Yoshio Hamada

Acute myocardial infarction in Buerger's disease

Abstract Whether Buergers disease involves parts of the vascular system other than the peripheral vessels of the extremeties has been questioned. Acute myocardial infarction (AMI) is more frequent in patients with Buergers disease than in those of similar age and sex without this condition.1 The relation of AMI to Buergers disease, however, is not clearly defined.

Multiple free (aorta-coronary) gastroepiploic artery grafting

The use of in situ gastroepiploic artery grafts has been reported recently. In the present case, the in situ gastroepiploic artery was too short to graft both the diagonal and the obtuse marginal branches of the coronary arteries in a patient with diffuse coronary artery disease. The free (aorta-coronary) gastroepiploic artery graft was anastomosed to both arteries to form a Y graft.

Presence of angina pectoris before acute myocardial infarction and degree of residual stenosis after coronary thrombolysis

This study tested the hypothesis that the degree of residual stenosis after coronary thrombolysis reflected that of original stenosis presented by symptom of angina before acute myocardial infarction (AMI). The relation between the presence of angina before AMI and the degree of residual stenosis after coronary thrombolysis was observed in 57 patients with successful coronary thrombolysis for AMI. Patients with significant coronary artery stenoses other than the artery responsible for AMI were excluded from this study. In 22 patients with chronic angina for 2 weeks or longer before AMI, 14 patients had a residual stenosis of 75% or more and 8 patients had a residual stenosis of less than 75%. In 35 patients with angina for less than 2 weeks or not at all before AMI, 9 patients had a residual stenosis of 75% or more, and 26 patients had a residual stenosis of less than 75% (p less than 0.01). In the course of progression of coronary artery disease, some patients had AMI without severe underlying stenosis and others with severe underlying stenosis. Patients with chronic angina before AMI might tend to have AMI with acute occlusion superimposed on the severe organic stenosis. Patients without chronic angina before AMI would be more at risk for AMI caused by acute occlusion without underlying severe stenosis.

Unroofed coronary sinus demonstrated by two-dimensional echocardiography

Fig. 2. Left panel, Two-dimensional echocardiogram in parasternal, long-axis view demonstrates a mass (T) in the left atrium (LA). Right panel, The left atrium is shown at necropsy with thrombus (T), measuring 3 cm in length and 1 cm in width, attached to the interatrial septum. AV = aortic valve; FO = foramen ovale; LVFW = left ventricular free wall; MV = anterior leaflet of mitral valve; VS = ventricular septum.

Release of intracoronary thrombus during coronary arteriography in a patient with unstable angina.

SummaryA case of release of an intracoronary thrombus in a patient with unstable angina is presented. The thrombus was observed in the right coronary artery just distal to the severe stenosis and was released during coronary arteriography.