Anomalous origin of the left coronary artery (LCA) from the right coronary artery sinus is a rare congenital coronary anomaly. We report a case of a 48-year-old symptomatic man who was admitted to our clinic with a history of hypertension, type 2 diabetes mellitus, myocardial infarction and hypercholesterolemia. Coronary angiography was performed revealing anomalous left coronary artery from the right coronary artery sinus. In addition, stenosis of RCA and well developed stenotic diagonal artery were detected with coronary angiography. We performed coronary by-pass with left internal mammarian artery to diagonal artery and vena saphena to right coronary artery (RCA). Both coronary angiography and intraoperative view should be evaluated well in patients with anomalous of the coronary artery.Keywords: coronary artery anomalies, coronary artery disease, coronary angiography, coronary by-pass Case ReportA 48-year-old man with a prior history of hypertension, type 2 diabetes mellitus, myocardial infarction, and hypercholesterolemia was admitted to our clinic because of stable angina pectoris. His symptoms had begun 3 months before admission. On admission, he was hypertensive (150/85 mmHg) with a regular pulse of 75 bpm. Cardiac auscultation was unremarkable, and the chest was clear. The ECG showed sinus rhythm at 75 bpm with significant ST-segment changes. Left Coronary angiogram (left anterior oblique caudal view) showed well developed diagonal artery which appeared like LCA. Right Coronary angiography (left anterior oblique view) was performed revealing anomalous left coronary artery (= the branch of RCA) from the right coronary artery sinus. In addition, 80%-90% stenosis in the mid RCA and 80% stenosis in the proximal diagonal artery were detected with coronary angiography (Figs. 1 and 2). We viewed well developed diagonal artery, which appeared like LCA and during the operation it was recognized that this artery was not LCA. So we performed coronary by-pass with left internal mammary artery to diagonal artery (Fig. 3) and vena saphena to RCA. On postoperative follow-up, our
Gestational diabetes mellitus (GDM) is a systemic disease that has poor maternal and fetal health outcomes. Patients who are diagnosed with GDM are more likely to encounter cardiovascular system diseases during pregnancy and after birth. Carotid intima-media thickness (CIMT) is used as an early indicator of diseases such as coronary artery disease. This study aims to define the effects of hyperglycemia at an early term using CIMT, maternal and fetal doppler flows in patients diagnosed with GDM. The study included 132 pregnant women who had reached the 24th gestational week. (GDM group n=65, Control group n=67) Comparisons were performed between women with similar demographic characteristics who received a 100-gr oral glucose test (OGT) and GDM diagnosis and who did not. The participants’ routine hemograms and biochemical tests were done during OGT. Fetal biometrics, amniotic fluid index, uterine artery doppler flow, and bilateral CIMT measurements were performed during the obstetric examinations. Gravida, para, and live birth rates of the GDM group participants were higher than those of the control group (p=0.003, 0.002, 0.002 respectively). The amniotic fluid index was found to be higher in the GDM group (p<0.001). Fasting glucose values and platelet counts were higher in the GDM group (p=0.031 and p<0.001). Other laboratory data demonstrated no statistically meaningful differences between the groups (p>0.05). When the doppler measurements were compared, umbilical artery pulsatility index values were discovered to be similar between the groups (p=0.509). While the right uterine artery (UtA) pulsatility index was higher in the GDM group (p<0.001), no statistically significant differences were found between the groups in terms of the left UtA pulsatility index (p=0.485). Right and left CIMTs were higher in the GDM group (p=0.001, p<0.001, p<0.001 respectively). While in the GDM group there was a positive correlation between the thrombocyte level and uterine artery resistance (r=0.336, p=0.006; r=0.397, p=0.044 respectively), no similar correlations were found in the control group. This study found that GDM patients had inflammation, increased resistance in uterine artery flow, and increased CIMT. It has been shown, there is a correlation between CIMT and glucose levels and between thrombocytosis and UtA resistance in GDM patients. Uterine artery doppler data and CIMT measurements could be used as an indicator of systemic inflammation and cardiovascular disease in patients with GDM.
Objective: Early detection of hypertension is important for maternal health. We aim to shed light on future studies by conducting a comprehensive bibliometric analysis of the literature on pregnancy hypertension. Material and Methods: In this study, articles published in the Web of Science Core Collection on hypertension in pregnancy between 1975 and 2019 were evaluated. Documents produced in 2020 excluded. The words "pregnancy" and "hypertension" were used as keywords for database scanning. Gunnmap web-based application used to visualize the scientific efficiency of countries. The Vosviewer (Version 1.6.14) program was also used to display bibliometric connections of data. Results: Two thousand, one hundred and twenty articles on the subject were identified. It has been observed that the number of citations to articles and articles published in recent years on hypertension in pregnancy has reached a peak. The USA and the UK were identified as the countries
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