Could MDCT be enough to send a patient with left main and tree vessel coronary artery disease to surgery? (original) (raw)
Related papers
Research Square (Research Square), 2023
Background Differentiating chronic total occlusion (CTO) from subtotal coronary occlusions (STOs) is often challenging to make from coronary angiography. Multidetector computerized tomography (MDCT) is essential in diagnosing and differentiating CTO from STO in symptomatic patients. The study is designed to explore the value of MDCT coronary angiography in discrimination between CTO and STO and assess the risk strati cation in patients with severe chest pain. Methods This study is a descriptive cross-sectional one conducted from January 2021 to June 2022. A total of fty patients (29 males, 21 females), ages ranging from (30-80 years), with coronary artery disease CAD) presented to the hospital with severe chest pain and were suspected of having arterial occlusion. They were examined using MDCT angiography. Results The prevalence of CAD was higher in males than females (58% vs. 42%). CAD was most prevalent in the age group of 51-60 (34%). Hypertension, DM, and smoking were the most common risk of CTO of coronary arteries. The CT ndings of the coronary arteries showed that 27 cases (54%) were occluded entirely, while 23 (46%) were sub-totally occluded. It was shown that coronary artery calci cation (CAC) was higher in patients with STO of coronary arteries compared to patients with CTO (26 cases subtotal vs. 20 cases total occlusion). The LAD was occluded in 30% of the patients and subtotal occluded in 20%, while the RCA was occluded in 14% and 18% subtotally occluded in the patients. The LCX was least frequent to occlusion. The Odd adjusted ratio (AOR) showed that diabetic patients had 1.68 increased Odds of having CTO of coronary arteries compared to non-diabetes (AOR = 1.68, 95% CI = .397-7.089), while hypertensive had 1.42 increased odds of having CTO compared to non-hypertensive (AOR = 1.42, 95% CI= (.366-5.474)). Smokers had 2.20 increased Odds of having CTO compared to non-smokers (AOR = 2.20, 95% CI = .461-10.532) Conclusion The study concluded that MDCT angiography is reliable and helps differentiate CTO from STO Hypertension, DM, and smoking are the most signi cant factors for CTO of coronary arteries. MDCT is recommended as a screening imaging tool for CAD symptomatic and asymptomatic populations.
Revista Española de Cardiología (English Edition), 2010
The prognosis of patients with coronary artery disease largely depends on the presence of a collateral circulation. The location and extent of the collateral circulation is highly variable and these parameters determine whether or not ischemic symptoms occur and whether left ventricular contractility is abnormal. The collateral circulation is generally established through small-caliber distal vessels, although many different forms have been described. We report on three patients with severe left coronary artery disease and collateral circulation through a large conus coronary artery that joined a proximal or medial segment of the left anterior descending coronary artery. In all three cases, left ventricular function was preserved.
Bangladesh Medical Research Council Bulletin, 2014
Noninvasive CT coronary angiography is a promising coronary imaging technique. In spite of the unprecedented temporal and spatial resolution and the inability to perform therapeutic interventions in the same session multi-detector computed tomography (MDCT) has been considering a promising alternative, non invasive tool for coronary artery imaging due to its high sensitivity and specificity for the detection of significant coronary artery stenosis. To evaluate the diagnostic accuracy of 64-slice MDCT for assessing haemodynamically significant stenoses of the coronary arteries in comparison with the conventional standard cardiac angiography. Fifty patients scheduled for conventional coronary angiography at the department of Radiology and Imaging, United Hospital, Dhaka were enrolled between July 2007 and June 2008. All patients underwent both conventional and MDCT angiography within mean 10.70 days. Overall sensitivity of 64-slice MDCT for the detection of stenosis ?50%, stenosis >...
Coronary computed tomography angiography in coronary artery disease
World journal of cardiology, 2011
To investigate the research directions of coronary computed tomography (CT) angiography in the diagnosis of coronary artery disease (CAD) based on a systematic review of the literature. A search of articles on coronary CT angiography in the diagnosis of CAD was performed during a 6-year-period between 2005 and 2010 from five main radiology journals namely, Radiology, American Journal of Roentgenology, European Radiology, European Journal of Radiology and British Journal of Radiology. Analysis of the references was focused on the research directions of coronary CT angiography with regard to the type of studies in terms of diagnostic value, application of dose-reduction strategies and resultant effective radiation doses with use of these techniques. One hundred and forty two studies were identified which met the selection criteria and were included in the analysis. 64-slice CT (single source and dual-source CT) dominated 78% of the coronary CT angiography studies. Prior to 2007, resea...
Anomalous Single Coronary Artery on Low Dose MDCT
Journal of Radiology Case Reports, 2013
Coronary artery anomalies may involve the origin, course, and structure of epicardial coronary arteries and occur in less than 1% of the general population. Clinical presentation ranges from being completely asymptomatic to sudden death. Multi-detector computed tomography has come a long way in the diagnosis of coronary artery anomalies since the introduction of 4 rows of detectors in scanners, considering its non invasive nature and the benefits of 3D reconstruction. Defining the coronary anatomy helps in clinical decision making and timely intervention. Since repeated angiographies may be required, low dose CT is an excellent investigation for diagnosis and post interventional follow up rather than repeated invasive catheter angiographies or high dose CT examination. We report two cases of clinically significant single coronary artery anomalies; a case of single Right coronary artery and another case of single Left coronary artery (Anomaly of origin & course). CASE REPORT Case 1: A 62 year old male patient presented with complaints of jaw pain associated with sweating for 7 days. He had a history of dyslipidemia and smoking, and Troponin I was negative. His clinical history included 3 episodes of frank syncope for which he was investigated previously. Physical examination, including vitals, was normal. Catheter angiography was performed which raised the suspicion of a single coronary artery (Figure 2a, b). CT coronary angiography was further advised for confirmation and ruling out a complete block of the Left main coronary artery.
The International Journal of Cardiovascular Imaging, 2006
Myocardial bridging is a congenital condition in which a segment of a major epicardial coronary artery has an intramyocardial course. Myocardial bridging is usually confined to a single vessel (typically the mid segment of the left anterior descending artery) and is usually asymptomatic, however, bridging may be associated with chest pain, myocardial infarction, or sudden cardiac death. While more commonly identified at autopsy, myocardial bridging is occasionally diagnosed by coronary angiography with identification of concomitant myocardial bridging involving both the left and right coronary arteries appearing to be uncommon. We present three patients presenting with atypical chest pain symptoms in whom concomitant right coronary artery and left anterior descending artery myocardial bridging was identified by ECG gated multidetector computed tomography (MDCT).
Cardiac CT angiography: comprehensive assessment of patient suspected coronary artery disease
Journal of the Medical Association of Thailand = Chotmaihet thangphaet, 2005
Coronary artery disease is the leading cause of mortality and morbidity worldwide. Although coronary angiography is currently a gold standard for diagnosis of coronary artery disease, some patients are of concern regarding small but not negligible risk of complications and discomfort of the procedure. In recent years, cardiac computerized tomographic angiography (CTA) is an attractive non-invasive modality for evaluation of chest pain in patients suspected to have coronary artery disease. The authors report a 61 year-old-man with a history of hypertension and hypercholesterolemia who presented with exertional angina pectoris for 3 weeks. Cardiac CTA was performed and revealed a severely stenotic lesion at the proximal left anterior descending coronary artery (LAD) with left ventricular ejection fraction of 53% and hypokinesia of anteroseptal and apical wall. The patient then was planned and underwent percutaneous coronary interventional procedure. This case highlights the utility of...