Spontaneous coronary artery dissection, which causes acute coronary syndrome and can result in sudden death, is rare; but its true incidence is underestimated, since most patients die suddenly, without diagnosis. The aim of this study was to show the importance of prompt diagnosis and treatment.
In reviewing the records of 5,000 consecutive patients who underwent coronary angiography between January 2001 and August 2006, we found 6 cases of spontaneous coronary artery dissection (an incidence rate of 0.12%). Five patients presented with left main coronary artery dissection and 1 patient, with right coronary artery dissection.
Angioplasty with stenting failed in the patient with right coronary artery dissection. Coronary artery bypass surgery was performed in all patients. The patient with right coronary artery dissection died of sepsis on the 30th postoperative day. The other 5 patients (83.3%) are still free of symptoms, and they had negative results on stress tests at the 6- and 12-month follow-up visits after coronary artery bypass surgery.
The clinical presentation of spontaneous left main coronary artery dissection was similar to that of atherosclerotic disease. However, early diagnosis of spontaneous coronary artery dissection by means of coronary angiography is of paramount importance, because urgent coronary artery bypass grafting can be lifesaving.
Spontaneous coronary artery dissection (CAD), which causes acute coronary syndrome and can result in sudden death, is a rare event. Spontaneous coronary artery dissection has been observed in 3 groups of patients: patients with coronary artery disease, young women during peripartum, and patients with idiopathic disease and no obvious associated factors. The pathogenesis of spontaneous CAD is still unclear.1,2
The clinical presentation of left main coronary artery (LMCA) dissection may be similar to that of a patient with atherosclerotic disease of the LMCA. Early diagnosis and urgent coronary artery bypass grafting (CABG) is lifesaving in patients with LMCA dissection. In this retrospective study, we present an account of our management of spontaneous CAD, and we review the medical literature in order to investigate the potential causes and optimal treatments of this condition. [ ]
Mayo Clinic SCAD Research Program Presentation A high-point for survivors and those impacted by SCAD was the research presentation which followed at Edward Hospital, Naperville, IL. This year attendees enjoyed meeting and hearing about the latest research findings presented by some of the researchers from the Mayo Clinic SCAD Research Programs (Rochester, MN): Sharonne Hayes, MD: Mayo Clinic SCAD Research Program Team Lead and Chair of our Scientific Advisory Committee Marysia Tweet, MD: Co-creator of Mayo Clinic SCAD Registry, Senior Cardiology/Fellow Jeanne Theis, PhD: Research Scientist in SCAD DNA Research Also attending from Mayo Clinic SCAD Research Program were Jill Boyum (SCAD Research Study Coordinator), Toni Sauber (Medical Secretary) and Brenda Speltz (Clinical Research Coordinator, SCAD Biobank). Category Nonprofits & Activism License Standard YouTube License
Unmanned aerial vehicles, popularly known as drones, are most often associated with airstrikes in modern warfare, but their history goes much further back than that. While drones came into the spotlight during the early years of the 21st century the idea of a remotely-operated flying machine was developed much earlier. A forerunner of what we […]
I have had epilepsy, you could say, all my life and have run out of anticonvulsants which manage the condition sufficiently.
For the past several month I have been experiencing, to various degrees, episodes when I cannot retain my balance or actually do fall over; accompanied by double vision wherein the second of the object appears to be quite distant from the first. These experiences began when I tried a new drug for me, last year, we discontinued the drug.
Now, using Perampanel I am having the same experiences though more extreme, the events usually occur either early mornings or late at night, though I had one mid-morning on Thursday.
Two days beforehand I was getting myself ready for a dental appointment ( Sydney Dental Hospital) after which I planned to visit Jessica at St. Vincent’s hospital where she has had her heart surgery – all good. I had gone into the bathroom to capture Jessica’s old walking stick hoping to remain upright on two sticks long enough for the episode to wear off and for me to do the usual ‘be in 2 places at once’ thing that is very much part of my life. By this time I was already having the seizure because of the fixated manner of thought processing, in the bathroom I tripped and fell hitting my forehead, back of head and hip on the porcelain toilet pedestal. Still have some very interesting op art on my face and rear.
I estimate that I was out for about 20 -30 minutes since I came to at the sound of the door being knocked which would have been Jessica’s Tuesday carer – the message to stop all services didn’t make its way to the end of the line. I still could not stand and crawled to the front door, praying she wouldn’t leave before I got to it. Hauling myself up by the lock I opened the door and then almost fell back over but was caught, the ambulance was called and a trip to Prince Of Wales Hospital Randwick saw me for about 8 ish hours, where no one knew which way was up either.
I surmise that there may be a drug interaction we have missed this else it is something new to me in my older age. When prescribed Epilim with Lamictal quite some years ago the combination brought me to my knees – let’s say, but nothing is recorded connecting Perampanel with any adverse chemical reaction – that I have found.
Now I have to do some Dr Google since it is getting too dangerous to be home alone or out in public alone, and it may be something literally in my head that needs seeing with an MRI- if this is the case it makes for a simple explanation by ???
Epilepsy is a brain disorder involving repeated, spontaneous seizures of any type. Epilepsy is not a single disorder but rather a wide spectrum of problems. What all types of epilepsy share are recurrent, unprovoked seizures caused by an uncontrolled electrical discharge from nerve cells in the cerebral cortex. This part of the brain controls higher mental functions, general movement, and the functions of the internal organs in the abdominal cavity, perception, and behavioral reactions.
Seizures are a symptom of epilepsy. Seizures (“fits,” convulsions) are episodes of disturbed brain function that cause changes in attention or behavior. They are caused by abnormally excited electrical signals in the brain.
A single seizure may be related to a temporary medical problem (such as brain or tumor withdrawal from alcohol). If repeated seizures do not happen again once this underlying problem is corrected, the person does not have epilepsy.
A single, first seizure that cannot be explained by a temporary medical problem has about a 25% chance of returning. After a second seizure occurs, there is about a 70% chance of future seizures and the diagnosis of epilepsy.
TYPES OF EPILEPSY
Epilepsy is generally classified into two main categories based on seizure type:
Partial (also called focal or localized) seizures. These seizures are more common than generalized seizures and occur in one or more specific locations in the brain. In some cases, partial seizures can spread to wide regions of the brain. They are likely to develop from specific injuries, but in most cases the exact origins are unknown ( idiopathic ).
Generalized seizures. These seizures typically occur in both sides of the brain. Many forms of these seizures are genetically based. There is usually normal neurologic function.
PARTIAL SEIZURES (ALSO CALLED FOCAL SEIZURES)
These seizures are subcategorized as “simple” or “complex partial.”
Simple Partial Seizures. A person with a simple partial seizure (sometimes known as Jacksonian epilepsy) does not lose consciousness, but may experience confusion, jerking movements, tingling, or odd mental and emotional events. Such events may include deja vu, mild hallucinations, or extreme responses to smell and taste. After the seizure, the patient usually has temporary weakness in certain muscles. These seizures typically last about 90 seconds.
Complex Partial Seizures. Slightly over half of seizures in adults are complex partial type. About 80% of these seizures originate in the temporal lobe, the part of the brain located close to the ear. Disturbances there can result in loss of judgment, involuntary or uncontrolled behavior, or even loss of consciousness. Patients may lose consciousness briefly and appear to others as motionless with a vacant stare. Emotions can be exaggerated; some patients even appear to be drunk. After a few seconds, a patient may begin to perform repetitive movements, such as chewing or smacking of lips. Episodes usually last no more than 2 minutes. They may occur infrequently, or as often as every day. A throbbing headache may follow a complex partial seizure.
In some cases, simple or complex partial seizures evolve into what are known as secondarily generalized seizures. The progress may be so rapid that the partial stage is not even noticed.
Generalized seizures are caused by nerve cell disturbances that occur in more widespread areas of the brain than do partial seizures. Therefore, they have a more serious effect on the patient. They are further subcategorized as tonic-clonic (or grand mal), absence (petit mal), myoclonic, or atonic seizures.
Tonic-Clonic (Grand Mal) Seizures. The first stage of a grand mal seizure is called the tonic phase, in which the muscles suddenly contract, causing the patient to fall and lie stiffly for about 10 – 30 seconds. Some people experience a premonition or aura before a grand mal seizure. Most, however, lose consciousness without warning. If the throat or larynx is affected, there may be a high-pitched musical sound (stridor) when the patient inhales. Spasms occur for about 30 seconds to 1 minute. Then the seizure enters the second phase, called the clonic phase. The muscles begin to alternate between relaxation and rigidity. After this phase, the patient may lose bowel or urinary control. The seizure usually lasts a total of 2 – 3 minutes, after which the patient remains unconscious for a while and then awakens to confusion and extreme fatigue. A severe throbbing headache similar to migraine may also follow the tonic-clonic phases.
Absence (Petit Mal) Seizures. Absence or petit mal seizures are brief losses of consciousness that occur for 3 – 30 seconds. Physical movement and loss of attention may stop for only a moment. Such seizures may pass unnoticed by others. Young children may simply appear to be staring or walking distractedly. Petit mal may be confused with simple or complex partial seizures, or even with attention deficit disorder. In petit mal, however, a person may experience attacks as often as 50 – 100 times a day.
Myoclonic. Myoclonic seizures are a series of brief jerky contractions of specific muscle groups, such as the face or trunk……