests, the hypothesis that asymptomatic patients with hemodynamically significant internal carotid artery stenosis have a lower ipsilateral collateral cerebral vascular resistance and hence greater blood flow than their symptomatic cohorts. We measured internal carotid artery blood flow and cerebral perfusion pressures intraoperatively prior to and after carotid endarterectomy in 35 ...

Background Risk stratification in anomalous aortic origin of a coronary artery (AAOCA) is challenged by the lack reliable method to detect myocardial ischemia. We prospectively studied safety and feasibility Dobutamine stress-cardiac magnetic resonance (DSCMR), test with excellent performance adults, pediatric patients AAOCA. Methods Consecutive DSCMR from 06/2014–12/2019 patients≤20 years old ...

Superior mesenteric vein thrombosis (SMVT) often presents with abdominal pain out of proportion to physical exam findings but can also be asymptomatic. If left untreated, the cause bowel ischemia, multisystem organ failure, and eventually death. Therefore, while rare, superior should considered as a differential diagnosis especially in cases inflammation hypercoagulability. Since SMVT present p...

Splanchnic or gastrointestinal ischemia is rare and randomized studies are absent. This review focuses on new developments in clinical presentation, diagnostic approaches, and treatments. Splanchnic ischemia can be caused by occlusions of arteries or veins and by physiological vasoconstriction during low-flow states. The prevalence of significant splanchnic arterial stenoses is high, but it rem...

OBJECTIVE In this study, we aimed to evaluate the diagnostic value of Technetium-99m methoxyisobutylisonitrile (Tc-99m MIBI) gated myocardial perfusion SPECT (MPS) in the detection of coronary artery disease (CAD) and silent myocardial ischemia (SMI) in patients with asymptomatic type 2 diabetes mellitus (DM). MATERIALS AND METHODS For this purpose, 35 patients with type 2 DM and 15 volunteer...

OBJECTIVE Silent myocardial ischemia is common in asymptomatic subjects without a prior history of coronary artery disease (CAD) and is associated with increased morbidity and mortality. Our objective was to determine whether endothelial dysfunction is associated with silent myocardial ischemia and whether the association is independent of genetic and familial factors. MATERIAL AND METHODS We...