Importance of multislice cardiac computed tomography for the diagnosis and evaluation of silent ischemia and myocardial Infarction: Two cases.

Currently, Multislice Computed Tomography (MSCT) is a very useful and an important tool for the noninvasive evaluation and during the intervention of coronary arterial pathology(1-13). We present the assessment of coronary artery disease in a 82-year-old male and another 57-year old male using a MSCT coronary angiography with 64-slice technology which was first described by Leschka S et al (5). First patient was admitted to the Cardiology Department with exercise dispnea, and palpitation from time to time for about one month. ECG and Exercise ECG ( Maxi-mal effort test) were normal. The patient who was a medical doctor denied directly conventional coronary angiography and 64-slice multi-detector CT technique was performed (Fig.1). Coronary artery plaque leading to severe coronary artery stenosis (%95) at the middle segment of LAD was detected and served as a guide for doing coronary angiography and for determining type and size of the stent. Single coronary lesion (LAD) was detected by coronary angiography (Fig.2) and the result was completely parallel to MSCT. Percutaneous coronary intervention was performed for LAD lesion and a drug-eluting stent was implanted after predilatation.The patient was exam-inved routinely every three mounths. He was asymptomatic at the end of the three years after the procedure.

Sessiz iskemi ve miyokart infaktüsü tanısı ve değerlendirmesinde multislice kardiyak komputerize tomografinin önemi

Currently, Multislice Computed Tomography (MSCT) is a very useful and an important tool for the noninvasive evaluation and during the intervention of coronary arterial pathology(1-13). We present the assessment of coronary artery disease in a 82-year-old male and another 57-year old male using a MSCT coronary angiography with 64-slice technology which was first described by Leschka S et al (5). First patient was admitted to the Cardiology Department with exercise dispnea, and palpitation from time to time for about one month. ECG and Exercise ECG ( Maxi-mal effort test) were normal. The patient who was a medical doctor denied directly conventional coronary angiography and 64-slice multi-detector CT technique was performed (Fig.1). Coronary artery plaque leading to severe coronary artery stenosis (%95) at the middle segment of LAD was detected and served as a guide for doing coronary angiography and for determining type and size of the stent. Single coronary lesion (LAD) was detected by coronary angiography (Fig.2) and the result was completely parallel to MSCT. Percutaneous coronary intervention was performed for LAD lesion and a drug-eluting stent was implanted after predilatation.The patient was exam-inved routinely every three mounths. He was asymptomatic at the end of the three years after the procedure.

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  • 1. Wilson GT, Gopalakrishnon P, Tak T. Noninvasive cardiac imaging with computed tomography. Clin Med Res. 2007 Oct; 5 (3): 165-71.
  • 2. Saia F, Schaar J, Regar E, Rodriguez G, De Feyter PJ, Mastik F, Marzocchi A, Marrozzini C, Ortolani P, Palmarini T, Branzi A, van der Steen AF, Serrays PW. Clinical imaging of the vulnerable plague in the coronary arteries: new intracoronary diagnostic methods. J Cardiovasc Med (Hagerstown) 2006; 7:21-28.
  • 3. Schroeder S, Kopp AF, Baumbach A, Meisner C, Kuettner A, Georg C, Ohnesorge B, Herdeg C, Claussen CD, Karsch KR. Noninvasive detection and evaluation of atherosclerotic coronary plaques with multislice computed tomography. J Am Coll Cardiol 2001; 37:1430-1435
  • 4. Hoffmann U, Ferencik M, Cury RC, Pena AJ. Coronary CT angiography. J Nucl Med. 2006; 47:797-806.
  • 5. Leschha S, Alkadhi H, Plass A, Desbiolles L,Grunenfelder J, Merincek B,Wildermuth S.Accuracy of MSCT coronary an-giograghy with 64-slice technology: First ex-perience. Eur Heart J 2005;26: 1482-1487.
  • 6. Hendel RC, Patel MR, Kramer CM, Poon M, Hendel RC, Carr JC, Gerstad NA, Gillam LD, Hodgson JM, Kim RJ, Kramer CM, Lesser JR, Martin ET, Messer JV, Redberg RF, Rubin GD, Rumsfeld JS, Taylor AJ, Weigold WG, Woodard PK, Brindis RG, Hendel RC, Douglas PS, Peterson ED, Wolk MJ, Allen JM, Patel MR; American College of Cardiology Foundation Quality Strategic Directions Committee Appropriateness Criteria Working Group; American College of Radiology; Society for Cardiovascular Magnetic Resonance; American Society of Nuclear Cardiology; North American Society for Cardiac Imaging; Society for Cardiovascular Angiography and Interventions; Society of Interventional Radiology. ACCF/ ACR/SCCT/SCMR/ASNC/NASCI/SCAI/ SIR 2006 appropriateness criteria for cardiac computed tomography and cardiac magnetic resonance imaging: a report of the American College of Cardiology Foundation Quality Strategic Directions Committee Apporpriateness Criteria Working Group, American College of Radiology, Society of Cardiovascular Computed Tomography, Society for Crdiovascular Magnetic Resonance, American Society of Nuclear Cardiology, North American Society for Cardiac Imaging, Society for Cardiovascular Angiography and Interventions, and Society of Interventional Radiology. J Am Coll Cardiol 2006; 48:1475-1497.
  • 7. Budoff MJ, Achenbach S, Blumenthal RS, Carr JJ, Goldin JG, Greenland P Guerci AD, Lima JA, Rader DJ, Rubin GD, Shaw LJ, Wiegers SE; American Heart Association Committee on Cardiovascular Imaging and Intervention; American Heart Association Council on Cardiovascular Imaging and Intervention; American Heart Association Committee on Cardiovascular Imaging, Council on Clinical Cardiology. Assessment of coronary artery disease by cardiac computed tomography. A scientific statement from the American Heart Association Committee on Cardiovascular Imaging and Intervention, Council on Cardiovascular Radiology and Intervention, and Committee on Cardiac Imaging, Council on Clinical Cardiology. Circulation 2006; 114:1761- 1791.
  • 8. Achenbach S, Moselewski F, Ropers D, Ferencik M, Hoffmann U, MacNeill B, Pohle K, Baum U, Anders K, Jang IK, Daniel WG, Brady TJ. Detection of calcified and noncalcified coronary atherosclerotic plaque by contrast-enhanced, submillimeter multidetector spiral computed tomography: a segment-based comparison with intravscular ultrasound. Circulation 2004; 109:14-17.
  • 9. Kopp AF, Schroeder S, Baumbach A, Kuettner A, Georg C, Ohnesorge B, Heuschmid M, Kuzo R, Claussen CD. Noninvasive characterisation of coronary lesion morphology and composition by multislice CT: first results in comparison with intracoronary ultrasound. Eur Radiol 2001; 11:1607-1611.
  • 10. Dirksen MS, Bax JJ, de Ross A, Jukema JW, van der Geest RJ, Geleijns K, Boersma E, van der Wall EE, Lamb HJ. Usefulness of dynamic multislice computed tomography of left ventricular function in unstable angina pectoris and comparison with echocardiography. Am J Cardiol 2002; 90:1157- 1160.
  • 11. Erzengin F, Büyüköztürk K. Cardiac Imaging, Internal Medicine (Clinical Text Book, 3000 pages.) in part 2. Edit: Prof. Dr.K.Büyüköztürk. Nobel Tıp LTD. Pages. 1663-1686; 2007.
  • 12. Filippo Cademartiri, Erica Maffei, Nico R.Mollet. Is dual-source CT coronary angiography ready fort the real world? Department of Radiology and Cardiology, Erasmus Medical Center, Rotterdam, The Netherlands; Department of Radiology and Cardiology, Azienda Ospedaliero-Universitaria/ University Hospital, Parma, Italy. Eur Heart Journal (2008) 29, 701-703.
  • 13. Erzengin F. Adventitial calcification: Surprise location and a new pathway. The 59th The European Cardiovasculer-Cardiology Congress, 18-23 April, İzmir, TURKEY.
  • 14. ) Erzengin F. The 7 8th EAS(European Atherosclerosis Society) Congress 19-24 th June 2010/ Hamburg - Germany (Accepted).
Ankara Üniversitesi Tıp Fakültesi Mecmuası-Cover
  • Başlangıç: 1947
  • Yayıncı: Erkan Mor
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