title: Bowel Angiodysplasia and Myocardial Infarction secondary to an ischaemic imbalance: a case report.
abstract: Angiodysplasia, defined as a vascular ectasia or arteriovenous malformation, is the most frequent cause of occult bleeding in patients older than 60 years and a significant association with several cardiac condition is described. Patients with anemia and negative findings on upper endoscopy and colonoscopy should be referred for further investigation of the small bowel. The investigation of choice, when available, is wireless capsule endoscopy. Several therapeutic options are available in this cases, as we reviewed in this report. We report a case of 78-year old man admitted to our Intensive Coronary Unit for dyspnea and chest pain. A diagnosis of non-ST-segment elevation acute coronary syndrome was made and a concomintant, significant anemia was found (hemoglobin 8.2 g/dl). No cororary disease was found by an angiography though the past medical history revealed systemic hypertension, chronic kidney disease (KDOQY stage III), and diabetes mellitus type II on insuline therapy. A Wireless Video capsule examination was positive for jejunum angiodysplasia and an argon plasma coagulation was chosen as terapeutic option. No subsequent supportive therapy and interventions were required in subsequent one year of follow-up.
authors.affiliation: Department of Translational Medical Sciences, University of Naples "Federico II", Naples, Italy.
authors.forename: Andrea
authors.initials: A
authors.lastname: Salzano
authors.affiliation: Department of Clinical Medicine and Surgery, University of Naples "Federico II" Naples, Italy, Via Sergio Pansini, 80131 Naples, Italy.
authors.forename: Aldo
authors.initials: A
authors.lastname: Rocca
authors.affiliation: Department of Cardiac Surgery, IRCCS Policlinico San Donato Milanese, Milan, Italy.
authors.forename: Michele
authors.initials: M
authors.lastname: Arcopinto
authors.affiliation: Department of Clinical Medicine and Surgery, University of Naples "Federico II", Naples, Italy.
authors.forename: Bruno
authors.initials: B
authors.lastname: Amato
authors.affiliation: Pulmonary Hypertension Center, Thoraxclinic at the University of Heidelberg, Heidelberg, Germany.
authors.forename: Alberto Maria
authors.initials: AM
authors.lastname: Marra
authors.affiliation: Centre Hospitalier de Luxembourg, Luxembourg Ville, Luxembourg.
authors.forename: Vincenzo
authors.initials: V
authors.lastname: Simonelli
authors.affiliation: Centre Hospitalier intercommunal de Poissy, Saint-Germain-en-Laye, France.
authors.forename: Pasquale
authors.initials: P
authors.lastname: Mozzillo
authors.affiliation: Unit of Hepatobiliary Surgery and Liver Transplant Center, Department of Gastroenterology and Transplantation, "A. Cardarelli" Hospital, Naples, Italy.
authors.forename: Antonio
authors.initials: A
authors.lastname: Giuliani
authors.affiliation: Department of Sport Sciences and Wellness, University of Naples "Parthenope", Naples, Italy.
authors.forename: Domenico
authors.initials: D
authors.lastname: Tafuri
authors.affiliation: Department of Public Health, University of Naples "Federico II", Naples, Italy.
authors.forename: Mariapia
authors.initials: M
authors.lastname: Cinelli
keywords: Angiodisplasya; Bowel; Ischemia; Miocardial Infarction