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a b s t r a c t Background: Carotid arterial intima-media thickness (IMT) has been a good indicator of the presence and extent of coronary artery disease (CAD) in observational studies. Since treadmill testing and stress echocardiography can have limited specificity in diagnosing CAD, other methods are required. Methods: B-mode ultrasound examinations were performed with Philips Sonos 7500, frequency of 7.0 MHz linear array transducer in order to calculate IMT. All the patients were catheterized percutaneously via the femoral vessels with standard Judkins technique.Angiographic scoring was performed by observers who were blinded to the carotid IMT scores.Results: The extent and severity scores for CAD were all positively correlated ( p < 0.0001 in every case). A significant, nearly linear correlation between IMT and advancing CAD ( p < 0.0001) was found. Patients with one, two and three-vessel CAD had significantly higher IMT than the patients without CAD. It was also found that the mean IMT values were more in patients (1.46 mm) with higher score (>20) of CAD than in patients with normal coronaries (0.73 mm). The extent score of CAD was found less (10.40%) in patients with normal IMT than in patients with elevated IMT (44.70%, p < 0.05). The univariate logistic regression analysis showed that increased IMT levels were associated with severity and extent of atherosclerosis.Conclusion: There is a strong correlation between carotid atherosclerosis and coronary atherosclerosis, and carotid IMT is a good predictor of presence and extent of CAD, hence it can be used as a marker in the prediction of pre-clinical atherosclerosis and CAD.

We present a patient with bilateral unruptured sinus of Valsalva aneurysms involving both the left and right coronary sinuses. The large left sinus aneurysm protruded into the left atrium and the right sinus aneurysm extended into the interventricular septum, producing a transient complete heart block.