Thagachagere Ramegowda Raghu

Idiopathic dilatation of the pulmonary artery-a case report.

Idiopathic dilatation of the pulmonary artery (IDPA) is a rare anomaly presenting with enlargement of the pulmonary artery in the absence of an identifiable cause. The natural history of this silent but potentially life‐threatening disease can be unpredictable. We report a case of IDPA in an 80‐year‐old female with a massively dilated pulmonary artery.

Acute Pulmonary Thromboembolism Masquerading as Pneumocystis Ji-roveci Pneumonia in a Newly Detected HIV Positive Patient

Pneumocystis jiroveci pneumonia is a very well documented opportunistic infection in retro-positive individuals. Studies have shown that venous and arterial thrombosis occurs with increased frequency in patients infected with HIV. The reported frequency of venous thromboembolism varies between 0.19% to 7.63%/ year and that of pulmonary thromboembolism around 0.26%. But here, we report a case in which a newly detected retro-positive patient had both pneumocystis jiroveci pneumonia and pulmonary thromboembolism leading to a diagnostic delay of PCP pneumonia.

Aortoiliac reconstruction in the setting of in-stent restenosis

Complex iliac artery obstructions, particularly bilateral stenosis or total iliac artery occlusions, are usually treated with aortofemoral or aortobifemoral graft surgery. However, surgical treatment is associated with 3% mortality rate and significant morbidity such as intestinal ischemia, spinal cord injury, and ureteral damage. Percutaneous interventions of aortic bifurcation offer a promising alternative to surgery with potentially lower morbidity and mortality risk. We report a case of peripheral artery disease who had underwent right transfemoral iliac angioplasty with femoropopliteal bypass presented again with bilateral lower limb ischemia, who was successfully treated with stent implantation with the kissing balloon technique.

Rheumatoid Arthritis and Acute Coronary Syndrome: Changing Clinical Presentation

Rheumatoid arthritis is a chronic systemic infl ammatory disease, Rheumatoid arthritis can affect the pericardium, myocardium, and endocardium. RA increases cardiovascular morbidity and mortality by accelerated atherosclerosis.

Unprotected Distal LMCA Angioplasty with Simulataneous Kissing Stent (SKS) Technique in Left Dominant Coronary Circulation: A Nightmare for Interventionist Case Report

Left main coronary artery stenosis is the most challenging lesion in patients with acute coronary syndromes. Since the amount of myocardium at risk is very high, the patient is often in cardiogenic shock, and the risk of death is high and even more so in left dominant coronary system. Left main stenosis is a Class I indication for CABG -ACC/AHA guidelines and has been a relative contraindication to PCI. We report an elderly patient presenting with ACS with ECG showing ST elevation in lead a VR. Coronary angiogram revealed left dominant system with left main stenosis and ostioproximal LAD and LCX disease. Double stenting of the unprotected left main with bifurcation disease done with SKS technique with simultaneous stenting and post balloon dilatation was done with good results. Current guidelines still indicate CABG as optimal treatment for LMCA lesions. The choice of stenting technique for LMCA bifurcations should be based on bifurca- tion morphology.

Trepopnoea due to aneurysm of the descending thoracic aorta compressing the heart: an unusual occurrence

Trepopnoea is a symptom often described in relation to heart failure especially in cases having right-sided pleural effusion or other forms of unilateral lung disease.1–3 A 50-year-old man with a history of development of severe breathlessness, profuse sweating, palpitations and dizziness on right decubitus position for the past 1–2 months was admitted with accelerated hypertension with acute pulmonary oedema. His blood pressure at the time of admission was 180/90 mm Hg, which dropped to 90/60 mm Hg every time the patient turned to the right lateral position. Echocardiography showed a large descending thoracic aortic aneurysm measuring 8.1×6.5 cm with spontaneous echo contrast …

Bilateral coronary ostial stenosis with bilateral renal ostial stenosis in cardiovascular syphilis: de novo percutaneous coronary intervention and in-stent restenosis

A 45-year-old gentleman with no cardiovascular risk factors presented with anterior wall myocardial infarction. The coronary angiogram showed critical ostial stenosis of both the right coronary artery (RCA) and the left main coronary artery (LMCA) with normal coronary bed distally. A 3.5 × 13 mm drug-eluting stent (DES) was implanted in the RCA and a 2.75 × 12 mm DES was implanted in the LMCA. …

UFO in the heart: revealed during balloon mitral valvuloplasty for severe mitral stenosis

A 39-year-old man presented with worsening dyspnoea on exertion of 1-year duration. Cardiac auscultation revealed a loud first heart sound with a soft, rumbling mid-diastolic murmur. ECG showed P mitrale with tall R wave in V1. Chest roentgenogram revealed cardiomegaly with straightening of the left heart border suggestive of left atrial (LA) appendage enlargement, dilation of the right and left pulmonary arteries (horizontal arrows) and prominence of the both upper lobe …

Primary aortic thrombus in young: a rare site, a novel treatment

A 35-year-old man previously asymptomatic, non-smoker presented with a history of acute onset severe ischaemic pain, paraesthesia and pulselessness involving the left upper limb from the axillary artery distally since 3 days, not preceded by fever or chest pain. ECG was normal and transthoracic echocardiogram showed a normally functioning heart with an abnormal mass in the arch of aorta, which could not be characterised adequately. There was no aortic regurgitation. CT aortogram revealed a large, immobile thrombus fixed in the arch of aorta causing subtotal occlusion of the ostium of the left subclavian artery, with the rest of the aorta having no evidence of atherosclerosis or aortitis …

Post angioplasty free wall rupture

Abstract Left ventricular free wall rupture (LVFWR) is an uncommon but mostly fatal complication. Its occurrence in the setting of rescue angioplasty is still rare. We report a case of LVFWR which was not directly related to the procedure and despite early recognition and treatment, was fatal.