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Clinical And Angiographic Characteristics Of Left Main CoronaryArtery Disease, A Retrospective Study

Authors: Mohammed H. AL Myahi * --- Kassim M. J. AL Doori * --- Jawad M. Hawas )
Journal: Journal of the Faculty of Medicine مجلة كلية الطب ISSN: 00419419 Year: 2007 Volume: 49 Issue: 1 Pages: 82-85
Publisher: Baghdad University جامعة بغداد


Background : Left main coronary artery (LMCA) disease represents important and serious portion of coronary artery disease(CAD).
Aim: The aim of this study is to estimate the incidence of LMCA disease among patients with CAD undergoing coronary artery angiography and to evaluate clinical characteristics of patients with LMCA disease.
Methods: The study involved review of clinical notes and coronary angiography of 1020 patients with CAD in Ibin Al Bitar hospital for cardiac surgery between April and September 2004.This review included evaluation of electrocardiogram (ECG), echocardiogram(ECHO),
ECG exercise test (EET) and coronary angiography.
Results: Among 56 patients proved to have left main coronary artery (LMCA) disease,40 patients had complete data available which were studied.
Mean age of patients with LMCA disease was 60 ± 8.07 years, 82% of them were males, 62% were smokers, 40% were diabetics and 55% were hypertensive.
In this group 62.5% of patients with LMCA disease presented as acute coronary syndrome (ACS) and 37.5% as chronic stable angina (CSA),normal left ventricular (LV) function was found in 75% of patients and 40% have normal electrocardiogram (ECG).
Patients with LMCA disease who have distal involvement represent 75%,15% have diffusely diseased LMCA, right coronary artery (RCA) was involved in 80% of patients and those with RCA involvement were more commonly presented with ACS (78%), while those without RCA involvement presented more as CSA.
Those patients who underwent ECG exercise test had poor functional Capacity, with mean exercise duration of 3.7 ± 2.3 minutes and mean metabolic equivalents (METs) of 4.5 ± 2.46.
The tests were positive in 76.9% of patients inconclusive in the rest but no negative tests were recorded.
No significant differences were observed between those patients with ACS and those with CSA in regard to patients' characteristics.
Conclusion: LMCA disease is not uncommon among those with CAD, it occurs in patients with multiple cardiovascular risk factors. Patients with LMCA disease usually have poor functional capacity and their ETTs are commonly positive and of high risk score. Involvements of right coronary artery (RCA) in addition to LMCA render the patients more unstable.

Coronary angiographic findings in patients with chest pain and rightbundle branch block

Authors: Mohammed H. Al Myahi --- Kassim M. J. Al Doori*, --- Ihssan A. Abid
Journal: Journal of the Faculty of Medicine مجلة كلية الطب ISSN: 00419419 Year: 2008 Volume: 50 Issue: 3 Pages: 282-285
Publisher: Baghdad University جامعة بغداد


Back ground : Coronary artery diseases are not uncommon in the presence of right bundle
branch block .
Aim : The aim of this study is to assess the findings of coronary angiography in patients with
chest pain and right bundle branch block.
Methods : The study involved review of case sheets and coronary angiography of one
hundred patients, who underwent coronary angiography due to chest pain suspected to have
coronary artery diseases (CAD) , fifty patients of them had right bundle branch block (RBBB) ,
the other fifty did not have RBBB , those 100 patients were presented to Ibin Al Bitar hospital
for cardiac surgery from January 2004 to June 2006.
History, clinical examinations, electrocardiogram (ECG) , ECG exercise tests (EET)
echocardiogram (ECHO) and coronary angiography had been performed.
Results : Mean age of patients was 53± 10.6 years, 84% were male , hypertension, diabetes
mellitus, and smoking as risk factors were present as 30%, 32% and 48% respectively. 58% of
patients presented with chronic stable angina (CSA) while 42% with acute coronary syndrome
(ACS), ECHO showed that left ventricular dysfunction (LVD) was present in 34%, EET was
positive in 11 of the 23 patients (47.8%) who were able to perform EET. Normal coronary
angiography found in 20% of patients and there were no significant difference in coronary
angiographic findings between patients with and without RBBB.
Conclusion : RBBB of indeterminate age has no significant impact on clinical and
haemodynamic characteristics of CAD patients and it may be incidental finding.

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