Double jeopardy: multi-modality imaging of monozygotic "twin cap" atherosclerosis

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Guide Wire Assisted Catheterization and Colored Dye Injection for Vascular Mapping of Monochorionic Twin Placentas
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Guide Wire Assisted Catheterization and Colored Dye Injection for Vascular Mapping of Monochorionic Twin Placentas

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Scott W Murray1, Robert M Cooper2, Clare Appleby2

  • 1Institute for Cardiovascular Medicine and Science, Liverpool Heart and Chest Hospital, Liverpool, UK; Department of Critical Care Research, University of Liverpool, Liverpool, UK.

Atherosclerosis
|October 6, 2014
PubMed

Insights

Investigating asymptomatic atherosclerosis is crucial. This case highlights identical twins with similar coronary artery disease, emphasizing genetic risk and the need for proactive cardiac care to prevent myocardial infarction.

Area of Science:

  • Cardiology
  • Genetics
  • Atherosclerosis Research

Background:

  • Asymptomatic atherosclerosis remains under-investigated in clinical cardiology.
  • The role of genetic predisposition in atherosclerosis warrants further attention.
  • Early detection and intervention are key to managing vulnerable plaque.

Observation:

  • A case study involving monozygotic twins with identical coronary artery lesions is presented.
  • One twin experienced a cardiac arrest, while the other remained asymptomatic despite similar disease.
  • This highlights the potential for silent, vulnerable atherosclerosis.

Findings:

  • Identical twins exhibited compositionally similar coronary artery lesions.
  • The clinical presentation varied significantly between twins, indicating differing rupture risk.
  • Non-invasive and invasive imaging revealed the extent and nature of the atherosclerosis.

Implications:

  • Active suspicion and intensive treatment are necessary for individuals with genetic risk factors for myocardial infarction.
  • Understanding genetic influences on atherosclerosis can guide personalized prevention strategies.
  • Further research into identifying and managing vulnerable, asymptomatic atherosclerosis is essential.

Keywords:
AtherosclerosisCTIVUSMRIOCTTwin studiesVulnerable plaque

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