Browse
Submit Data
Databases
API
Help

Dataset Information

34 Views

0 Connections

0 Citations

0 Reanalyses

0 Downloads

Omics score: 0

Left main coronary artery thrombus after cannabis consumption: a case report.

ABSTRACT:

Background

Left main coronary thrombus is a rare angiographic finding associated with serious outcomes such as sudden death and cardiogenic shock. Rupture of an underlying atherosclerotic plaque is the main risk factor. The role of cannabis consumption in the pathophysiology of acute cardiovascular disease is controversial.

Case presentation

We present a case of non-ST-elevation myocardial infarction characterized by a mobile left main coronary thrombus in a young male cannabis consumer successfully treated with manual aspiration, dual anti-platelet, and unfractionated heparin therapy.

Conclusion

Cannabis consumption could be a risk factor for coronary artery thrombosis. The pathophysiology mechanism of action is not well understood. Reaching an optimal management is a potential challenge for physicians.

SUBMITTER: Matta A

PROVIDER: S-EPMC8244647 | biostudies-literature |

REPOSITORIES: biostudies-literature

ACCESS DATA

Json Xml

Similar Datasets

Multivessel spontaneous coronary artery dissection involving the left main coronary artery: a case report.

Project description:BackgroundSpontaneous coronary artery dissection (SCAD) is an infrequent and often misdiagnosis of a non-atherosclerotic cause of acute coronary syndrome (ACS). It is an important cause of ACS in young women, responsible for up to 25% of all cases in women <50 years of age without cardiovascular risk factors. Clinical presentation ranges from ST-segment-elevation myocardial infarction (MI) to ventricular fibrillation and sudden death. The treatment of patients with SCAD is a challenge and the ideal management strategy has yet to be determined.Case summaryA 42-year-old woman without family history of cardiac disease and neither traditional atherosclerotic risk factors presented to our centre with an anterior acute ST-segment-elevation MI secondary to multiple spontaneous dissections of the left main, anterior descending, and ramus intermedius coronary arteries. Stenting was performed in the left anterior descending coronary artery and left main coronary artery to resolve its occlusion. Fibromuscular dysplasia was confirmed via computed tomography angiography.DiscussionMore cases are now being identified of SCAD due to increased clinical index of suspicion, earlier use of invasive angiography, and intracoronary imaging in patients presenting with acute chest pain. Despite this, the absence of previous cardiovascular risk factors and the ignorance of this pathology delay the start of an adequate medical treatment and the performance of a cardiac catheterization. Prognostic data are limited, partly because of its underdiagnosis and lack of prospective studies, so its knowledge is necessary to improve the prognosis of these patients.

| S-EPMC6439423 | biostudies-literature

Left main coronary artery vasospasm: A case report of misdiagnosed severe coronary artery disease.

Project description:Introduction and importanceLeft main coronary artery (LMCA) vasospasm is rare and can cause demand-supply mismatch that can mimic coronary artery disease (CAD). This could lead to misdiagnosis and inappropriate referral for surgical intervention.Case presentationA 55-year-old woman with no cardiac risk factors presented with anginal chest pain. Vital signs were stable and physical exam was unremarkable. Chest x-ray was normal and electrocardiography (ECG) revealed sinus bradycardia with nonspecific ST-segment and T-wave changes in the inferolateral leads present on prior ECGs. Echocardiography revealed a left ventricular ejection fraction of 60-65% without regional wall motion abnormalities and cardiac troponin was within normal limits. Nuclear stress test was unsuccessful due to severe reaction to regadenoson. Subsequent invasive coronary angiography revealed an isolated 70% stenosis of the LMCA. Patient was referred for surgery, however, coronary computed tomography angiography (CCTA) prior to surgery unmasked spasm and prevented unnecessary surgery.Clinical discussionCoronary spasm is diagnosed clinically based on typical symptoms, transient ECG changes, and a negative stress test with no regional wall motion abnormalities on echocardiography. During episodes of spasm, coronary angiography would reveal an area of stenosis in the affected coronary segment. This could lead to a misdiagnosis of CAD and, in cases of LMCA stenosis, inappropriate referral for surgical intervention.ConclusionLMCA spasm is rare but can mimic CAD leading to misdiagnosis and unnecessary surgery. Physicians should have a high suspicion for spasm especially in patients with anginal chest pain who lack CAD risk factors. CCTA can unmask spasm and prevent unnecessary interventions.

| S-EPMC9111888 | biostudies-literature

Percutaneous intervention of left main coronary artery chronic total occlusion: A case report.

Project description: Not available

| S-EPMC5998863 | biostudies-literature

Delayed percutaneous coronary intervention for an extensive iatrogenic left main coronary artery dissection: a case report.

Project description:BackgroundIatrogenic left main coronary artery dissection is a rare but serious complication that can occur both during diagnostic coronary angiography and percutaneous coronary intervention. Early diagnosis and choice of optimal management are of crucial importance for patient's outcome while representing a challenge for clinicians.Case presentationWe present a case of iatrogenic left main coronary artery dissection occurring during diagnostic coronary angiography in a 53-year-old Greek woman with a history of coronary artery bypass grafting. Although dissection was greatly extending to mid left anterior descending artery, delayed percutaneous coronary intervention was successfully performed by carefully wiring the true lumen.ConclusionsDelayed percutaneous coronary intervention, performed 25 days following the index event, proved to be a feasible and effective strategy for treating a widely extended left main coronary artery iatrogenic dissection.

| S-EPMC9743719 | biostudies-literature

Acute coronary syndrome of the left main coronary artery caused by a huge floating thrombus in the ascending aorta: a case report of intravascular ultrasound effectiveness.

Project description:BackgroundLeft main coronary artery (LMCA)-acute coronary syndrome (ACS) is a rare complication of a floating thrombus in the ascending aorta. However, diagnosing the aetiology of LMCA-ACS during an emergency situation is challenging. We present a rare case of LMCA-ACS caused by a large thrombus in the ascending aorta, confirmed by intravascular ultrasound (IVUS).Case summaryA 90-year-old woman presented to the emergency department complaining of chest pain and syncope. On admission, her electrocardiogram showed normal sinus rhythm and a complete right bundle branch block with significant ST depression in the V3-V6 leads; hence, ACS was suspected. The first emergency angiogram of the left coronary artery showed filling defect in the proximal ascending aorta. IVUS revealed a large thrombus in the ascending aorta. The thrombus extended from the ascending aorta to the proximal left anterior descending coronary artery. IVUS confirmed that there was no dissection of the coronary artery or the proximal ascending aorta. Based on the IVUS findings, this case was diagnosed as ACS of the LMCA caused by a floating thrombus in the ascending aorta.DiscussionThis rare case of LMCA-ACS caused by a thrombus in the ascending aorta was confirmed by IVUS, which can be a useful imaging tool for diagnosing morphological abnormalities during emergencies.

| S-EPMC8374986 | biostudies-literature

Left main-like bifurcation primary percutaneous coronary intervention case report: anomalous right coronary artery ostium from the left anterior descending.

Project description:BackgroundA single coronary artery ostium (SCAO) is estimated to be present in 0.066% of the general population. The proximal coronary course and the relationship with surrounding structures are related to malignant vs. benign prognoses. We present a case of SCAO with the right coronary artery (RCA) arising from the mid-left anterior descending (LAD), complicated by anterior and inferior STEMI because of acute thrombotic occlusion at the bifurcation and its percutaneous management.Case summaryA 56-year-old male was admitted with sudden onset of resting chest pain. His ECG showed an anterior, inferior, and right ventricular STEMI. Via trans-radial access, coronary angiography showed significant stenoses at the left main and the circumflex but also a thrombotic occlusion at the proximal segment of the LAD while no RCA was seen. After crossing the LAD occlusion, the dominant RCA appeared from the mid-LAD. A provisional stent technique was performed achieving good results. Coronary computed tomography angiography showed an SCAO congenital anomaly with a patent stent in the bifurcation accompanied by diffuse coronary artery disease causing mild stenosis of the left main, proximal, and distal circumflex.DiscussionThe RCA arising from the mid-LAD with pre-pulmonic course has been described in only 37 cases. One reported an LAD/RCA bifurcation treatment with two stents technique in a stable scenario. The present is the first case reported of an acute thrombotic occlusion of an LAD/RCA bifurcation clinically resulting in a left main equivalent STEMI treated successfully with primary percutaneous coronary intervention using a bifurcation technique.

| S-EPMC7780483 | biostudies-literature

Transesophageal imaging of a left main coronary artery ostium occlusion in infective endocarditis: a case report.

Project description:A 43-year-old woman was admitted due to fever, chills, and headache for several days and was diagnosed as infective endocarditis. Intraoperative transesophageal echocardiography (TEE) examination confirmed severe aortic stenosis and showed relatively fresh 1.5 cm vegetation on the left coronary cusp of the aortic valve (AV) with frequent diastolic prolapse into the aortic root. This mobile vegetation partially occluded left coronary ostium, but it did not cause cardiac failure. TEE showed the vegetation to be in good position across the AV. The AV replacement with removal of vegetation and mitral valvuloplasty were performed. The patient was weaned from cardiopulmonary bypass without any hemodynamic instability or changes in ST segment on electrocardiography. She was discharged on the 28th postoperative day without any complication.

| S-EPMC4452675 | biostudies-literature

Giant coronary artery aneurysm of the left main treated with a covered stent: a case report.

Project description:BackgroundCoronary artery aneurysms (CAAs) of the left main represent a small subset of coronary artery disease and are associated with cardiovascular death. Because of its rare entity, large data are lacking and therefore treatment guidelines are missing.Case summaryWe describe a case of a 56-year-old female with a past medical history of spontaneous dissection of the distal descending left artery (LAD) 6 years before. She presented to our hospital with a non-ST elevation myocardial infarction and a coronary angiogram showed a giant saccular aneurysm of the shaft of the left main coronary artery (LMCA). Given the risk of rupture and distal embolization, the heart team decided to go for a percutaneous approach. Based on a pre-interventional 3D reconstructed CT scan and guided by intravascular ultrasound, the aneurysm was successfully excluded with a 5 mm papyrus-covered stent. At 3-month and 1-year follow-up, the patient is still asymptomatic and repeat angiographies showed full exclusion of the aneurysm and the absence of restenosis in the covered stent.DiscussionWe describe the successful percutaneous IVUS-guided treatment of a giant LMCA shaft coronary aneurysm with a papyrus-covered stent with an excellent 1-year angiographic follow-up showing no residual filling of the aneurysm and no stent restenosis.

| S-EPMC9972523 | biostudies-literature

Case Report: Extrinsic Compression of the Left Main Coronary Artery by a Giant Sinus of Valsalva Aneurysm.

Project description:Sinus of Valsalva aneurysm (SoVA) is an uncommon clinical entity, which is present in roughly 0. 09% of the general population. The cause can either be acquired or congenital. Clinically the SoVA of unruptured status are rarely captured or even diagnosed due to atypical clinical presentations. Here, we present a rare case of exertional angina pectoris and recurrent syncope due to an extrinsically compressed left coronary artery by a giant SoVA in a 50-year-old female patient. This SoVA was successfully repaired by the surgical exclusion and the patient was still doing well after 2 years of follow-up.

| S-EPMC8634469 | biostudies-literature

Left main coronary artery compression by a large pulmonary artery aneurysm in the absence of pulmonary hypertension: a case report.

Project description:BackgroundPulmonary artery aneurysms (PAAs) are rare and they are infrequently diagnosed due to the non-specificity of their symptoms. However, their related complications, mainly described in patients with pulmonary hypertension (PH), are associated with significant morbidity and mortality.Case summaryWe report the case of a 64-year-old woman previously operated on for pulmonary valve stenosis, who presented with rapid worsening of dyspnoea and sudden onset of chest pain. Physical examination did not show heart failure symptoms, and an echocardiogram showed significant but not severe pulmonary regurgitation with preserved right and left ventricular function. Estimated pulmonary artery (PA) pressure was normal. As myocardial ischaemia was suspected the patient underwent a coronary computed tomography angiography that showed compression of the left main coronary artery by a large PAA. Early diagnosis led to surgery that solved her symptoms.DiscussionComprehensive medical evaluation of symptomatic patients with PA dilatation, even in the absence of PH, is key to rule out the possibility of serious complications as soon as possible.

| S-EPMC6426109 | biostudies-literature

OmicsDI is part of the ELIXIR infrastructure

OmicsDI is an Elixir interoperability service. Learn more ›

Tweets

OmicsDI Databases

PRIDE
PeptideAtlas
MassIVE
JPOST Repository
Physiome Model Repository

EGA
EVA
ENA
LINCS
PAXDB
Cell Collective

MetaboLights
Metabolomics Workbench
MetabolomeExpress
GNPS
BioModels
FAIRDOMHub

ArrayExpress
dbGaP
ExpressionAtlas
GEO
NODE

Information

Databases
Help
API
Contact us
Code on GitHub
Terms of use
Submit Data