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A 78-year-old man with long-standing end-stage renal failure and a previous mitral-valve replacement presented with a one-month history of episodes of effort-related syncope. Results of physical examination and echocardiography were consistent with the presence of severe aortic stenosis. At coronary angiography, striking calcification of the left coronary artery outlining the major coronary vessels was evident on initial fluoroscopy (Panel A). Selective coronary angiography (Panel B) revealed severe left main-stem disease (arrow) and diffuse left and right coronary artery disease. Although coronary-artery calcification is common, even in young patients who are undergoing dialysis, the relation between atherosclerosis and vascular calcification is . . . [Full Text of this Article] |
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