There has been an increase in the use of central venous catheters (CVCs) in clinical practice. One of the most dangerous complications associated with their use is symptomatic or asymptomatic thrombosis (T), sometimes associated with superior vena cava (SVC) syndrome, resulting from impaired venous drainage. The right heart clots can induce an increased risk of mortality due the potential pulmonary embolism (PE). We report a case of asymptomatic 83-year-old woman in whom the thrombosis was detected after an echocardiogram. Echocardiography demonstrated a cardiac mass, and the T was confirmed by (magnetic resonance imaging) MRI. The clinical scenario, a high index of suspicion and routine use of echocardiogram in patients with CVC, can lead to a correct diagnosis, preventing dangerous complications.
We describe a case of a single coronary artery originating from the right coronary sinus and bifurcating into the left coronary artery (LCA) and right coronary artery (RCA) in a 74-year old woman, with a non-ST elevation acute myocardial infarction (NSTEMI). Diagnosis was made by coronary angiography which ruled out stenosis, and showed normal LCA and RCA branching. The connection path of LCA, with the opposite cusp, was defined retroaortic by multislice computed tomography (CT). The variants of this coronary anomaly, together with their clinical implications and pathophysiology of acute myocardial infarction (AMI) are discussed. Multislice CT is fundamental for clinical decision making.
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