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Biomedical subjects

D Luke Glancy

Publications and source records attributed to D Luke Glancy.

At least 37 records · Page 2Linked to original sources
PubMed2002

Right coronary artery arising from the pulmonary trunk in a 63-year-old man.

Unlike anomalous origin of the left coronary artery (CA) from the pulmonary trunk (PT), right CA from the PT, a rare congenital malformation, may present in adulthood. We herein describe a man with anomalous origin of the right CA from the PT who presented with angina and syncope at age 63.

Angina Pectoris↗
PubMed2002

ECG discrimination between right and left circumflex coronary arterial occlusion in patients with acute inferior myocardial infarction: value of old criteria and use of lead aVR.

STUDY OBJECTIVES: Prior studies have proposed several ECG criteria for identifying the culprit artery in patients with acute inferior myocardial infarction (MI). We applied each criterion to our patients to assess its utility. In doing so, we discovered a previously unreported, but highly useful, criterion utilizing lead aVR. STUDY DESIGN: Retrospective review. PATIENTS: Thirty consecutive patients with symptoms of acute MI, ST-segment elevation in the inferior ECG leads, an appropriate rise and fall of creatine kinase and troponin I levels, and coronary arteriography within 7 days of the onset of symptoms. MEASUREMENTS: The ECG recorded within 24 h of the onset of symptoms that had the most prominent ST-segment changes was analyzed. In the 12 standard leads and in lead V(4)R, ST-segment elevation or depression was measured 0.06 s after the J point. RESULTS: Four previously described criteria were useful in identifying the right coronary artery (RCA) or the left circumflex coronary artery (LCX) as the culprit: ST-segment elevation in lead I, ST-segment more or less elevated in lead II than in lead III, ST-segment elevation >or= 0.5 mm in lead V(4)R, and various combinations of ST-segment elevation or depression in leads V(1) and V(2). A new criterion was found to be at least as useful as any previously described: the presence and amount of ST-segment depression in lead aVR. CONCLUSIONS: At least five different ST-segment criteria help to identify the RCA or the LCX as the culprit artery in patients with acute inferior MI. One of these, the amount of ST-segment depression in lead aVR, has not been reported previously and needs validation in a larger study.

Coronary Angiography↗
PubMedDate not supplied

Clinical case of the month. Chest pain, diaphoresis, and dyspnea in a hypertensive 53-year-old man.

Aortic dissection is a life-threatening condition requiring urgent diagnosis and treatment. The initial challenge for the physician lies in distinguishing aortic dissection from more common conditions such as myocardial infarction that also are characterized by chest pain. Subsequent management depends on imaging techniques that define whether just the descending aorta is affected or its more proximal portions as well. Mortality and morbidity are high, especially when the ascending aorta is involved.

Aortic Dissection↗
PubMedDate not supplied

Risk factors among medically indigent women < or = 45 years old with angiographically proven obstructive coronary arterial disease.

BACKGROUND: Risk factors for angiographically proven coronary arterial disease (CAD) have not been assessed in a large cohort of young medically indigent women, who are known to have more CAD than better educated and more affluent women. METHODS: In a 2-year period, 165 medically indigent women < or = 45 years old underwent coronary arteriography for symptoms suggesting CAD. We compared the prevalence of risk factors in the 100 with obstructive CAD with the prevalence in the 65 with non-obstructive or no CAD. RESULTS: Both groups had high prevalences of all of the standard risk factors. Compared to the 65 without, the 100 with obstructive CAD more often smoked, had diabetes mellitus, had a family history of CAD, and more often had had a myocardial infarct. CONCLUSION: CAD in medically indigent young women is not rare and is best predicted by symptoms, smoking, and diabetes mellitus.

Adult↗