Quinte mri case notes

This gives a temporal resolution of 20—30 ms for images with an in-plane resolution of 1.

Received Jun 23; Accepted Jul This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

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This article has been cited by other articles in PMC. Although there have been several cases of ARCAPA reported in the literature, we present a case which highlights the challenges of diagnosing this rare condition and the Quinte mri case notes value of using multiple imaging modalities.

A healthy 48 year old female presented with angina and exertional shortness of breath. She had a normal cardiovascular examination, negative cardiac enzymes and an unremarkable chest X-ray. She did, however, have T-wave inversions in leads V1—V3. Transthoracic echocardiography TTEas the first imaging investigation, led to an initial provisional diagnosis of a coronary-cameral fistula.

It showed unusual colour Doppler signals in the right ventricle and a prominent pattern of diastolic flow within the right ventricular myocardium, especially along the interventricular septum.

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Cardiac CT and MRI are non-invasive, three-dimensional imaging modalities with high diagnostic accuracy for coronary artery anatomic anomalies. If echocardiography and conventional angiography have been inconclusive, cardiac CT and MRI are especially important diagnostic tools.

Anomalous origin of the right coronary artery from the pulmonary artery ARCAPA is very rare and has an incidence of only 0.

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ARCAPA has a broad range of clinical manifestations ranging from sudden death, chest pain, and shortness of breath to incidental discovery in asymptomatic individuals.

Case Report A previously healthy year-old female presented to the emergency department with sudden onset right scapular and right thoracic chest pain, as well as shortness of breath with exertion.

She had no previous cardiovascular history and her only cardiac risk factor was a four pack-year history of smoking.

On physical examination, her vital signs and cardiovascular examination were normal. There was no evidence of congestive cardiac failure or murmurs.

She had tenderness to palpation inferior to her right scapula. Shoulder examination was otherwise normal. Her chest X-ray did not show cardiomegaly or signs of pulmonary edema. In the emergency department, it was suspected that her scapular pain was musculoskeletal in nature, as there was a clear history of repetitive strain and the pain responded to simple analgesics.

On the other hand, her thoracic chest pain, exertional symptoms, and nonspecific T wave changes were still unexplained. Upon further questioning, she reported a similar acute presentation of right thoracic chest pain two years ago while visiting overseas.

She had a brief hospital stay at the time; however, a definitive diagnosis was not made. Since that time, she had described frequent episodes of shortness of breath and thoracic chest discomfort precipitated by moderate exercise and relieved within five minutes of rest.

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Given the potential ischaemic nature of these symptoms, her primary care physician had previously referred her for formal cardiac investigation. An exercise-stress test had been inconclusive and a dobutamine stress echo DSE was negative for ischaemia. While in hospital, a standard transthoracic echocardiogram TTE was performed; it showed normal LV size and systolic function, no valvular abnormalities, and no evidence of diastolic dysfunction.

The TTE was remarkable for very unusual colour Doppler signals in the right ventricle Figures 1 a and 1 b. There was a prominent pattern of diastolic flow within the right ventricular myocardium, especially along the interventricular septum.

It was hypothesized that this flow was within dilated and tortuous coronary arteries. The differential diagnosis included a coronary-cameral fistula involving the right ventricle RV and ALCAPA anomalous left coronary artery from the pulmonary artery.Quinte Irish Canadian Society celebrates an Irish Christmas By Terry McNamee Irish culture is alive and well in Belleville and area, thanks in large part to the Quinte Irish Canadian Society.

Indiana State is waiving the application fee for Fall degree-seeking freshmen and transfer students until October 1. Some restrictions may apply. Free Essay: Background to the Case Here are some questions to help you analyze the background of the case: • State the background as you understand it • What.

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Instructions for Completing the AFM Patient Summary Form GENERAL. admission and discharge notes, MRI report, MRI images, neurology consult notes, infectious disease Indicate whether case -patient had an MRI of the brain performed.

DATE BRAIN MRI PERFORMED.