Right coronary artery aneurysms are rare and may result from severe coronary disease, with few cases described in the literature. Mortality is high, and therapy is still controversial. We report the case of a 72-year-old woman with arterial hypertension, and a family history of coronary artery disease, who evolved for 2 months with episodes of palpitations and dyspnea on moderate exertion. During the evaluation, a giant aneurysm was found in the proximal third of the right coronary artery. The patient underwent surgical treatment with grafting of the radial artery to the right coronary artery and ligation of the aneurysmal sac, with good clinical course.
Ao Prof. Dr. Carlos Eduardo Rochitte, meu orientador, de vasto conhecimento, experiência e rigor científico. Abriu-me as portas à essa pós-graduação e me acolheu na USP. Minha eterna gratidão e admiração pela oportunidade, paciência e orientação.Ao Prof. Dr. Tiago Augusto Magalhães, meu coorientador, se tornou mais que isso, se tornou um amigo. Sua contribuição foi enorme para a realização desse projeto. Minha eterna gratidão, admiração, respeito e amizade.Ao Dr. Rafael Willain Lopes, do Hospital do Coração -HCOR pela sua relevante contribuição com a segunda opinião dos exames de perfusão miocárdica pela medicina nuclear. Ao Dr. Augusto Hiroshi Uchida, especialista em ergometria e métodos gráficos pela sua relevante contribuição na segunda opinião dos testes ergométricos.Ao biomédico Douglas Carli Silva, especialista em tomografia computadorizada da Siemens Healthineers, pelas relevantes contribuições nas análises da reserva fracionada de fluxo por tomografia computadorizada.
Purpose: To evaluate antimalarial with or without anticoagulant treatment, in patients with recent SARS-COV-2 infection. Methods: Clinical study carried out at Samuel Libânio Clinic Hospital, University of Vale do Sapucaí, Pouso Alegre-MG. Approved by the Ethics Committee (4.034.077) and registered in the Clinical Trials (NCT04788355). Suspected patients for COVID-19 were included in the emergency room. The groups were: C (control) with 6 patients, A (anticoagulant apixaban) with 9 patients, H (hydroxychloroquine) with 5 patients and HA (hydroxychloroquine and anticoagulant apixaban) with 8 patients. Results: there were no significant differences between groups. The HA group, in which there was an intervention with two drugs, presented a greater number of days with symptoms (p = 0.037) and worse results, when compared to the control: most relevant symptoms, were: cough (p = 0.001), and anosmia / ageusia (p = 0.011) headache (p = 0.001). Conclusion: The present study began when there were doubts about the use of drugs such as Hydroxychloroquine (HCQ) and apixaban (APX). The reduced “n” was defined through bureaucratic and polemic issues independent of the authors’ actions. No clinical benefit was associated with HCQ and APX. There was an increase in the number of symptomatic days when HCQ and APX were administered. Despite the limitations, there was no therapeutic indication of the evaluated drugs.
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