In the Netherlands, coronary-vascular disease is still the main cause of death with around 48,000 deaths each year. This means that one out of three deaths is due to coronary-vascular disease. Therefore knowledge of epidemiology, diagnosis and treatment (by medication, PCI or CABG) of vascular disease is of utmost importance. This issue of the Netherlands Heart Journal is dedicated to coronary artery disease and deals with several of its aspects, by means of interesting case reports and reports on imaging modalities.
The conditions discussed include pheochromocytoma mimicking an acute myocardial infarction,1 giant aneurysm of a coronary bypass graft that is compressing the right ventricle,2 left main coronary artery stenosis,3 pseudonormalisation of the T wave as a sign of myocardial ischaemia,4 Takayasu’s arteritis,5 acute myocardial infarction due to aorta dissection,6 and pseudodissection after PCI.7
We also include a report of patient with both coronary and cerebral thrombosis caused by the psychostimulating herbal drug Khat.8
Special attention in this issue is also reserved for congenital anomalies, present in approximately 1% of the population in a benign or malign form. The imaging report by Braat, for instance, presents a patient with severe coronary artery disease and an anomalous origin and course of the circumflex coronary artery.9
Knowledge of (congenital) variations is considered essential, since the malign forms bear clinical consequences and require treatment. Apart from cardiac catheterisation, MRI and especially multislice CT can easily differentiate between the evil and the non-evil forms.
Thus it will be no surprise that the role of imaging in detecting disease and guiding treatment also appears of paramount importance in the discussed cases, be it catheterisation, MRI or multi-slice CT imaging. These modalities, together with the echo-Doppler techniques, should now be considered to belong to the standard work package of groups of cardiologist working in cooperation.
Please enjoy this issue and the take home messages from its contents.
References
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