Biomedical subjects

A Rangel

Publications and source records attributed to A Rangel.

39 records · Page 3Linked to original sources

PubMedDate not supplied

[Acute myocardial infarction with normal coronary arteries as initial manifestation of polyarteritis nodosa. A case report].

A thirty four-year-old-white man in good health developed an acute anterior wall myocardial infarction (AMI), Killip II with normal coronary arteries. No thrombolytic therapy was given. Selective angiography revealed multiple aneurysms in mesenteric and renal arteries. The diagnosis of polyarteritis nodosa (PAN) was performed. AMI in PAN is secondary to arteritis with thrombosis, or to atherosclerosis due to steroid therapy. This case, having multiorgan vascular aneurysms involvement without previous cardiac symptomatology nor steroid therapy, presented as his first cardiac complication an AMI with normal coronary arteries probably due to selective arteritis.

Adult↗

PubMedDate not supplied

A case of giant arteriovenous shunt in a renal carcinoma.

We present the case of a 51 year-old-white male with a giant right renal arteriovenous fistula secondary to a carcinoma. Neither the aorta nor the kidneys were visualized after the injection of 60 mL of contrast media into the abdominal aorta. Moreover, the right kidney could not be visualized after 30 mL of contrast media were injected selectively into the right renal artery. This was due to a great arteriovenous shunt through the right kidney. The right renal angiogram was obtained through digital imaging, after injecting contrast media into the right renal artery, previously occluded by a balloon-catheter. The image of an hypervascularized nephroma was obtained, depicting an important arteriovenous shunt of the contrast material toward the inferior vena cava from a fistula located in the right inferior renal pole. The occlusion of the right renal artery was partially achieved by injecting 40 mL of boiling contrast media, followed by small fragments of Gelfoam suspended in the contrast substance. The balloon-catheter remained inflated in the right renal artery until a nephrectomy was performed. As far as we know, a case in which the aorta and renal circulation are unable to be seen by means of conventional angiography, because of the presence of a renal arteriovenous shunt to the fistula, has not been described.

Angiography, Digital Subtraction↗

PubMedDate not supplied

[Occlusion of interventricular septal rupture in 2 patients with an infarction].

We describe two women with interventricular septal rupture secondary to a myocardial infarction due to a total obstruction of the anterior descendent coronary artery. With the aim to stabilize the hemodynamic state of the patients before the surgical closure of the defect, we inserted a balloon-catheter introducing it to the left ventricle from the aorta and inflating it in the right ventricle after passing it through the septal orifice. After occlusion, we observed decreases in the pulmonary to systemic blood flow ratio (6% in one patient and 26% in the other) and in the arteriovenous blood flow shunt (8 and 31%); a 10% systemic blood flow increase was observed in one patient. Since the pulmonary arterial pressure did not change and the pulmonary blood flow increased, an increase of the pulmonary arterial resistance was observed but no modification of the pulmonary and systemic arterial pressure occurred. In the following days, the oxymetric differences between the pulmonary artery and the right atrium showed a tendency to remain below the figures before occlusion and the pulmonary blood flow and pressure showed a tendency to decrease. One patient died 14 days after the surgical closure of the rupture, and the other, seven days after the balloon occlusion of the rupture before any surgery. We present the physiological evolution of the patients.

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