Journal of the American College of Cardiology Ó 2014 by the American College of Cardiology Foundation Published by Elsevier Inc.
Vol. 63, No. 15, 2014 ISSN 0735-1097/$36.00 http://dx.doi.org/10.1016/j.jacc.2013.10.095
IMAGES IN CARDIOLOGY
Dilated Cardiomyopathy With Inferior Wall Myocardial Infarction A Rare Presentation of Takayasu Arteritis Sudhanshu Kumar Dwivedi, MD, DM, Rajiv Bharat Kharwar, MD, Anupam Mehrotra, MD, Mahim Saran, MD, Sharad Chandra, MD, DM, Ram Kirti Saran, MD, DM Lucknow, Uttar Pradesh, India
From the Department of Cardiology, King George’s Medical University, Lucknow, Uttar Pradesh, India. Manuscript received October 2, 2013; accepted October 17, 2013.
21-year-old man was referred to us for evaluation of absence of bilateral upper limb pulse. He had an inferior wall myocardial infarction (A) 5 days earlier, for which he underwent thrombolysis with streptokinase. Two-dimensional transthoracic echocardiography (B to E; Online Videos 1 and 2) showed dilated left atrium and left ventricle, moderate mitral regurgitation, dilated descending thoracic aorta, and poor left ventricular systolic function (left ventricular ejection fraction 30%). Multidetector computed tomography with volume rendering (F) showed total occlusion of brachiocephalic and left subclavian artery, severe stenosis of bilateral renal arteries, and aneurysmal dilation of descending aorta. Coronary angiography (G, H; Online Videos 3 and 4) showed complete occlusion of the proximal right coronary artery, which was filling retrogradely from the normal left anterior descending artery and left circumflex artery. Invasive aortography (I, J; Online Videos 5 and 6) showed findings similar to computed tomography. DA ¼ descending aorta; LA ¼ left atrium; LAD ¼ left anterior descending; LV ¼ left ventricle; RA ¼ right atrium; RCA ¼ right coronary artery.
A
Vol. 63, No. 15, 2014 ISSN 0735-1097/$36.00 http://dx.doi.org/10.1016/j.jacc.2013.10.095
IMAGES IN CARDIOLOGY
Dilated Cardiomyopathy With Inferior Wall Myocardial Infarction A Rare Presentation of Takayasu Arteritis Sudhanshu Kumar Dwivedi, MD, DM, Rajiv Bharat Kharwar, MD, Anupam Mehrotra, MD, Mahim Saran, MD, Sharad Chandra, MD, DM, Ram Kirti Saran, MD, DM Lucknow, Uttar Pradesh, India
From the Department of Cardiology, King George’s Medical University, Lucknow, Uttar Pradesh, India. Manuscript received October 2, 2013; accepted October 17, 2013.
21-year-old man was referred to us for evaluation of absence of bilateral upper limb pulse. He had an inferior wall myocardial infarction (A) 5 days earlier, for which he underwent thrombolysis with streptokinase. Two-dimensional transthoracic echocardiography (B to E; Online Videos 1 and 2) showed dilated left atrium and left ventricle, moderate mitral regurgitation, dilated descending thoracic aorta, and poor left ventricular systolic function (left ventricular ejection fraction 30%). Multidetector computed tomography with volume rendering (F) showed total occlusion of brachiocephalic and left subclavian artery, severe stenosis of bilateral renal arteries, and aneurysmal dilation of descending aorta. Coronary angiography (G, H; Online Videos 3 and 4) showed complete occlusion of the proximal right coronary artery, which was filling retrogradely from the normal left anterior descending artery and left circumflex artery. Invasive aortography (I, J; Online Videos 5 and 6) showed findings similar to computed tomography. DA ¼ descending aorta; LA ¼ left atrium; LAD ¼ left anterior descending; LV ¼ left ventricle; RA ¼ right atrium; RCA ¼ right coronary artery.
A
