Two consecutive fatal cases of acute myocardial infarction caused by free floating thrombus in the ascending aorta and review of literature

Free floating thrombus in the ascending aorta is an uncommon source of acute myocardial infarction. We report on two cases of young women who died of acute myocardial infarction caused by a free floating thrombus in the sinus of Valsalva obstructing the coronary arteries' ostia. The first case reports on a 30-year-old pregnant woman who anamnestically had episodes with short loss of consciousness and weakness. The second case presents a 37-year-old woman suffering from multiple sclerosis with no previous history of thrombotic events. The review of literature revealed a predominance of women (eight females and three males). Interestingly, the coronary arteries bear no preference concerning the right (RCA) or left coronary artery (LCA) being more often occluded by a free floating thrombus. Especially, younger women (mean age 45.5 years, range 30-59 years) with no history of cardiac symptoms and without atherosclerotic changes seem to be predispositioned. The hypothesis that thrombus formation in cases without plaque disruption may depend on an endothelial erosion which seems to be more common in younger women and promoted by a hyperthrombogenic state is supported by our two cases. A comprehensive literature search revealed, that these are the first two reports on a free floating thrombus being the cause of fatal acute myocardial infarction in a pregnant woman, respectively, a woman suffering from multiple sclerosis.     

Spontaneous Coronary Artery Dissection: Case Report and Literature Review

Spontaneous coronary artery dissection (SCAD) is a rare cause of acute myocardial infarction and sudden cardiac death. It occurs most commonly in otherwise healthy women during pregnancy or the postpartum period. The true incidence of SCAD is underestimated, as most cases are diagnosed at autopsy. The pathophysiology of SCAD is still not fully understood, and its management can be challenging. This report describes a 35‐year‐old pregnant female who presented with an acute antero‐lateral ST elevation secondary to spontaneous dissection of the left anterior descending artery and the circumflex artery. The diagnosis was established by coronary artery angiography. However, the patient died following cardiac tamponade. The examination of this case represented a starting point for the reviewing of the diagnosis, clinical course, and management of SCAD, and for the placing of this in context with the existing literature. This study highlights the importance of prompt diagnosis and subsequent lifesaving treatment.     

双峰驼肾动脉血管分布的铸型观察

运用管道铸型技术以及扫描电镜技术对双峰驼肾动脉血管进行了系统观察。结果显示,双峰驼肾动脉在入肾门前约4~8 cm处分为背干和腹干,入肾后在肾窦内相继形成肾段动脉。左右两肾段动脉的分支分布各有特点,各段动脉分支延伸至肾的皮髓交界处,形成弓形动脉;弓形动脉是叶间动脉的延续,并不与肾表面相平行;肾血管球以及出、入球微动脉因分布区域的不同,形态结构也不尽一致。表明,双峰驼肾各段动脉分布的规律性强,段动脉分支之间没有吻合支存在;肾各部位的血管球随分布区域的不同,其形态结构也呈现一定的变化。     

急性热应激对肉鸡股动脉压等生理指标的影响

通过对 30只 2 5日龄常温饲养的商品代雄性AA肉鸡 ,置于 4 2 .0℃± 0 .5℃控温小木箱中 ,给予高温刺激 ,并进行肉鸡股动脉压等指标的动态检测 ,探讨了肉鸡热应激发生发展的规律。结果显示 ,热暴露第 10min时平均股动脉压 (mFAP)显著下降 (P <0 .0 5 ) ,第 15～ 5 0min时平均股动脉压极显著下降 (P <0 .0 1) ,第 30min时股动脉收缩压最大变化速率 ( dp/dtmax)极显著升高(P <0 .0 1) ,第 5 0min时极显著降低 (P <0 .0 1) ;第 2 0min时股动脉舒张压最大变化速率(︱ -dp/dtmax︱ )极显著升高 (P <0 .0 1) ,第 4 0min时显著降低 (P <0 .0 5 ) ,第 5 0min时极显著降低 (P <0 .0 1)。平均股动脉压与呼吸频率、心率呈极显著正相关 (P <0 .0 1,n =4 5 ) ,相关系数分别为 0 .4 6 4和 0 .4 70 ;与体温呈极显著负相关 (P <0 .0 1,n =4 5 ) ,相关系数为 - 0 .790。证实 ,肉鸡的股动脉压在短时间内极显著下降 ,可能为高温条件下肉鸡死亡的主要原因。     

垂体后叶素致冠状动脉痉挛症的实验病理学研究

作者通过大鼠舌下静脉注射垂体后叶素致冠状动脉痉挛,运用组织学、酶组织化学及电镜技术研究冠状动脉痉挛症引起心肌急性缺血的形态学变化特点,同时对大鼠心肌自溶性变化与上述结果进行了分析比较,认为心肌纤维磷钨酸苏木素(PTAH)染色出现不规则横带且伴有心肌间质小血管壁腺苷三磷酸酶(ATPase)活性下降,有助于冠状动脉痉挛症引起心肌缺血的诊断。     

Death Due to an Unusual Angio‐Seal‐Related Complication: Case Report and Literature Review

Angio‐SealTM is a vascular closure device (VCD) that can be applied to the femoral artery following cardiac catheterization to achieve hemostasis. Although it has been demonstrated to be superior to conventional manual pressure and to reduce time to hemostasis and patient ambulation, the use of this VCD is not without its complications. In this report, we describe the case of a 55‐year‐old man who died due to an extremely rare event that occurred several hours after the deployment of an Angio‐SealTM VCD: acute complete transverse laceration of the femoral artery that occurred because of the particular fragility of the vessel due to an unrecognized and asymptomatic arteriosclerotic disease. Few data are available in the literature about the incidence of such events, and much more remains to be done to determine how to prevent and manage its occurrence.     

Sudden Death After Myocardial Infarction in a High‐School Athlete

Abstract: This is an unusual case of ischemic heart disease occurring in a young female athlete, aged 14 years, in whom almost the entire posterior wall of the left ventricle was affected. The patient collapsed and died suddenly after a vigorous physical activity while resting at home. The ischemic lesion was apparently owing to right orifice stenosis in association with a small hypoplastic right coronary artery.     

胆囊收缩素(CCK)在冠状动脉粥样硬化斑块中的表达

目的揭示胆囊收缩素(CCK)在冠状动脉粥样硬化斑块中的表达情况,以进一步探讨CCK在动脉粥样硬化形成过程中的作用。方法选用100例35～92岁男性尸检冠状动脉粥样硬化标本,分为粥样硬化Ⅰ～Ⅱ级组和Ⅲ～Ⅳ级组,同时设正常对照组,用免疫组化技术进行检测。结果对照组CCK呈阴性表达,而冠状动脉粥样硬化组呈阳性表达(P0.01),Ⅰ～Ⅱ级组与Ⅲ～Ⅳ级组之间CCK表达无显著差异(P0.05)。结论 CCK在冠状动脉粥样硬化斑块中的有表达,但不随粥样硬化斑块程度的变化而变化。     

冠心病某些危险因素与"瘀毒"病因关系探讨

冠心病"瘀毒"病因的提出成为防治冠心病的一个新思路,某些危险因素的存在和控制不理想是"瘀毒"病因产生和发展的重要因素.应通过临床研究探索"瘀毒"病因产生的临床表征和微观病理变化,在辨证论治基础上合理应用活血解毒方药对冠心病防治具有重要意义.     

A rare case of sudden death due to IgG4-related giant coronary artery aneurysms

Immunoglobulin G4-related disease (IgG4-RD) is a fibro-inflammatory condition that can affect many organs, either simultaneously or metachronously. In recent years, IgG4-related vascular complications of larger arteries such as the aorta and iliac arteries have been increasingly identified. Among vascular complications, coronary artery involvement in the forms of either periarteritis or coronary artery aneurysms (CAAs) has also been reported; however, are very rare in comparison. This case report presents a rare case of a sudden death due to occlusive thrombosis of IgG4-related giant CAAs measuring up to 10 cm in diameter, demonstrates their possible clinical progression, and shows how they can distort normal anatomy which may then pose challenges in the interpretation of postmortem-computed tomography scans. It also briefly discusses the diagnosis of IgG4-RD in arteries, both clinically and in the postmortem setting.