Coronary artery ectasy is a rare coronary disease often revealed by an acute myocardial infarction.The management of this pathology is not well established.We are reporting two cases of ST-elevation myocardial infarction associated with coronary artery ectasy.These cases were reported using electrocardiography and coronary angiography data and the modalities of treatment.Then a discussion was made on the basis of the literature concerning the topic of coronary artey ectasy and myocardial infarction.Our work adds to the literature by providing additional data on the link between artery coronary ectasy and acute myocardial infarction as well as the management modalities.

Introduction: The location of the conduction pathways and their intimate anatomical relationship with the aortic valve provide insight into the occurrence of arrhythmias and conduction disorders during aortic stenosis. These disorders have an important prognostic impact. our work proposes to determine and describe the rhythm and conduction disorders encountered in aortic stenosis in a Moroccan population group while recalling the causes and the prognostic and therapeutic impacts of this association. Materials and methods: This is a retrospective study of 148 patients with aortic stenosis hospitalized at the cardiology center of the HMIMV over a period of 24 months during which we analyzed the clinical and electrocardiographic data in order to describe and analyze the rhythm and conduction disorders encountered in this pathology. Statistical analysis was performed with SPSS software, version 18. Results: The mean age of the population was 65 (57, 74) years, the sex ratio was 1.21 with male predominance. Smoking (current or former) reported in 38.5% of patients was the main modifiable cardiovascular risk factor, followed by hypertension in 35.8% of patients. Dyspnea of effort was the most frequent reason for consultation at 81% of which 64% (of these) were at least of the functional class III of the NYHA. Palpitations and lipothymia or syncope accounted for 21% and 16.2% of the series. The aortic stenosis was tight overall with a mean aortic area of 0.8 [O, 6; 1] cm². Aortic stenosis was rarely isolated. In 36% of cases, it was associated with rhythm and conduction disorders. Among these disorders, atrial fibrillation was the most frequent (36.5%), followed by left anterior hemiblock (17%), LBBB (13.5%) and RBBB (9.5%). Finally there was 9.4% of complete atrioventricular block. Conclusion: The occurrence of arrhythmias and conduction disorders during aortic stenosis is frequent and due to multifactorial mechanism. In the literature, their prevalence is variable ......

Introduction: The risk factors for aortic stenosis have been shown to be similar to those for atherosclerosis. Thus, coronary disease is often found simultaneously in patients with aortic stenosis. Our work aims to determine the frequency of coronary disease in a Moroccan population with aortic stenosis while recalling the causes and the prognostic and therapeutic impacts of this association. Materials and Methods: This is a retrospective study of 148 patients hospitalized at the cardiology center of the military hospital of Rabat over a period of 24 months, during which we analyzed clinical, electrocardiographic, echocardiographic and coronarographic data of the patients in order to evaluate the coronary involvement during aortic stenosis. Results: The mean age of the population was 65 [57, 74] years, the sex ratio was 1.21. Smoking reported in 38.5% of patients was the main modifiable cardiovascular risk factor, followed by hypertension in 35.8% of patients. Dyspnea on exertion was the most frequent reason for consultation at 81%, 64% of which were at least NYHA functional class III, followed by angina, which represented 33% of the series. The aortic stenosis was tight in the majority (mean SAo: 0.8 cm²) and the left ventricular ejection fraction was preserved overall. Coronary artery disease was associated with aortic stenosis in 24% of cases, with predominantly monotruncal involvement (53%) followed by tritruncal involvement (30%). 21.6% of these patients underwent coronary artery bypass grafting concomitantly with surgical replacement of the aortic valve. Conclusion: The incidence of coronary artery disease associated with aortic stenosis is variable according to age. It is higher in European series because of aging. In our relatively younger population, it is lower but not negligible.

The coronary artery calcium (CAC) score is a cardiovascular risk feature that is not widely used. It reflects the burden of coronary artherosclerosis of an individual. It is shown in the literrature that the use of the CAC score improves the global cardiovascular risk assesment. The CAC score might lead directly to coronarography if it is very high. We report the case of twelve (12) patients that were at risk of chronic coronary disease but were asymptomatic. They could not go through effort test and benefited from CAC score, then coronarography was directly performed. The calcium score was positive for 11 patients (91.7%). One patient (8.3%) had an intermediate score. Nine (09) patients (75%) had significant lesions, three (03) patients (25%) had no significant lesions despite a positive calcium score and one (01) patient (8.3%) had significant coronary lesions with an intermediate calcium score.

A 57-years-old man presented in our department of emergency with an acute chest pain infarct-like. The electrocardiogram realised showed an ST elevation in the infero-latero-basal leads suggesting an occlusion of the right coronary artery or the left circumflex coronary artery. However, the coronary angiography that was performed showed a subocclusion of the proximal left anterior descending coronary artery, in contrast to the expected results. This case was reported using electrocardiography and coronary angiography data and the electrocardiogram changes after a percutaneous coronary intervention. The particularity of this case lies in the lack of correlation between the electrocardiographic Changes and the Coronary Angiographic Findings.