Non-Atherosclerotic Causes of Acute Coronary Syndrome and Management of The Patients

Psöriyazis ve kardiyovasküler hastalık arasındaki ilişki son yıllardaki epidemiyolojik veriler ile desteklenmiştir. Psöriyazis hastalarında kardiyovasküler hastalıklarının birlikte görülme sıklığının artmasından dolayı dermatoloji uzmanları bu hastalığını bir sistemik hastalık olarak düşünmeli ve dikkatli olmalıdır. Bundan dolayı çalışmalar psöriyazis hastalığında kardiyovasküler hastalık gelişme riskini araştırmaya, özel stratejilerin ve kılavuzların geliştirelebilmesine yoğunlaşmıştır

Non-Atherosclerotic Causes of Acute Coronary Syndrome and Management of The Patients

Acute coronary syndromes (ACS) are one of the leading causes of death and morbidity in industrialized countries. Typical presentation includes acute chest pain, cardiac troponin elevation and possibly associated electrocardiogram abnormalities. In great majority of the cases, myocardial infarction (MI) is due to atherosclerosis, usually with plaque rupture and consequent vessel occlusion. However, a minority of patients may suffer an MI for a range of other rare reasons such as coronary vasospasm, coronary thrombosis in situ or embolization from a distal source, hypercoagulable states, spontaneous coronary dissection, some coronary anomalies including coronary bridges and inflammatory states.

___

  • Maseri A, Severi S, Nes MD, et al. Variant angina: one as- pect of a continuous spectrum of vasospastic myocardial ischemia. Pathogenetic mechanisms, estimated incidence and clinical and coronary arteriographic findings in 138 patients. Am J Cardiol 1978;42:1019–35
  • Ginsburg R, Schroeder JS, Harrison DC. Coronary artery spasm––pathophysiology, clinical presentations, diag- nostic approaches and rational treatment. West J Med 1982;136:398-410
  • Lange RA, Hillis LD. Cardiovascular complications of co- caine use. N Engl J Med 2001; 345: 351–8.
  • Minor RL Jr, Scott BD, Brown DD, Winniford MD. Cocaineinduced myocardial infarction in patients with normal coronary arteries. Ann Intern Med 1991; 115: 797–806.
  • Williams MJ, Restieaux NJ, Low CJ. Myocardial infarction in young people with normal coronary arteries. Heart 1998; 79: 191–4.
  • Dimmitt SB, Beilin LJ, Hockings BE. Verapamil withdrawal as a possible cause of myocardial infarction in a hyper- tensive woman with a normal coronary angiogram. Med J Aust 1988; 49: 218.
  • Kozeny GA, Ragona BP, Bansal VK, et al. Myocardial in- farction with normal results of coronary angiography fol- lowing diltiazem withdrawal. Am J Med 1986; 80:1184–6.
  • Yamagishi M, Miyatake K, Tamai J, Nakatani S, Koyama J, Nissen SE. Intravascular ultrasound detection of athero- sclerosis at the site of focal vasospasm in angiographi- cally normal or minimally narrowed coronary segments. J Am Coll Cardiol 1994;23:352–7.
  • Amant C, Hamon M, Bauters C et al. The angiotensin II type 1 receptor gene polymorphism is associated with coronary artery vasoconstriction. J Am Coll Cardiol 1997; 29: 486–90.
  • Meierhenrich R, Carlsson J, Brockmeier J, Miketic S, Sorges E, Tebbe U. Acute myocardial infarction in pa- tients with angiographically normal coronary arteries: clinical features and medium term follow-up. Z Kardiol 2000; 89:36–42.
  • Gehani AA, al-Mulla AW, Chaikhouni A et al. Myocardial infarction with normal coronary angiography compared with severe coronary artery disease without myocardial infarction: the crucial role of smoking. J Cardiovasc Risk 2001;8:1–8.
  • Tun A, Khan IA. Acute myocardial infarction with angio- graphically normal coronary arteries. Heart Lung 2000; 29: 348–50.
  • Kawano H, Ogawa H. Endothelial function and coronary spastic angina. Intern Med 2005; 44: 91–9.
  • Nitenberg A, Antony I, Foult JM. Acetylcholine-induced coronary vasoconstriction in young, heavy smokers with normal coronary arteriographic findings. Am J Med 1993; 95: 71–7.
  • Kugiyama K, Yasue H, Okumura K, et al. Nitric oxide activ- ity is deficient in spasm arteries of patients with coronary spastic angina. Circulation 1996;94:266–71.
  • Halcox JP, Schenke WH, Zalos G, et al. Prognostic value of coronary vascular endothelial dysfunction. Circulation 2002; 106: 653–8.
  • Stern S, Bayes de Luna A. Coronary artery spasm: a 2009 update. Circulation 2009;119:2531-4.
  • DeLoughery TG. Coagulation abnormalities and cardiovas- cular disease. Curr Opin Lipidol 1999; 10: 443–8.
  • Braunstein JB, Kershner DW, Bray P, et al. Interaction of hemostatic genetics with hormone therapy: new insights to explain arterial thrombosis in postmenopausal women. Chest 2002; 121: 906–20.
  • Anderson TJ. Assessment and treatment of endothelial dysfunction in humans. J Am Coll Cardiol 1999; 34: 631–8.
  • Ambrose JA, Barua RS. The pathophysiology of cigarette smoking and cardiovascular disease: an update. J Am Coll Cardiol 2004; 43: 1731–7.
  • Deb A, Caplice NM. Lipoprotein(a): new insights into mechanisms of atherogenesis and thrombosis. Clin Cardiol 2004; 27: 258–64.
  • Ammann P, Marschall S, Kraus M, et al. Characteristics and prognosis of myocardial infarction in patients with normal coronary arteries. Chest 2000; 117: 333–8.
  • Dacosta A, Tardy-Poncet B, Isaaz K, et al. Prevalence of factor V Leiden (APCR) and other inherited thrombophil- ias in young patients with myocardial infarction and nor- mal coronary arteries. Heart 1998; 80: 338–40.
  • Lande G, Dantec V, Trossaert M, Godin JF, Le Marec H. Do inherited prothrombotic factors have a role in myocardi- al infarction with normal coronary arteriogram? J Intern Med 1998; 244: 543–4.
  • Sadiq A, Ahmed S, Karim A, Spivak J, Mattana J. Acute myocardial infarction: a rare complication of protein C deficiency. Am J Med 2001; 110: 414.
  • Peterman MA, Roberts WC. Syndrome of protein C defi- ciency and anterior wall acute myocardial infarction at a young age from a single coronary occlusion with oth- erwise normal coronary arteries. Am J Cardiol 2003; 92: 768–70.
  • Menge H, Faig HG, Lang A, Fahrenkrog U, Lollgen H. Homozygous form of factor V Leiden mutation as the cause of a myocardial infarction in patient with an unremark- able coronary vascular system? Dtsch Med Wochenschr 2001; 126:684–6.
  • Alihanoglu YI, Alur I, Yildiz BS, Esin F, Bilge A. Myocardial Infarction in Young Female Patient Using Oral Contraseptives and Combination of Factor V Leiden Mutation. Journal of Academic Emergency Medicine. 2012 Article in pres. Ref. No:95967
  • Mansourati J, Da Costa A, Munier S et al. Prevalence of factor V Leiden in patients with myocardial infarction and normal coronary angiography. Thromb Haemost 2000; 83: 822–5.
  • Van de Water NS, French JK, Lund M, Hyde TA, White HD, Browett PJ. Prevalence of factor V Leiden and prothrom- bin variant G20210A in patients age <50 years with no significant stenoses at angiography three to four weeks after myocardial infarction. J Am Coll Cardiol 2000; 36: 717–22.
  • Rallidis LS, Belesi CI, Manioudaki HS, et al. Myocardial in- farction under the age of 36: prevalence of thrombophilic disorders. Thromb Haemost 2003; 90: 272–8.
  • Da Costa A, Tardy B, Haouchette K, et al. Long term prog- nosis of patients with myocardial infarction and normal coronary angiography: impact of inherited coagulation disorders. Thromb Haemost 2004; 91: 388–93.
  • Al-Obaidi MK, Philippou H, Stubbs PJ, et al. Relationships between homocysteine, factor VIIa, and thrombin genera- tion in acute coronary syndromes. Circulation 2000; 101: 372–7.
  • Ogawa M, Abe S, Saigo M, et al. Homocysteine and hemo- static disorder as a risk factor for myocardial infarction at a young age. Thromb Res 2003; 109: 253–8.
  • Steele P, Rainwater J, Vogel R. Abnormal platelet survival time in men with myocardial infarction and normal coro- nary arteriogram. Am J Cardiol 1978; 41: 60–2.
  • Schindler AE. Differential effects of progestins on hemo- stasis. Maturitas 2003; 46(Suppl. 1):S31–7.
  • Faraday N, Goldschmidt-Clermont PJ, Bray PF. Gender differences in platelet GPIIb-IIIa activation. Thromb Haemost 1997; 77: 748–54.
  • Khetawat G, Faraday N, Nealen ML, et al. Human mega- karyocytes and platelets contain the estrogen receptor beta and androgen receptor (AR): testosterone regulates AR expression. Blood 2000; 95: 2289–96.
  • Raymond R, Lynch J, Underwood D, Leatherman J, Razavi M. Myocardial infarction and normal coronary arteriogra- phy: a 10 year clinical and risk analysis of 74 patients. J Am Coll Cardiol 1988; 11: 471–7.
  • Brecker SJ, Stevenson RN, Roberts R, Uthayakumar S, Timmis AD, Balcon R. Acute myocardial infarction in patients with normal coronary arteries. BMJ 1993; 307: 1255–6.
  • Radomski MW, Moncada S. The biological and pharmaco- logical role of nitric oxide in platelet function. Adv Exp Med Biol 1993; 344: 251–64.
  • Allen RA, Kluft C, Brommer EJ. Acute effect of smoking on fibrinolysis: increase in the activity level of circulating extrinsic (tissue-type) plasminogen activator. Eur J Clin Invest 1984; 14: 354–61.
  • Verheugt FW, ten Cate JW, Sturk A, et al. Tissue plasmino- gen activator activity and inhibition in acute myocardial infarction and angiographically normal coronary arteries. Am J Cardiol 1987; 59: 1075–9.
  • Hamsten A, Wiman B, de Faire U, Blomback M. Increased plasma levels of a rapid inhibitor of tissue plasminogen activator in young survivors of myocardial infarction. N Engl J Med 1985;313:1557–63.
  • Hamsten A, Blomback M, Wiman B et al. Haemostatic function in myocardial infarction. Br Heart J 1986;55: 58–66.
  • Ichiki K, Ikeda H, Haramaki N, Ueno T, Imaizumi T. Longterm smoking impairs platelet-derived nitric oxide release. Circulation 1996; 94:3109–14.
  • Celermajer DS, Sorensen KE, Georgakopoulos D, et al. Cigarette smoking is associated with dose-related and potentially reversible impairment of endothelium-depen- dent dilation in healthy young adults. Circulation 1993; 88: 2149–55.
  • Kiowski W, Linder L, Stoschitzky K, et al. Diminished vas- cular response to inhibition of endothelium-derived ni- tric oxide and enhanced vasoconstriction to exogenously administered endothelin-1 in clinically healthy smokers. Circulation 1994; 90: 27–34.
  • Graziani MS, Zanolla L, Righetti G, et al. Lipoprotein(a) concentrations are increased in patients with myocardial infarction and angiographically normal coronary arteries. Eur J Clin Chem Clin Biochem 1993;31:135–7.
  • Sorensen KE, Celermajer DS, Georgakopoulos D, Hatcher G, Betteridge DJ, Deanfield JE. Impairment of endo- theliumdependent dilation is an early event in children with familial hypercholesterolemia and is related to the lipoprotein(a) level. J Clin Invest 1994;93:50–5.
  • Stein JH, Rosenson RS. Lipoprotein Lp(a) excess and coro- nary heart disease. Arch Intern Med 1997;157: 1170–6.
  • Juhan-Vague I, Pyke SD, Alessi MC, Jespersen J, Haverkate F, Thompson SG. Fibrinolytic factors and the risk of myo- cardial infarction or sudden death in patients with angina pectoris. ECAT Study Group. European Concerted Action on Thrombosis and Disabilities. Circulation 1996; 94: 2057–63.
  • Thogersen AM, Jansson JH, Boman K, et al. High plasmin- ogen activator inhibitor and tissue plasminogen activator levels in plasma precede a first acute myocardial infarc- tion in both men and women: evidence for the fibrinolytic system as an independent primary risk factor. Circulation 1998; 98: 2241–7.
  • Miyao Y, Fujimoto K, Kugiyama K, et al. Plasminogen ac- tivator inhibitor contributes to the coronary wall thick- ening in patients with angiographically normal coronary. Thromb Res 2003; 112: 123–9.
  • Rosendaal FR, Vessey M, Rumley A, et al. Hormonal re- placement therapy, prothrombotic mutations and the risk of venous thrombosis. Br J Haematol. 2002;116:851– 854.
  • ACC/AHA Task Force on Practice Guidelines (Writing Committee to Revise the 2002 Guidelines for the Management of Patients With Unstable Angina/Non–ST- Elevation Myocardial Infarction). ACC/AHA 2007 guide- lines for the management of patients with unstable an- gina/non–ST-elevation myocardial infarction. Circulation. 2007;116:e148–e304.
  • Andreotti F, Testa L, Biondi-Zoccai GG, Crea F. Aspirin plus warfarin compared to aspirin alone after acute coronary syndromes: an updated and comprehensive meta-analysis of 25,307 patients. Eur Heart J. 2006; 27:519 –526.
  • Galiuto L, Enriquez-Sarano M, Reeder GS, et al. Eosinophilic myocarditis manifesting as myocardial in- farction: early diagnosis and successful treatment. Mayo Clin Proc 1997; 72: 603–10.
  • Prizel KR, Hutchins GM, Bulkley BH. Coronary artery em- bolism and myocardial infarction. Ann Intern Med 1978; 88: 155– 61.
  • Yutani C, Imakita M, Ueda-Ishibashi H, Katsuragi M, Fujita H. Coronary artery embolism with special reference to invasive procedures as the source. Mod Pathol 1992; 5: 244–9.
  • Dollar AL, Pierre-Louis ML, McIntosh CL, Roberts WC. Extensive multifocal myocardial infarcts from cloth em- boli after replacement of mitral and aortic valves with cloth-covered, caged-ball prostheses. Am J Cardiol 1989; 64: 410–2.
  • Ackermann DM, Hyma BA, Edwards WD. Malignant neo- plastic emboli to the coronary arteries: report of two cases and review of the literature. Hum Pathol 1987; 18: 955–9.
  • Kraus PA, Lipman J. Coronary embolism causing myocar- dial infarction. Intensive Care Med 1990; 16: 215–6.
  • Obarski TP, Loop FD, Cosgrove DM, Lytle BW, Stewart WJ. Frequency of acute myocardial infarction in valve repairs versus valve replacement for pure mitral regurgitation. Am J Cardiol 1990; 65: 887–90.
  • Doty JR, Wilentz RE, Salazar JD, Hruban RH, Cameron DE. Atheroembolism in cardiac surgery. Ann Thorac Surg 2003; 75: 1221–1226.
  • Sharifi M, Frohlich TG, Silverman IM. Myocardial infarc- tion with angiographically normal coronary arteries. Chest 1995; 107: 36–40.
  • Freed LA, Benjamin EJ, Levy D, et al. Mitral valve pro- lapse in the general population: the benign nature of echocardiographic features in the Framingham Heart Study. J Am Coll Cardiol 2002; 40: 1298–304.
  • Theal M, Sleik K, Anand S, Yi Q, Yusuf S, Lonn E. Prevalence of mitral valve prolapse in ethnic groups. Can J Cardiol 2004; 20: 511–5.
  • Crump R, Shanding AH, Van Natta B, Ellestad M. Prevalence of patent foramen ovale in patients with acute myocar- dial infarction and angiographically normal coronary ar- teries. Am J Cardiol 2000; 85: 1368–1370.
  • Carano N, Agnetti A, Hagler DJ, Tchana B, Squarcia U, Bernasconi S. Acute myocardial infarction in a child: pos- sible pathogenic role of patent foramen ovale associ- ated with heritable thrombophilia. Pediatrics 2004; 114: e255–8.
  • Ross R. Atherosclerosis–an inflammatory disease. N Engl J Med 1999; 340: 115–26.
  • Rifai N, Ridker PM. High-sensitivity C-reactive protein: a novel and promising marker of coronary heart disease. Clin Chem 2001; 47: 403–11.
  • Cannon CP, Braunwald E, McCabe CH, et al. Antibiotic treatment of Chlamydia pneumoniae after acute coro- nary syndrome. N Engl J Med 2005; 352: 1646–54.
  • Korkmaz C, Cansu DU, Kasifoglu T. Myocardial infarction in young patients (\ or = 35 years of age) with systemic lupus erythematosus: a case report and clinical analysis of the literature. Lupus 2007; 16: 289–297.
  • Cocco G, Gasparyan AY Myocardial ischemia in Wegener’s granulomatosis: coronary atherosclerosis versus vasculi- tis. Open Cardiovasc Med J 2010; 4:57–62.
  • Rangel A, Lavalle C, Chavez E, et al. Myocardial infarc- tion in patients with systemic lupus erythematosus with normal findings from coronary arteriography and without coronary vasculitis– case reports. Angiology 1999; 50: 245–53.
  • Bukiej A, Dropinski J, Rys D, Musial J. Myocardial in- fraction as the first manifestation of systemic lupus erythematosus in a 22-year-old man. Pol Arch Med Wewn2004;111:213–6.
  • Luca NJ, Yeung RS. Epidemiology and management of Kawasaki disease. Drugs 2012 May 28;72(8):1029-38.
  • Bac DJ, Lotgering FK, Verkaaik AP, Deckers JW. Spontaneous coronary artery dissection during pregnancy and postpartum. Eur Heart J 1995;16:136–8.
  • Badmanaban B, McCarty D, Mole DJ, McKeown PP, Sarsam MA. Sponataneous coronary artery dissection presenting as cardiac tamponade. Ann Thorac Surg 2002;73:1324–6.
  • Thistlethwaite PA, Trazi RY, Giordano FJ, Jamieson SW. Surgical management of spontaneous left main coronary artery dissection. Ann Thorac Surg 1998;66:258–60.
  • Aliyary S, Mariani MA, Verhorst PM, Hartmann M, Stoel MG, von Birgelen C. Staged therapeutic approach in spontaneous coronary dissection. Ann Thorac Surg 2007;83:1879-81.
  • Kearney P, Singh H, Hutter J, Khan S, Lee G, Lucey J. Spontaneous coronary artery dissection: a report of three cases and review of the literature. Postgrad Med J 1993;69:940–5.
  • Madu EC, Kosinski DJ, Wilson WR, Burket MW, Fraker TD Jr, Ansel GM. Two-vessel coronary artery dissection in the peripartum period. Case report and literature review. Angiology 1994; 45: 809–16.
  • Kamineni R, Sadhu A, Alpert JS. Spontaneous coronary ar- tery dissection: report of two cases and a 50-year review of the literature. Cardiol Rev 2002; 10: 279–84.
  • Pretty HC. Dissecting anneurysm of coronary artery in a woman aged 42; rupture. BMJ 1931;1:667.
  • Jorgensen MB, Aharonian V, Mansukhani P, Mahrer PR. Spontaneous coronary artery dissection: A cluster of cases with this rare finding. Am Heart J 1994;127:1382–7.
  • Heefner WA. Dissection haematoma of the coronary ar- tery. JAMA 1973;223:550–1
  • Koul AK, Hollander G, Moskovits N, Frankel R, Herrera L, Shani J. Coronary artery dissection during pregnancy and the postpartum period: Two case reports and review of literature. Catheter Cardiovasc Interv 2001;52:88–94.
  • Bager AC, Beeuwkes R, Ainey L, Silverman K. Hypothesis: Vasa vasorum and neovascularisation of human coronary arteries. A possible role in the pathophysiology of athero- sclerosis. N Engl J Med 1984;310:175–7.
  • Robinowitz M, Virmani R, McAllister H. Spontaneous coro- nary artery dissection and eosinophilic inflammation: A cause and effect relationship. Am J Med 1982;72:923–8.
  • Dowling GP, Buja LM. Spontaneous coronary artery dissec- tion occurs with and without peri-adventitial inflamma- tion. Arch Pathol Lab Med 1987;111:470–2.
  • Steinhauer JR, Caulfield JB. Spontaneous coronary artery dissection associated with cocaine use: A case report and brief review. Cardiovasc Pathol 2001;10:141–5.
  • Ellis CJ, Haywood GA, Monro JL. Spontaneous coronary artery dissection in a young woman resulting from intense gymnasium “work-out” Int J Cardiol 1994;47:193–4.
  • Masuda T, Akiyama H, Kurosawa T, Ohwada T. Long-term follow-up of coronary artery dissection due to blunt chest trauma with spontaneous healing in a young woman. Intensive Care Med 1996;22:450–2.
  • Borczuk AC, van Hoeven KH, Factor SM. Review and hy- pothesis: The eosinophil and peripartum heart disease (myocarditis and coronary artery dissection)--coincidence or pathogenetic significance? Cardiovasc Res.1997;33:527– 32.
  • Bonacchi M, Prifti E, Giunti G, et al. Emergency man- agement of spontaneous coronary artery dissection. J Cardiovasc Surg (Torino) 2002;43:189–93.
  • Martín Dávila F, Delgado Portela M, García Rojo M, et al. Coronary artery dissection in alpha-1-antitrypsin defi- ciency. Histopathology 1999;34:376–8.
  • Azam MN, Roberts DH, Logan WF. Spontaneous coronary artery dissection associated with oral contraceptive use. Int J Cardiol 1995;48:195–8.
  • Saunders SL. Spontaneous coronary artery dissection possibly related to drug hypersensitivity in a male. Gen Physiol Biophys 1990;9:291–9.
  • Basso C, Morgagni GL, Thiene G. Spontaneous coronary artery dissection: a neglected cause of acute myocardial ischaemia and sudden death. Heart 1996; 75: 451–4.
  • Engelman DT, Thayer J, Derossi J, Scheinerman J, Brown L. Pregnancy related coronary artery dissection: A case report and collective review. Conn Med 1993;57:135–9.
  • Mortensen KH, Thuesen L, Kristensen IB, Christiansen EH. Spontaneous coronary artery dissection: A Western Denmark Heart Registry Study. Catheter Cardiovasc Interv 2009;74:710–7.
  • Arnold JR, West NE, van Gaal WJ, Karamitsos TD, Banning AP. The role of intravascular ultrasound in the man- agement of spontaneous coronary artery dissection. Cardiovasc Ultrasound 2008;6:24.
  • Maeder M, Ammann P, Angehrn W, Rickli H. Idiopathic spontaneous coronary artery dissection: Incidence, diag- nosis and treatment. Int J Cardiol 2005;101:363–9.
  • Sarmento-Leite R, Machado PR, Garcia SL. Spontaneous coronary artery dissection: Stent it or wait for healing? Heart 2003;89:164.
  • Benham R, Tillinghast S. Thrombolytic therapy in spontaneous coronary artery dissection. Clin cardiol 1991;14:611–4.
  • Almeda F, Barkatullah S, Kavinsky CJ. Spontaneous coro- nary artery dissection. Clin Cardiol 2004;27:377–80.
  • Antman EM, Anbe DT, Armstrong PW, et al. ACC/AHA Guidelines for the management of patients with ST- elevation myocardial infarction: Executive summary. J Am Coll Cardiol 2004;44:671–719.
  • Atay Y, Yagdi T, Turkoglu C, Altintig A, Buket S. Sponatneous dissection of the left main coronary artery: A case report and review of the literature. J Card Surg 1996;11:371–5.
  • Levin DC, Fellows KE, Abrams HL Hemodynamically sig- nificant primary anomalies of the coronary arteries. Angiographic aspects. Circulation 1978;58:25–34.
  • Angelini P Coronary artery anomalies: an entity in search of an identity. Circulation 2007;115:1296–1305.
  • Irvin RG. The angiographic prevalence of myocardial bridging in man. Chest 1982;81:198–202.
  • Soran O, Pamir G, Erol C, et al The incidence and sig- nificance of myocardial bridge in a prospectively defined population of patients undergoing coronary angiography for chest pain. Tokai J Exp Clin Med 2000;25:57–60.
  • Alegria JR, Herrmann J, Holmes DR Jr, et al. Myocardial bridging. Eur Heart J 2005; 26:1159–1168.
European Journal of General Medicine-Cover
  • Başlangıç: 2015
  • Yayıncı: Sağlık Bilimleri Araştırmaları Derneği
Sayıdaki Diğer Makaleler

Indications for Percutaneous Closure in Adult Congenital Heart Defect

Mehmet Güngör KAYA, İdris ARDIÇ

Takayasu&#8217;s arteritis and mitral stenosis---a rare association

Goutam DATTA, Biswakesh MAJUMDER, Dipankar MUKHERJEE

Common interosseous artery arising from the radial artery and ulnar artery origin from proximal brachial artery: multipl arterial variants

Suat KESKİN, Zeynep KESKİN, Mehmet Akif TEBER

Sinus Node Dysfunction and Atrial Fibrillation Associated with Isolated Sinoatrial Node Artery Ectasia

Ahmet KARABULUT, Bulent UZUNLAR

Inferior wall aneurysm of the left ventricle and severe mitral regurgitation following acute myocardial infarction

Murat YÜKSEL, Nihat POLAT, Ertan VURUSKAN, İdris ARDIÇ

Non-Atherosclerotic Causes of Acute Coronary Syndrome and Management of The Patients

Yusuf İzzettin ALİHANOGLU, İsmail Dogu KİLİC, Bekir Serhat YİLDİZ

Pseudoephedrine- induced Ventricular Tachycardia

Meryem TAHMAZ, Baki KUMBASAR, Savas OZTURK, Rumeyza KAZANCİOGLU

A rare vasculitis of childhood, Takayasu arteritis: Report of two cases

Aydın ECE, Velat ŞEN, Sevgi YAVUZ, Ali GÜNEŞ, Ünal ULUCA, Cahit ŞAHİN

Disintegration of a Balloon-Expandable Stent in the Iliac Artery upon Delivery: Successful Endovascular Management

Fuat ÖZKAN, Bora PEYNİRCİOĞLU, Murat CANYİGİT, Onur ERGUN, Barbaros Erhan CİL, Saruhan CEKİRGE

Extensive Intestinal Ischemia After Acute Aortic Dissection

Fehmi ATES, Serkan YARAŞ, Bünyamin SARITAŞ, Engin ALTINTAŞ, Orhan SEZGİN