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Cureus 2022 May 22;14(5):e25226. Epub 2022 May 22.

Cardiology Department, Dubai Hospital, Dubai Health Authority, Dubai, ARE.

The initial electrocardiogram finding in the setting of acute myocardial infarction typically shows either persistent ST-segment elevation or non-ST-segment elevation. In young adults, when coronary angiography is performed, can further classify the patient with an occluded vessel and those with non-occluded coronary arteries. In these subgroups, myocardial infarction can be explained on the basis of coronary artery thrombosis, embolization, spontaneous coronary artery dissection, myocardial bridging, coronary aneurysms, ectasia, anomalous origin of coronary arteries coronary microvascular dysfunction, and vasospasm, or a combination of these factors. Read More

Cureus 2022 May 20;14(5):e25154. Epub 2022 May 20.

Cardiology, Clemenceau Medical Center, Beirut, LBN.

Epipericardial or epicardial fat necrosis (EFN) is a self-limited inflammatory process occurring in the mediastinal fat surrounding the heart. It is an uncommon cause of acute chest pain and mimics more critical clinical disorders such as acute coronary syndrome, aortic dissection, and pulmonary embolism. However, EFN is frequently overlooked and under-recognized in emergency departments (EDs) owing to the unfamiliarity of this condition among physicians and radiologists. Read More

J Clin Med 2022 Jun 7;11(12). Epub 2022 Jun 7.

Department of Vascular and Endovascular Surgery, University Hospital of Heidelberg, 69120 Heidelberg, Germany.

Background: Although patients with multiple arterial dissections in distinct arterial regions rarely present with known connective tissue syndromes, we hypothesized that mild connective tissue abnormalities are common findings in these patients.

Methods: From a consecutive register of 322 patients with cervical artery dissection (CeAD), we identified and analyzed 4 patients with a history of additional dissections in other vascular beds. In three patients, dermal connective tissue was examined by electron microscopy. Read More

Genes (Basel) 2022 Jun 8;13(6). Epub 2022 Jun 8.

Centro de Genética y Genómica, Instituto de Ciencias e Innovación en Medicina, Facultad de Medicina Clínica Alemana Universidad del Desarrollo, Santiago 8320000, Chile.

Marfan Syndrome (MFS) is an autosomal dominant condition caused by variants in the fibrillin-1 () gene. Cardinal features of MFS include ectopia lentis (EL), musculoskeletal features and aortic root aneurysm and dissection. Although dissection of the ascending aorta is the main cause of mortality in MFS, the clinical course differs considerably in age of onset and severity, even among individuals who share the same causative variant, suggesting the existence of additional genetic variants that modify the severity of the cardiovascular phenotype in MFS. Read More

Diagnostics (Basel) 2022 Jun 4;12(6). Epub 2022 Jun 4.

Inherited and Rare Cardiovascular Diseases Unit, Department of Traslational Medical Sciences, University of Campania "Luigi Vanvitelli", Monaldi Hospital, 80131 Naples, Italy.

Thoracic aortic dilatation is a progressive condition that results from aging and many pathological conditions (i.e., connective tissue, inflammatory, shear stress disorders, severe valvular heart disease) that induce degenerative changes in the elastic properties, leading to the loss of elasticity and compliance of the aortic wall. Read More

J Card Surg 2022 Jun 23. Epub 2022 Jun 23.

Bristol Heart Institute, Bristol University, Bristol, UK.

Significant dilemma exists regarding the management of the aortic root pathology in acute aortic dissections. Several strategies for both repair and replacement exist and there is a lack of clarity on the superiority of one over the other. Important factors that influence management strategies include involvement of the sinuses, the competence of the aortic valve, the presence of Marfans syndrome, and connective tissue disorders, as well as availability of surgical expertise. Read More

Dtsch Arztebl Int 2022 09 5(Forthcoming). Epub 2022 Sep 5.

Background: Dissections of the cervical brain-supplying arteries are a leading cause of ischemic stroke in young adults, with an annual incidence of 2.5-3 / 100 000 for carotid artery dissection and 1-1.5 / 100 000 for vertebral artery dissection. Read More

Methodist Debakey Cardiovasc J 2022 3;18(3):89-93. Epub 2022 Jun 3.

Houston Methodist DeBakey Heart & Vascular Center, Houston Methodist Hospital, Houston, Texas, US.

The articles in our Points to Remember column highlight important "need to know" facts about conditions that cardiovascular healthcare professionals may encounter. These may come from any medical specialty, such as nephrology or neurology. The article in this issue is provided by Swaminathan Perinkulam Sathyanarayanan, MD, Department of Internal Medicine, University of South Dakota, and Smitha Narayana Gowda, MD, and Alpesh Shah, MD, Houston Methodist DeBakey Heart & Vascular Center, Houston Methodist. Read More

Rev Esp Cardiol (Engl Ed) 2022 Jun 15. Epub 2022 Jun 15.

Fundación Instituto para la Mejora de la Asistencia Sanitaria (IMAS), Madrid, Spain.

Introduction and objectives Spontaneous coronary artery dissection (SCAD) is a rare cause of acute myocardial infarction (AMI). We sought to compare the results on in-hospital mortality and 30-day readmission rates among patients with AMI-SCAD vs AMI due to other causes (AMI-non-SCAD). Methods Risk-standardized in-hospital mortality (rIMR) and risk-standardized 30-day readmission ratios (rRAR) were calculated using the minimum dataset of the Spanish National Health System (2016-2019). Read More

J Investig Med High Impact Case Rep 2022 Jan-Dec;10:23247096221104466

Division of Cardiology, Department of Internal Medicine, Texas Tech University Health Sciences Center, Lubbock, Texas, USA.

Spontaneous coronary artery dissection (SCAD) is an infrequent cause of acute coronary syndrome (ACS) caused by a nontraumatic tear in the coronary artery wall. The true incidence is thought to be underestimated owing to its diagnostic difficulty as coronary angiography is insensitive in assessing the arterial wall structure, thereby warranting additional diagnostic modalities such as intravascular ultrasound. We report a case of a young woman who had been taking oral contraceptives, and presented with acute non-ST segment elevation myocardial infarction due to SCAD with superimposed thrombosis. Read More

Cureus 2022 May 12;14(5):e24945. Epub 2022 May 12.

Department of Medicine and Department of Cardiovascular Medicine, University of Florida Health, Gainesville, USA.

A case of an anxious 59-year-old woman, who presented with chest pressure, nausea, and vomiting, is described. After hours of symptoms that worsened despite medical management, cardiac catheterization was performed. Angiography revealed diffuse, long, tubular disease of multiple coronary vessels. Read More

Vasc Endovascular Surg 2022 Jun 15:15385744221109037. Epub 2022 Jun 15.

Department of Cardiovascular and Thoracic Surgery, St Luc Hospital, Catholic University of Louvain, Brussels, Belgium.

: LDS is an autosomal dominant connective tissue disease. It is a rare multi-systemic disorder with serious vascular impact. : We report a case of a 38-year-old male with Loeys-Dietz syndrome (LDS) suffering from major aortic complications. Read More

Heart 2022 Jun 15. Epub 2022 Jun 15.

Cardiology, Erasmus Medical Center, Rotterdam, The Netherlands

Objective: Women with Turner syndrome (TS) are at increased risk of aortic dissection, which is a life-threatening event associated with aortic dilation. Knowledge on the development of aortic dilation over time remains limited. This study aims to describe the prevalence of aortic dilation, to find associated factors and to study aortic growth in women with TS. Read More

Vopr Kurortol Fizioter Lech Fiz Kult 2022 ;99(3):58-65

Moscow Scientific and Practical Center for Medical Rehabilitation, Restorative and Sports Medicine of the Department of Health of the City of Moscow, Moscow, Russia.

Extracorporeal shock wave therapy (ESWT) is a relatively new branch of physiotherapy.

Purpose Of The Study: Conduct an analytical review of the available literature data on the use of ESWT in oncology.

Material And Methods: A review was conducted, including data from electronic databases: Scopus, Web of Science, MedLine, World Health Organization, The Cochrane Central Register of Controlled Trials, ScienceDirect, US National Library of Medicine National Institutes of Health, PubMed, Google Scholar, elibrary, CyberLeninka, disserCat. Read More

Cureus 2022 May 12;14(5):e24934. Epub 2022 May 12.

Emergency Medicine, King Fahd University Hospital, Dammam, SAU.

Lateral medullary syndrome (LMS), also known as Wallenberg syndrome, is a cerebrovascular event following ischemia of the lateral part of the medulla oblongata. Some of its etiologies include atherosclerotic changes, hypertension, thromboembolism, vertebral artery dissection (VAD), and aneurysm. We present a case of a 45-year-old male with LMS with a gradual onset of atypical symptoms of LMS, which has led to a late diagnosis of our patient. Read More

Cureus 2022 May 10;14(5):e24893. Epub 2022 May 10.

Internal Medicine, Rutgers-New Jersey Medical School/ Trinitas Regional Medical Center, Elizabeth, USA.

Levine's sign is a universal sign of ischemic chest pain, defined as an individual holding a clenched fist over the chest that has a low sensitivity but is relatively specific for ischemia. Spontaneous coronary artery dissection (SCAD) is a nonatherosclerotic and a very unusual cause of acute myocardial infarction.In literature,it has been more common in young women, postpartum, or with fibromuscular dysplasia. Read More

Tech Hand Up Extrem Surg 2022 Jun 6. Epub 2022 Jun 6.

Department of Orthopaedic Surgery, HSC, The University of New Mexico, Albuquerque, NM.

Severe thenar muscle atrophy resulting in dysfunctional thumb abduction and opposition is a well-documented finding associated with long-standing severe carpal tunnel syndrome. This problem has been addressed in the past through various opposition tendon transfers. Historically, the Camitz procedure, or its modifications using the palmaris longus tendon, were recommended. Read More

J Cardiothorac Surg 2022 Jun 13;17(1):151. Epub 2022 Jun 13.

Department of Vascular Surgery, The First Hospital of Hebei Medical University, No. 89 Donggang Street, Yuhua District, Shijiazhuang, 500000, Hebei, China.

Background: The aim of this study was to explore whether or to what extent metabolic syndrome (METs) and its components were associated with hypoxemia in acute type A aortic dissection (ATAAD) patients after surgery.

Methods: This study involved 271 inpatients who underwent surgery. Demographic and clinical data were collected. Read More

Am J Emerg Med 2022 May 6;58:159-174. Epub 2022 May 6.

Department of Emergency Medicine, UHS Southern California Medical Education Consortium, Temecula, CA 92592, USA.

Introduction: Pericardial tamponade requires timely diagnosis and management. It carries a high mortality rate.

Objective: This review incorporates available evidence to clarify misconceptions regarding the clinical presentation, while provifing an in-depth expert guide on bedside echocardiography. Read More

Ann Vasc Surg 2022 Jun 9. Epub 2022 Jun 9.

Section of Vascular Surgery, Department of Surgery, Washington University School of Medicine, 660 S. Euclid Avenue, St. Louis, MO 63110, USA. Electronic address:

Objective: In individuals with heritable thoracic aortic disease (HTAD), endovascular repair for treatment of aortic aneurysm and dissection may be lifesaving but is associated with increased risk of failure of endovascular repair and adverse outcomes. This study reports our experience with early and late outcomes of endovascular aortic and branch vessel repair in patients with HTAD.

Methods: A retrospective case series was performed by chart review of individuals with HTAD followed at Washington University School of Medicine/Barnes-Jewish Hospital who underwent endovascular aortic and/or branch vessel repair. Read More

Vasc Specialist Int 2022 Jun 30;38:12. Epub 2022 Jun 30.

Departments of Intensive Care Medicine, Elisabeth-Tweesteden Hospital, Tilburg, The Netherlands.

We present a case of Brown-Séquard syndrome (BSS) after thoracic endovascular aortic repair (TEVAR) to treat Stanford type B aortic dissection. A 49-year-old male presented to the emergency department with acute tearing pain between the scapulae, connected to respiratory movements. Computed tomography showed Stanford type B aortic dissection from the left subclavian artery to the level of the 11th thoracic vertebra. Read More

J Cardiol Cases 2022 Jun 15;25(6):413-415. Epub 2022 Feb 15.

Medical College of Georgia, Augusta, GA, USA.

Myocardial infarction with non-obstructive coronary artery (MINOCA) accounts for 5-6% of all acute coronary syndrome presentations. Common causes of MINOCA include coronary vasospasm, coronary embolism/thrombosis, myocarditis, and spontaneous coronary artery dissection. Of them all, myocarditis is the most common cause of MINOCA, accounting for up-to 33% of all MINOCA cases. Read More

J Endovasc Ther 2022 Jun 9:15266028221102657. Epub 2022 Jun 9.

Department of Intervention Medicine, The Second Hospital, Cheeloo College of Medicine, Shandong University, Jinan, People's Republic of China.

Purpose: The purpose of this study was to evaluate the efficacy and safety of zone 2 thoracic endovascular aortic repair assisted by the chimney technique or single-branched stent graft for the preservation of the left subclavian artery, and summarize our single-center experience with the techniques.

Materials And Methods: From February 2017 to June 2020, 137 patients who underwent left subclavian artery revascularization during zone 2 thoracic endovascular aortic repair were enrolled. Patients had acute type B aortic dissection and penetrating aortic ulcer associated with intramural hematoma. Read More

Front Med (Lausanne) 2022 23;9:890567. Epub 2022 May 23.

Department of Emergency Medicine, Zhongshan Hospital, Fudan University, Shanghai, China.

Objective: We sought to find a bedside prognosis prediction model based on clinical and image parameters to determine the in-hospital outcomes of acute aortic dissection (AAD) in the emergency department.

Methods: Patients who presented with AAD from January 2010 to December 2019 were retrospectively recruited in our derivation cohort. Then we prospectively collected patients with AAD from January 2020 to December 2021 as the validation cohort. Read More

Radiol Case Rep 2022 Aug 3;17(8):2779-2783. Epub 2022 Jun 3.

Radiology Department, Yalgado Ouédraogo CHU, Ouagadougou Burkina Faso.

Aortic dissection is a rare but serious condition Its association with pulmonary embolism is exceptional and produces a real therapeutic dilemma. We are discussing the case of a 67-year-old male patient who presented with paraplegia with infectious syndrome. The chest X-ray performed to screen for an infectious site led to the suspicion of an aortic aneurysm and the CT angiography showed Stanford type B aortic dissection associated with bilateral proximal pulmonary embolism. Read More

Cureus 2022 May 5;14(5):e24761. Epub 2022 May 5.

Emergency and Critical Care Center, Kurashiki Central Hospital, Kurashiki, JPN.

A 67-year-old man developed an abdominal aortic aneurysm (AAA) and Stanford type B acute aortic dissection. He received liberal antihypertensives for complicated spinal cord ischemia and, subsequently, experienced loss of appetite, followed by vomiting without abdominal pain. Computed tomography revealed AAA expansion and compression of the duodenum between the superior mesenteric artery (SMA) and AAA. Read More

BMC Cardiovasc Disord 2022 Jun 7;22(1):256. Epub 2022 Jun 7.

Department of Cardiology, Zhongda Hospital, School of Medicine, Southeast University, 87 Dingjiaqiao, Nanjing, 210009, People's Republic of China.

Background: Spontaneous coronary artery dissection (SCAD) is now recognized as an important cause of acute coronary syndrome (ACS), which is thought to be more prevalent in women. However, the male patients, on the other hand, cannot be easily ignored.

Case Presentation: A 26-year-old male suffered from SCAD that occurred in the left main coronary artery (LMCA) and a secondary acute myocardial infraction (AMI). Read More

Ital J Pediatr 2022 Jun 6;48(1):85. Epub 2022 Jun 6.

Department of Neonatology, Institute for Maternal and Child Health IRCCS "Burlo Garofolo", Trieste, Italy.

Background: Loeys-Dietz syndrome (LDS) is a rare connective tissue disorder characterized by cardiovascular manifestations, especially aortic dilatations and arterial tortuosity, craniofacial and skeletal features, joint laxity or contractures, skin abnormalities, hypotonia and motor delay. Its diagnosis is established by the identification of a pathogenic variant in TGFBR1, TGFBR2, SMAD2, SMAD3, TGFB2 or TGFB3 genes. In newborns and toddlers, vascular complications such as aneurism rupture, aortic dissection, and intracerebral incidents, can occur already in the weeks of life. Read More

Radiol Case Rep 2022 Aug 29;17(8):2657-2660. Epub 2022 May 29.

Northern General Hospital, Herries Rd, Sheffield, S5 7AU, UK.

Intramural Hematoma (IMH) forms part of the acute aortic syndrome, aortic dissection, and penetrating aortic ulcer. It is a life-threatening aortic disease that warrants prompt diagnosis and management. Like aortic dissections, it is classified using the Stanford classification system as type A (proximal to the origin of the left subclavian artery) and type B (distal to the origin of the left subclavian artery). Read More

Cureus 2022 May 3;14(5):e24705. Epub 2022 May 3.

Internal Medicine and Endocrinology, SUNY Health Science Center, Brooklyn, USA.

Coronary artery plaque rupture, erosion, thrombosis, and dissection account for nearly all acute myocardial infarction (AMI). However, coronary artery embolism remains a significant cause of AMI that is essentially unaccounted for. In this report, we present two cases of acute coronary syndrome caused by coronary embolism. Read More