10
views
0
recommends
+1 Recommend
1 collections
    0
    shares
      • Record: found
      • Abstract: found
      • Article: found

      Coronary Artery Angiographic Changes in Veterans Poisoned by Mustard Gas

      research-article

      Read this article at

      ScienceOpenPublisherPubMed
      Bookmark
          There is no author summary for this article yet. Authors can add summaries to their articles on ScienceOpen to make them more accessible to a non-specialist audience.

          Abstract

          Objectives: We aimed to identify coronary artery involvement in mustard gas-poisoned patients. Methods: We conducted a case-control study on 40 mustard gas-poisoned patients who underwent coronary artery angiography due to cardiac pain. The study was performed during a 3-year interval on patients who were referred to three main hospitals of Mashhad, Iran. The nonexposed control group consisted of 40 normal individuals who had undergone angiography for the same reasons. The primary outcome measurement was coronary artery involvement and its location. Data were collected through studying the angiography films. Results: Among the 40 poisoned patients studied, 15 (37.5%) had coronary artery ectasia, mainly in the left anterior descending artery, but 25 (62.5%) did not. The same values were 2 (5%) and 38 (95%) in the nonexposed group, respectively, which was significantly different compared to the exposed group (p = 0.001). The odds ratio was 11.40. Conclusions: The prevalence of coronary artery ectasia in mustard gas-poisoned patients was 7.5 times more than in nonexposed controls. Considering the proposed odds ratio, the occurrence of coronary artery ectasia is around 11.4 times greater in mustard gas-poisoned veterans. This is the first study to suggest a strong correlation between mustard gas poisoning and coronary artery ectasia.

          Related collections

          Most cited references6

          • Record: found
          • Abstract: found
          • Article: not found

          Comparison of early and late toxic effects of sulfur mustard in Iranian veterans.

          Sulfur mustard is an alkylating agent that reacts with ocular, respiratory, cutaneous, and bone marrow tissues, resulting in early and late toxic effects. We compare these effects based on the experience in Iranian veterans exposed to the agent during the Iran-Iraq conflict (1983-88). The first clinical manifestations of sulfur mustard poisoning occurred in the eyes with a sensation of grittiness, lacrimation, photophobia, blepharospasm, and corneal ulceration. Respiratory effects appeared as rhinorhea, laryngitis, tracheobronchitis, and dyspnoea. Skin lesions varied from erythema to bullous necrotization. Initial leukocytosis and lymphopenia returned to normal within four weeks in recovered patients, but marked cytopenia with bone marrow failure occurred in fatal cases. Late toxic effects of sulfur mustard were most commonly found in lungs, skin and eyes. Main respiratory complications were chronic obstructive pulmonary disease, bronchiectasis, asthma, large airway narrowing, and pulmonary fibrosis. Late skin lesions were hyperpigmentation, dry skin, atrophy, and hypopigmentation. Fifteen of the severely intoxicated patients were diagnosed with delayed keratitis, having corneal vascularization, thinning, and epithelial defect. Respiratory complications exacerbated over time, while cutaneous and ocular lesions decreased or remained constant. Both the severity and frequency of bronchiectatic lesions increased during long-term follow-up. The only deteriorating cutaneous complication was dry skin. The maximum incidence of delayed kaeratitis was observed 15 to 20 years after initial exposure. Being suggested as the main cause ofassociated with malignancies and recurrent infections, natural killer cells were significantly lower 16 to 20 years after intoxication.
            Bookmark
            • Record: found
            • Abstract: found
            • Article: not found

            Prevalence of ectasia in human coronary arteries in patients in northern Greece referred for coronary angiography.

            We determined the prevalence of coronary artery ectasia (CAE) in patients who were referred to our institution for coronary angiography for any reason and investigated its potential association with angiographically significant coronary artery disease (CAD). We also examined whether CAE and CAD are topographically associated. In 10,524 consecutive patients from January 1, 1995 to December 31, 2003, the corresponding coronary angiographies were analyzed and cases of CAE were identified, recorded, and summarized. CAE was found in 287 patients (2.7%). It was markedly more prevalent in men than in women (p < 0.0001). Younger patients exhibited a higher prevalence of CAE (p < 0.01), and this was confirmed for men (p < 0.05) but not for women. Co-existence with CAD was noted in 250 cases of CAE (87.1%) (p = 0.001). CAD increased remarkably throughout the study (p < 0.001), whereas the prevalence of CAE remained unchanged. The prevalence of CAE was significantly greater in the right coronary artery than in the left anterior descending (LAD) coronary artery and the left circumflex artery (p < 0.0001), whereas CAD most commonly affected the LAD (p < 0.0001). Further, CAE in the right coronary artery showed a strong association with the existence of CAD in the LAD (p = 0.015). In conclusion, CAE is more frequent in young men who show a predilection for the right coronary arterial system. Although associated with CAD, a direct causal relation cannot be established.
              Bookmark
              • Record: found
              • Abstract: found
              • Article: not found

              Coronary artery ectasia: remains a clinical dilemma.

              Coronary artery ectasia (CAE) is defined as localized coronary dilatation that exceeds the diameter of normal adjacent segments or the diameter of the patient's largest coronary vessel by 1.5 times. The incidence of CAE varies from 1.5 to 5% in most literature; however, it was reported as high as 10% in some nations. Although, the pathogenesis of CAE is not fully understood, atherosclerosis remains the main association with CAE, in the western world. Kawasaki disease is another common cause of acquired heart disease in children, causing CAE. Kawasaki disease prevalence is overstated by its geographical distribution. Current modalities of investigation looked at the anatomical distribution of the disease and its possible ischemic effects. Biomarkers were studied in depth to explain the active nature of CAE; however, the common association with atherosclerosis weakens its significance. Here we reviewed CAE, its prevalence, relationship to other systemic anomalies in the vascular bed, pathogenesis and diagnostic tools currently in use.
                Bookmark

                Author and article information

                Journal
                CRD
                Cardiology
                10.1159/issn.0008-6312
                Cardiology
                S. Karger AG
                0008-6312
                1421-9751
                2011
                November 2011
                06 October 2011
                : 119
                : 4
                : 208-213
                Affiliations
                aDepartment of Interventional Cardiology, Imam Reza Hospital, bAllergy Research Center, School of Medicine, cHealth Promotion Research Center, dSchool of Traditional and Complementary Medicine, eSchool of Nursing and Midwifery, and fDepartment of Radiation Oncology, Mashhad University of Medical Sciences, Mashhad, Iran
                Author notes
                *Dr. Farahzad Jabbari, Allergy Research Center, Qaem Hospital, Mashhad 91766-99199 (Iran), Tel. +985 118 400 001, E-Mail jabari.f.md@gmail.com
                Article
                331436 Cardiology 2011;119:208–213
                10.1159/000331436
                21985793
                b6b57d04-6b2c-4eac-a921-387a5635a179
                © 2011 S. Karger AG, Basel

                Copyright: All rights reserved. No part of this publication may be translated into other languages, reproduced or utilized in any form or by any means, electronic or mechanical, including photocopying, recording, microcopying, or by any information storage and retrieval system, without permission in writing from the publisher. Drug Dosage: The authors and the publisher have exerted every effort to ensure that drug selection and dosage set forth in this text are in accord with current recommendations and practice at the time of publication. However, in view of ongoing research, changes in government regulations, and the constant flow of information relating to drug therapy and drug reactions, the reader is urged to check the package insert for each drug for any changes in indications and dosage and for added warnings and precautions. This is particularly important when the recommended agent is a new and/or infrequently employed drug. Disclaimer: The statements, opinions and data contained in this publication are solely those of the individual authors and contributors and not of the publishers and the editor(s). The appearance of advertisements or/and product references in the publication is not a warranty, endorsement, or approval of the products or services advertised or of their effectiveness, quality or safety. The publisher and the editor(s) disclaim responsibility for any injury to persons or property resulting from any ideas, methods, instructions or products referred to in the content or advertisements.

                History
                : 07 February 2011
                : 27 July 2011
                Page count
                Figures: 1, Tables: 5, Pages: 6
                Categories
                Original Research

                General medicine,Neurology,Cardiovascular Medicine,Internal medicine,Nephrology
                Coronary artery ectasia,Mustard gas,Aneurysm

                Comments

                Comment on this article