A year-old male presents to the ED after experiencing intermittent chest pain for 2 days. He describes substernal chest pressure radiating to his jaw. He is short of breath and diaphoretic. His temperature is His ECG is below:.
Relief of vasospasm with fasudil after off-pump coronary artery bypass grafting: a case study
Coronary artery disease: an example case study
The most common surgical procedure encountered is the Aorto-Coronary Bypass Graft ACBG for various indications such as left main coronary artery stenosis, severe triple-vessel disease, angina refractory to medical therapy, or recurrent CHF due to ischemia. Less common are removal of intracardiac tumors and LV aneurysmectomy. To perform the surgery, the patient is usually put on "pump" or cardiopulmonary bypass CPB. This involves cannulation of the right atrium and aorta and later cross-clamping of the aorta , allowing the entire cardiac output to bypass the patient's heart and lungs. Blood flow is maintained using a pump and the blood is oxygenated via a membrane oxygenator incorporated into the circuit. Several myocardial preservation techniques are used to protect the heart from ischemic damage during this period.
This chapter illustrates various general issues in genetic epidemiology in relation to coronary artery disease CAD. Researchers aiming to identify susceptibility genes have used several different definitions of CAD, some focusing on the common presentation of myocardial infarction MI and others adopting broader criteria, often imposing an upper limit to age at diagnosis to minimise environmental effects. Many candidate gene association studies and a few large genome-wide linkage studies have been conducted, but with limited success. Several heritable quantitative traits are strongly related to risk of CAD e. Quantitative traits have the advantage of being measurable on any individual, allowing them to be studied in population-based cohorts.