Superior Mesenteric Artery Syndrome Analysis

Cardiovascular Assessment: No visible pulsations, no heaves or lifts. Apical pulse present in the fifth intercostal space at the left midclavicular line. Auscultation of apical rate 62 beats per minute, normal rhythm regular S1 - S2 heart sounds present. Pulsations present when supine and disappear at a 45 degree angle position. Extremities are brown color without redness, cyanosis, lesions or varicosities bilaterally. Temperature warm bilaterally, Allen test was negative. Homan’s sign negative. Carotids: +2 and present bilaterally. Right Radial +2, left radial +1 , Right Brachial: +2

Anomalous coronary arteries currently affect approximately 1% of the population. And due to the lack of frequency in which coronary anomalies occur, interest and ability to research these anomalies is lacking. The issue is that athletes, specifically young healthy athletes, are at large risk of death from coronary anomalies. In fact, anomalies cause 11.8% of deaths in amateur athletes. This has lead to a current increase in research of these anomalies. Coronary anomalies are typically present at birth, but due to their lack of symptoms they are rarely diagnosed. Encompassing a wide spectrum, these anomalies include but are not limited by: separation of the LAD and LC from the valsalva, absent left circumflex, ectopic origin of the RCA, small

There were no differences in age and education between the OSA group and the non-OSA group. There were higher rates of male patients (67% vs. 20%, p< 0.03) compared to those in the non-OSA group. Further, among those in the highest quartile of ischemic microvascular burden (highest quartile of both DWMH and PVH volumes), 80% of them were in the OSA group. Moreover, patients in the OSA group had a higher rate of having advanced lesions, such as beginning confluence of foci or large confluent areas, compared to those in the non-OSA group (t=2.96, p<0.001).

Thank you for your post Rhea. You have identified key takeaways for emerging benefits and limitations of the three imaging modalities for diagnosing PAD. I would like to reverberate your thoughts on the disease process for emphasis. Patients with notable symptoms of peripheral arterial disease (PAD) with affectation of lower extremities are primarily assessed with an ankle-brachial index and segmental pressure measurements (Pollak, Norton, & Kramer, 2012). Classification of PAD can be accomplished with noninvasive angiography utilizing computed tomography (CTA) or magnetic resonance angiography (MRA), as well as with duplex ultrasonography (US) depending on patient’s specific needs and limitations (Pollak, Norton, & Kramer). In my further

A 45-year-old male comes into the emergency department with symptoms of acute dizziness, dyspnea, chest pressure, and palpitations. He states that he feels that his heart is “racing.”. He has a history of hypertension (HTN) and coronary heart disease (CAD) status post one bare metal stent. He is currently on clopidogrel, aspirin, metoprolol, and Llisinopril. His BP blood pressure is 87/60 mmHg, pulse heart rate 160–-170 beats/min, respirations rate 26 breaths/min, oxygen saturation 90% on room air, and afebrile. His physical exam has pertinent positive findings of diminished global breath sounds and rapid sinus heart sounds. He has no jugular venous distention (JVD), abdominal tenderness, nuchal rigidity, lower extremity swelling, or focal

The arterial stenosis is frequently mistakenly identified. Acute ischemia can also be caused by the simultaneous development of portal hypertension or thrombosis of the Superior mesenteric vein. Identify this disease in the beginning is difficult that’s why imaging studies are very important in these cases. As time passes it was noticed that the aorta has becoming more tortuous, especially in women and those who are committed with hypertension. Thus, sometimes aorta can be seen compressing the inferior vena cava. Aorta can suffer alteration in its size, commonly aortic dilatation. Sometimes involves the full length of the vessel, including the thoracic segment, and is associated with marked lengthening of the artery, a situation defined as dolichoectasia of the aorta.

Change is never easy. However, survival is not a luxury, it is a necessity. Peripheral arterial diseases (PAD) are required to be managed wisely or it can turn into a threat perilous threat. PAD management has 2 main goals, to lower cardiovascular risk & to improve the ability to walk.

Echocardiographic examination revealed diastolic relaxation delay with an ejection fraction of 67%. Cerebral MR angiography demonstrated 85-90% stenosis at the proximal part of the basilar artery and 40-50% stenosis at the cavernous segment of the right internal carotid artery (ICA). Digital subtraction angiography (DSA) was performed, which revealed stenoses in the distal segments of the bilateral internal carotid arteries, V4 segments of the bilateral vertebral arteries and at the junction of basilar artery, which were more prominent on the right side (Figure 2).

In 1963, Harjola3 described a case of chronic abdominal pain in a young woman that he attributed to mesenteric ischemia caused by extrinsic compression of the celiac artery. Since then, the topic has been the focus of numerous controversies regarding its pathophysiology, definitive diagnosis, and optimal treatment4. There is still considerable doubt about the real existence of the CACS. Asymptomatic compression or stenosis of the celiac artery is common, and compression of this artery by fibers of the median arcuate ligament has been demonstrated on arteriography in asymptomatic patients1. Similarly, autopsy studies have shown that the celiac artery is compressed by the median arcuate ligament in up to one-third of individuals5. The difficulty

Ms. Karen Johnson, a 60-year-old woman who presents cyanosis, arteriostenosis and some problems in the heart electric’s system. This patient has suffered bradycardia and hypertension based on her previous medical history in last 5 years. She has no symptoms of pyrexia, and epigastric pain. There is no abnormality in her abdominal organs.

Angina pectoris is a term used to describe the syndrome of chest pain resulting from myocardial ischemia (Griffin et al., 2008). Normal non-ischemic myocardial tissues differ from the cardiac tissue of an individual with myocardial ischemia because the normal tissue has adequate blood supply whereas the tissue in angina has inadequate blood supply from blocked coronary arteries. Unstable angina is diagnosed when ischemia is neither severe nor prolongs for more than 20 minutes and regularly occurs at rest (Sami & Willerson, 2010). Patients who have unstable angina are at a high risk for a new infarction and its sequelae such as cardiac death until the endothelial injury is repaired. The purpose of this paper is to present a case analysis of

Each carotid artery was palpated one at the time and rated 2+ equal bilaterally with smooth contour. There was no presence of JVD. Auscultation at angle of jaw, midcervical area, and base of the neck, no presence of bruits. Precordium, no heaves visible. Heart auscultated with a diaphragm of the stethoscope. Regular rhythmic S2 and S1 sound heard at aortic, pulmonic, erb’s point, and tricuspid, no presence of murmur or splitting. Apical pulse listened for one full minute at 5th intercostal space in the left midclavicular line, rated 84, loud with regular rhythmic. History of hypertension. Client denied history of coronary arteries disease. Labs Na/138, K/3.9, Cl/10.2, Calcium/8.8, CO2/27.4, Anion gap/12.5; CBC with PLT no differential, RBC/3.54, HGB/10.5, HCT 30.8, PLT/275. Currently taking metoprolol (50 mg tabs PO BID) to manage heart rate. Diltiazem 120 mg PO daily for hypertension. Lovenox 40 mg subcutaneous every 24 hours to prevent deep vein thrombosis.

It is to be noted that the patient was involved in a motor vehicle accident on 13/08/2012, at which time he sustained a fracture of the shaft of the left humerus. This was treated conservatively in a U-slab. Furthermore, Prof. Aden found that he also sustained a dislocation of the left shoulder as well as an open Lisfranc injury of the left foot. The shoulder dislocation was reduced and the open Lisfranc injury was cleaned, stitched, reduced and treated in a below-knee cast.

Discrepancy in the results between contrast enhanced MRI & TRICKS –MRA regarding the size of the nidus was seen in (3) patients ( > or < 2cm) & in the number of the feeding arteries (Single or multiple) in ( 6) patients. This discrepancy had changed the choice of treatment where embolization was successful in 6 cases, combined embolization and surgery needed in five cases, while sclerotherapy was significant in 4cases of small AVM nidus (

An experienced board certified interventional radiologist read, analyzed and interpreted the CT venography and DSA data. Clinical presentations, compression of the left common iliac vein by the right common iliac artery, presence of collateral veins, narrowing of LCIV lumen and degree of stenosis was considered as the diagnostic criteria for diagnosing MTS. The compression level of LCIV was calculated and rated on CT using a method described by Narayan et al.(11) in which distal RCIV was used as the reference denominator to calculate the percentage of left iliac vein compression. The percentage was then used to rate compression level of LCIV as none (0%-25%), mild (>25%-50%), moderate (>50%-75%) and severe (>75%). Many studies and literature(12)