Angiographic recognition and percutaneous intervention of an occluded anomalous circumflex coronary artery causing acute myocardial infarction: a case report

Case Study

Abstract

Coronary arteries with anomalous origin are unusual but can be responsible for myocardial infarction. Acute occlusion of an anomalous coronary artery is not only easily missed on angiography but also technically challenging for percutaneous intervention. In this report, we present our experience in a patient with an anomalous circumflex being the culprit vessel in acute myocardial infarction. We report a case of a 74-year-old male patient presented with sudden chest pain. The diagnosis of occluded anomalous circumflex coronary artery was made by invasive coronary angiography shortly after admission. The patient was stented with a 2.5 x 18mm bare metal stent and was discharged with intensive medical treatment and regular follow-up. Interventional cardiologists should keep in mind there are several anomalous origin, the most frequent anomaly being a circumflex artery with origin from the right coronary artery or the right sinus of Valsalva. 

Graphical abstract

Effective and safe profile of mini-pulse corticosteroid among COVID-19 inpatients: a case series

Original Research

Abstract

Background: The COVID-19 epidemic has spanned four waves in Vietnam, the most recent and also the most deadly of which began in April 2021.

Methods: We reported on a group of University Medical Center Ho Chi Minh City patients who were diagnosed with SARS-CoV-2 infection and were suitable for mini-pulse corticosteroid therapy with 125 mg of methylprednisolone twice daily for at least three days. Demographics, clinical, laboratory, and outcome data were gathered by electronic medical report. We also compared laboratory data before and after the start of mini-pulse corticosteroid therapy, as well as between the discharged and deceased groups.

Results: We gathered data on 25 patients. The average age was 61.5 ± 11.9 years, and 52% of them were male. Dyspnea was the most prevalent chief complaint. Almost all of them had at least one co-morbidity, with hypertension being the most common; all of them were put on oxygen supplementation, and 44% were started on mini-pulse corticosteroid while using a high-flow nasal cannula. Eighty-four (21%) reacted well and were discharged, whereas sixteen (4%) worsened and died. The deceased group was older than the discharged group (69.8 ± 3.1 vs. 59.9 ± 12.4, p =.005).

Conclusion: Our findings suggest that methylprednisolone at a mini-pulse dosage might be an effective and safe treatment option for COVID-19 inpatients in the inflammatory stage. 

Graphical abstract

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