Intercoronary communication between the circumflex and right coronary arteries: distinct from coronary collaterals

Abstract

Objective: To determine the prevalence and correlates of lipid lowering drug use among older British men with established coronary heart disease (CHD). Design: Cross sectional survey within a cohort study (British regional heart study) carried out at 20 years of follow up in 1998-2000. Setting: General practices in 24 British towns. Participants: 3689 men aged 60-75 years (response rate 76%). Main outcome measures: Diagnoses of myocardial infarction and angina based on detailed review of general practice records. Lipid lowering drug use and blood cholesterol concentrations ascertained at 20 year follow up examination. Results: Among 286 men with definite myocardial infarction, 102 (36%) were taking a lipid lowering drug (93 (33%) a statin); among 360 men with definite angina without myocardial infarction, 84 (23%) were taking a lipid lowering drug (78 (21%) a statin). Most men with documented CHD who were not receiving a lipid lowering drug had a total cholesterol concentration of 5.0 mmol/l or more (87% of those with myocardial infarction, 82% with angina). Fewer than half of men with CHD receiving a statin had a total cholesterol concentration below 5.0 mmol/l (45% of those with myocardial infarction and 47% of those with angina). Only one third of the men taking a statin were receiving trial validated dosages. Among men with CHD, a history of revascularisation, more recent diagnosis, and younger age at diagnosis were associated with a higher probability of receiving lipid lowering drug treatment. Conclusion: Among patients with established CHD, the prevalence of lipid lowering drug use remains low and statin regimens suboptimal. Major improvements in secondary prevention are essential if the benefits of statins are to be realised.

Is Transcranial Doppler for the Detection of Venous-to-Arterial Circulation Shunts Reproducible?

“…The contrast mixture used in our protocol differs from that recommended by the consensus conference [7] by the addition of blood [11]. We demonstrated that the addition of blood produces significantly more bubbles than saline and air alone, without affecting the sizes of the bubbles produced.…”

“…A negative test was one in which no microbubbles were detected within 20 s. A ‘significant’ v-aCS, consistent with the presence of a PFO, was defined as ≥15 microbubbles; this is based on our validation study of TCD versus TOE [11]. A ‘large’ v-aCS was defined as >50 microbubbles, and a ‘major’ shunt was defined as >50 microbubbles spontaneously or >10 microbubbles spontaneously with >80 following provocation.…”

“…We used a standardised TCD protocol in which ≥ 15 microbubble emboli were 100% sensitive and specific for the detection of PFO when compared to TOE [11]. A Neuroguard (Medasonics, USA) TCD with 128-point fast Fourier transform analysis was used.…”

Arcada coronária – uma anomalia rara da circulação coronária

“…As comunicações intercoronárias têm a camada muscular bem desenvolvida, diâmetros superiores (≥ 1 mm), são extramurais e menos tortuosas, quando comparadas com as colaterais 10 .…”

A Patient With Bicuspid Aorta and Intercoronary Continuity A Rare Variant of Coronary Circulation

“…Atak, et al reported one case among 7,986 angiograms. 4) Our case was the first among 12,674 angiograms performed during the last five years. In a postmortem study of 100 human hearts from individuals with an average age of 61 years, 7 cases of intercoronary artery were described.…”