Faculty Bibliography

We sought to determine the role of an abnormal ankle-brachial index (ABI) in an African-American population with suspected coronary artery disease (CAD) referred for diagnostic coronary angiography. In this population, an ABI < or =0.90 predicted the presence of > or =3-vessel or left main CAD with a sensitivity of 85% and specificity of 77%. However, a normal ABI did not predict absence of 1- or 2-vessel CAD. These results suggest that in this population, the ABI can be used to increase the pretest probability of severe CAD.

BACKGROUND:Endometriosis has rarely been associated with ascites and less often with pleural (usually right-sided) effusion. CASE/METHODS:A multiparous, reproductive-aged woman was referred for evaluation of possible ovarian carcinoma following the development of dyspnea, progressive abdominal distention, weight loss and increasing secondary dysmenorrhea. Imaging demonstrated normal ovaries in the presence of massive ascites and right-sided pleural and pericardial effusions. At laparotomy, grade IV endometriosis was noted. Total abdominal hysterectomy, bilateral salpingo-oophorectomy and appendectomy were performed, with subsequent resolution of all cavity fluid accumulations. CONCLUSION/CONCLUSIONS:Pericardial and pleural effusions in the presence of ascites may be associated with endometriosis.