Images in cardiology
Coronary artery fistula presenting as unstable angina
Fístula de artéria coronária apresentando-se como angina instável
Miguel Silva Vieira
, Nuno Antunes, Diana Anjo, Paulo Palma, Henrique Carvalho, Severo Torres
Corresponding author
Cardiology Department, Hospital Santo António, Centro Hospitalar do Porto, Porto, Portugal
Read
6977
Timeswas read the article
1747
Total PDF
5230
Total HTML
Share statistics
array:24 [ "pii" => "S2174204913000470" "issn" => "21742049" "doi" => "10.1016/j.repce.2013.02.009" "estado" => "S300" "fechaPublicacion" => "2013-02-01" "aid" => "213" "copyright" => "Sociedade Portuguesa de Cardiologia" "copyrightAnyo" => "2012" "documento" => "article" "crossmark" => 0 "licencia" => "http://creativecommons.org/licenses/by-nc-nd/4.0/" "subdocumento" => "sco" "cita" => "Rev Port Cardiol. 2013;32:165-7" "abierto" => array:3 [ "ES" => true "ES2" => true "LATM" => true ] "gratuito" => true "lecturas" => array:2 [ "total" => 3912 "formatos" => array:3 [ "EPUB" => 140 "HTML" => 3118 "PDF" => 654 ] ] "itemSiguiente" => array:20 [ "pii" => "S2174204913000287" "issn" => "21742049" "doi" => "10.1016/j.repce.2013.01.015" "estado" => "S300" "fechaPublicacion" => "2013-02-01" "aid" => "200" "copyright" => "Sociedade Portuguesa de Cardiologia" "documento" => "article" "crossmark" => 0 "licencia" => "http://creativecommons.org/licenses/by-nc-nd/4.0/" "subdocumento" => "sco" "cita" => "Rev Port Cardiol. 2013;32:169-71" "abierto" => array:3 [ "ES" => true "ES2" => true "LATM" => true ] "gratuito" => true "lecturas" => array:2 [ "total" => 5092 "formatos" => array:3 [ "EPUB" => 140 "HTML" => 4073 "PDF" => 879 ] ] "en" => array:11 [ "idiomaDefecto" => true "cabecera" => "<span class="elsevierStyleTextfn">Image in cardiology</span>" "titulo" => "Usefulness of cardiac computed tomography in planning and evaluating alcohol septal ablation" "tienePdf" => "en" "tieneTextoCompleto" => "en" "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "169" "paginaFinal" => "171" ] ] "titulosAlternativos" => array:1 [ "pt" => array:1 [ "titulo" => "Utilidade da tomografia computorizada cardíaca no planeamento e avaliação do resultado da ablação septal por álcool" ] ] "contieneTextoCompleto" => array:1 [ "en" => true ] "contienePdf" => array:1 [ "en" => true ] "resumenGrafico" => array:2 [ "original" => 0 "multimedia" => array:7 [ "identificador" => "fig0020" "etiqueta" => "Figure 4" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr4.jpeg" "Alto" => 997 "Ancho" => 2168 "Tamanyo" => 241724 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0020" class="elsevierStyleSimplePara elsevierViewall">(A): Cardiac magnetic resonance (phase-sensitive inversion recovery), late enhancement study in short-axis view; (B): cardiac CT (MPR), 12 mm thickness, in the same view.</p>" ] ] ] "autores" => array:1 [ 0 => array:2 [ "autoresLista" => "Ana Faustino, Nuno Ferreira, Nuno Bettencourt, Mónica Carvalho, Daniel Leite, Vasco Gama" "autores" => array:6 [ 0 => array:2 [ "nombre" => "Ana" "apellidos" => "Faustino" ] 1 => array:2 [ "nombre" => "Nuno" "apellidos" => "Ferreira" ] 2 => array:2 [ "nombre" => "Nuno" "apellidos" => "Bettencourt" ] 3 => array:2 [ "nombre" => "Mónica" "apellidos" => "Carvalho" ] 4 => array:2 [ "nombre" => "Daniel" "apellidos" => "Leite" ] 5 => array:2 [ "nombre" => "Vasco" "apellidos" => "Gama" ] ] ] ] ] "idiomaDefecto" => "en" "Traduccion" => array:1 [ "pt" => array:9 [ "pii" => "S0870255112003046" "doi" => "10.1016/j.repc.2012.07.009" "estado" => "S300" "subdocumento" => "" "abierto" => array:3 [ "ES" => true "ES2" => true "LATM" => true ] "gratuito" => true "lecturas" => array:1 [ "total" => 0 ] "idiomaDefecto" => "pt" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S0870255112003046?idApp=UINPBA00004E" ] ] "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2174204913000287?idApp=UINPBA00004E" "url" => "/21742049/0000003200000002/v1_201305171228/S2174204913000287/v1_201305171228/en/main.assets" ] "itemAnterior" => array:19 [ "pii" => "S2174204913000469" "issn" => "21742049" "doi" => "10.1016/j.repce.2013.02.008" "estado" => "S300" "fechaPublicacion" => "2013-02-01" "aid" => "212" "copyright" => "Sociedade Portuguesa de Cardiologia" "documento" => "article" "crossmark" => 0 "licencia" => "http://creativecommons.org/licenses/by-nc-nd/4.0/" "subdocumento" => "sco" "cita" => "Rev Port Cardiol. 2013;32:163-4" "abierto" => array:3 [ "ES" => true "ES2" => true "LATM" => true ] "gratuito" => true "lecturas" => array:2 [ "total" => 2957 "formatos" => array:3 [ "EPUB" => 138 "HTML" => 2255 "PDF" => 564 ] ] "en" => array:11 [ "idiomaDefecto" => true "cabecera" => "<span class="elsevierStyleTextfn">Image in cardiology</span>" "titulo" => "Novel mutation in the <span class="elsevierStyleItalic">KCNH2</span> gene associated with long QT syndrome" "tienePdf" => "en" "tieneTextoCompleto" => "en" "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "163" "paginaFinal" => "164" ] ] "titulosAlternativos" => array:1 [ "pt" => array:1 [ "titulo" => "Nova mutação identificada no gene <span class="elsevierStyleItalic">KCNH2</span> associado à síndrome do QT longo" ] ] "contieneTextoCompleto" => array:1 [ "en" => true ] "contienePdf" => array:1 [ "en" => true ] "resumenGrafico" => array:2 [ "original" => 0 "multimedia" => array:7 [ "identificador" => "fig0005" "etiqueta" => "Figure 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 3035 "Ancho" => 3000 "Tamanyo" => 1065308 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">(A) and (B) The first two electrocardiograms, with corrected QT interval between 428 and 468 ms. (C) The novel mutation identified in exon 4 of the <span class="elsevierStyleItalic">KCNH2</span> gene.</p>" ] ] ] "autores" => array:1 [ 0 => array:2 [ "autoresLista" => "Doroteia Silva, Gabriel Miltenberger-Miltenyi, Maria José Correia, António Nunes Diogo" "autores" => array:4 [ 0 => array:2 [ "nombre" => "Doroteia" "apellidos" => "Silva" ] 1 => array:2 [ "nombre" => "Gabriel" "apellidos" => "Miltenberger-Miltenyi" ] 2 => array:2 [ "nombre" => "Maria José" "apellidos" => "Correia" ] 3 => array:2 [ "nombre" => "António Nunes" "apellidos" => "Diogo" ] ] ] ] ] "idiomaDefecto" => "en" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2174204913000469?idApp=UINPBA00004E" "url" => "/21742049/0000003200000002/v1_201305171228/S2174204913000469/v1_201305171228/en/main.assets" ] "en" => array:16 [ "idiomaDefecto" => true "cabecera" => "<span class="elsevierStyleTextfn">Images in cardiology</span>" "titulo" => "Coronary artery fistula presenting as unstable angina" "tieneTextoCompleto" => true "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "165" "paginaFinal" => "167" ] ] "autores" => array:1 [ 0 => array:4 [ "autoresLista" => "Miguel Silva Vieira, Nuno Antunes, Diana Anjo, Paulo Palma, Henrique Carvalho, Severo Torres" "autores" => array:6 [ 0 => array:4 [ "nombre" => "Miguel Silva" "apellidos" => "Vieira" "email" => array:1 [ 0 => "zemiguelvieira@gmail.com" ] "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">¿</span>" "identificador" => "cor0005" ] ] ] 1 => array:2 [ "nombre" => "Nuno" "apellidos" => "Antunes" ] 2 => array:2 [ "nombre" => "Diana" "apellidos" => "Anjo" ] 3 => array:2 [ "nombre" => "Paulo" "apellidos" => "Palma" ] 4 => array:2 [ "nombre" => "Henrique" "apellidos" => "Carvalho" ] 5 => array:2 [ "nombre" => "Severo" "apellidos" => "Torres" ] ] "afiliaciones" => array:1 [ 0 => array:1 [ "entidad" => "Cardiology Department, Hospital Santo António, Centro Hospitalar do Porto, Porto, Portugal" ] ] "correspondencia" => array:1 [ 0 => array:3 [ "identificador" => "cor0005" "etiqueta" => "⁎" "correspondencia" => "Corresponding author." ] ] ] ] "titulosAlternativos" => array:1 [ "pt" => array:1 [ "titulo" => "Fístula de artéria coronária apresentando-se como angina instável" ] ] "resumenGrafico" => array:2 [ "original" => 0 "multimedia" => array:7 [ "identificador" => "fig0030" "etiqueta" => "Figure 2" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr2.jpeg" "Alto" => 468 "Ancho" => 1400 "Tamanyo" => 96909 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">(A): coronary angiography depicting no obstructive epicardial disease in the left dominant coronary circulation. (B and C): the right coronary artery was a small caliber vessel, with significant tortuosity in its proximal segment, but with no obstructive disease. An abnormal vessel was noted (arrows) arising from its proximal course and heading left, toward a posterior-superiorly located structure. LAD: left anterior descending artery; LCx: left circumflex artery; RCA: right coronary artery.</p>" ] ] ] "textoCompleto" => "<span class="elsevierStyleSections"><p id="par0005" class="elsevierStylePara elsevierViewall">A 74-year-old man, with a history of heavy smoking, presented with unstable angina (<a class="elsevierStyleCrossRef" href="#fig0025">Figure 1</a>). Dobutamine stress echocardiography showed ischemia in the right coronary artery territory. Coronary angiography revealed no obstructive epicardial disease in the left dominant circulation (<a class="elsevierStyleCrossRef" href="#fig0030">Figure 2</a>A); the right coronary artery (RCA) was a small caliber and tortuous vessel, with only minor atheroma. However, an abnormal vessel arising from the proximal RCA was noted (<a class="elsevierStyleCrossRef" href="#fig0030">Figure 2</a>B and C), confirmed as a fistulous connection to the left atrium by multislice computed tomography, which also excluded other vascular anomalies (<a class="elsevierStyleCrossRef" href="#fig0035">Figure 3</a>). This was deemed to be causing a coronary steal phenomenon. Exercise myocardial perfusion imaging under anti-ischemic therapy excluded residual ischemia and the patient was successfully conservatively managed (<a class="elsevierStyleCrossRef" href="#fig0040">Figure 4</a>).</p><elsevierMultimedia ident="fig0025"></elsevierMultimedia><elsevierMultimedia ident="fig0030"></elsevierMultimedia><elsevierMultimedia ident="fig0035"></elsevierMultimedia><elsevierMultimedia ident="fig0040"></elsevierMultimedia><p id="par0010" class="elsevierStylePara elsevierViewall">Coronary-pulmonary artery fistulas (CPAF) are rare, often incidental findings of coronary angiography, thought to be remnants of a vascular connection from the mediastinal mesoderm. Coronary steal has been reported even in small fistulas, due to runoff to a low-pressure system, with reduction of intracoronary diastolic perfusion pressure. Treatment should be based on the presence of symptoms and anatomy (number and size, nature of feeding vessel, draining site, quantification of myocardium at risk of ischemia and shunt), with catheter and surgical options being offered if technically feasible.</p><p id="par0015" class="elsevierStylePara elsevierViewall">Given the fistula's small size, from a non-dominant coronary artery, and in the absence of right ventricular impairment or significant ischemic burden, a conservative approach was followed. We highlight the role of multimodality imaging to depict CPAF anatomy and their relationship with relevant cardiac structures, and the role of stress testing in guiding therapy.</p><span id="sec0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle">Ethical disclosures</span><span id="sec0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle">Protection of human and animal subjects</span><p id="par0020" class="elsevierStylePara elsevierViewall">The authors declare that no experiments were performed on humans or animals for this investigation.</p></span><span id="sec0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle">Confidentiality of data</span><p id="par0025" class="elsevierStylePara elsevierViewall">The authors declare that they have followed the protocols of their work center on the publication of patient data and that all the patients included in the study received sufficient information and gave their written informed consent to participate in the study.</p></span><span id="sec0020" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle">Right to privacy and informed consent</span><p id="par0030" class="elsevierStylePara elsevierViewall">The authors have obtained the written informed consent of the patients or subjects mentioned in the article. The corresponding author is in possession of this document.</p></span></span><span id="sec0025" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle">Conflicts of interest</span><p id="par0035" class="elsevierStylePara elsevierViewall">The authors have no conflicts of interest to declare.</p></span></span>" "textoCompletoSecciones" => array:1 [ "secciones" => array:2 [ 0 => array:3 [ "identificador" => "sec0005" "titulo" => "Ethical disclosures" "secciones" => array:3 [ 0 => array:2 [ "identificador" => "sec0010" "titulo" => "Protection of human and animal subjects" ] 1 => array:2 [ "identificador" => "sec0015" "titulo" => "Confidentiality of data" ] 2 => array:2 [ "identificador" => "sec0020" "titulo" => "Right to privacy and informed consent" ] ] ] 1 => array:2 [ "identificador" => "sec0025" "titulo" => "Conflicts of interest" ] ] ] "pdfFichero" => "main.pdf" "tienePdf" => true "fechaRecibido" => "2012-06-11" "fechaAceptado" => "2012-06-18" "apendice" => array:1 [ 0 => array:1 [ "seccion" => array:2 [ 0 => array:4 [ "apendice" => "<p id="par0040" class="elsevierStylePara elsevierViewall">Supplementary material associated with this article can be found in the online version available at <span class="elsevierStyleInterRef" href="doi:10.1016/j.repc.2012.06.013">doi:10.1016/j.repc.2012.06.013</span></p>" "etiqueta" => "Appendix A" "titulo" => "Supplementary material" "identificador" => "sec0030" ] 1 => array:4 [ "apendice" => "<p id="par0045" class="elsevierStylePara elsevierViewall"><elsevierMultimedia ident="upi0005"></elsevierMultimedia><elsevierMultimedia ident="upi0010"></elsevierMultimedia><elsevierMultimedia ident="upi0015"></elsevierMultimedia><elsevierMultimedia ident="upi0020"></elsevierMultimedia><elsevierMultimedia ident="fig0005"></elsevierMultimedia><elsevierMultimedia ident="fig0010"></elsevierMultimedia><elsevierMultimedia ident="fig0015"></elsevierMultimedia><elsevierMultimedia ident="fig0020"></elsevierMultimedia></p>" "etiqueta" => "Appendix A" "titulo" => "Supplementary data" "identificador" => "sec0035" ] ] ] ] "multimedia" => array:12 [ 0 => array:7 [ "identificador" => "fig0025" "etiqueta" => "Figure 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 844 "Ancho" => 1900 "Tamanyo" => 435110 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">Admission 12-lead electrocardiogram showing no relevant ST-segment changes.</p>" ] ] 1 => array:7 [ "identificador" => "fig0030" "etiqueta" => "Figure 2" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr2.jpeg" "Alto" => 468 "Ancho" => 1400 "Tamanyo" => 96909 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">(A): coronary angiography depicting no obstructive epicardial disease in the left dominant coronary circulation. (B and C): the right coronary artery was a small caliber vessel, with significant tortuosity in its proximal segment, but with no obstructive disease. An abnormal vessel was noted (arrows) arising from its proximal course and heading left, toward a posterior-superiorly located structure. LAD: left anterior descending artery; LCx: left circumflex artery; RCA: right coronary artery.</p>" ] ] 2 => array:7 [ "identificador" => "fig0035" "etiqueta" => "Figure 3" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr3.jpeg" "Alto" => 594 "Ancho" => 1400 "Tamanyo" => 95833 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0015" class="elsevierStyleSimplePara elsevierViewall">Multislice computed tomography. (A): 2D multiplanar reformatted image revealing a fistulous connection (arrows) between the proximal right coronary artery (RCA) and the left atrium (LA). (B): 3D volume-rendered image showing the fistula (arrows) arising from the proximal right coronary artery with a retro-aortic course. RA: right atrium; RVOT: right ventricular outflow tract.</p>" ] ] 3 => array:7 [ "identificador" => "fig0040" "etiqueta" => "Figure 4" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr4.jpeg" "Alto" => 1331 "Ancho" => 1800 "Tamanyo" => 333033 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0020" class="elsevierStyleSimplePara elsevierViewall">Exercise single-photon emission computed tomography using standard Bruce protocol (8:43 minutes achieving 85% of the age-predicted maximum heart rate, 10.1 metabolic equivalents) showing no residual ischemia.</p>" ] ] 4 => array:5 [ "identificador" => "upi0005" "tipo" => "MULTIMEDIAECOMPONENTE" "mostrarFloat" => false "mostrarDisplay" => true "Ecomponente" => array:2 [ "fichero" => "mmc1.doc" "ficheroTamanyo" => 23040 ] ] 5 => array:6 [ "identificador" => "upi0010" "etiqueta" => "Video 1" "tipo" => "MULTIMEDIAECOMPONENTE" "mostrarFloat" => false "mostrarDisplay" => true "Ecomponente" => array:3 [ "fichero" => "mmc2.avi" "ficheroTamanyo" => 881824 "Video" => array:2 [ "flv" => array:5 [ "fichero" => "mmc2.flv" "poster" => "mmc2.jpg" "tiempo" => 0 "alto" => 0 "ancho" => 0 ] "mp4" => array:2 [ "fichero" => "mmc2.m4v" "poster" => "mmc2.jpg" ] ] ] ] 6 => array:6 [ "identificador" => "upi0015" "etiqueta" => "Video 2" "tipo" => "MULTIMEDIAECOMPONENTE" "mostrarFloat" => false "mostrarDisplay" => true "Ecomponente" => array:3 [ "fichero" => "mmc3.avi" "ficheroTamanyo" => 530368 "Video" => array:2 [ "flv" => array:5 [ "fichero" => "mmc3.flv" "poster" => "mmc3.jpg" "tiempo" => 0 "alto" => 0 "ancho" => 0 ] "mp4" => array:2 [ "fichero" => "mmc3.m4v" "poster" => "mmc3.jpg" ] ] ] ] 7 => array:6 [ "identificador" => "upi0020" "etiqueta" => "Video 3" "tipo" => "MULTIMEDIAECOMPONENTE" "mostrarFloat" => false "mostrarDisplay" => true "Ecomponente" => array:3 [ "fichero" => "mmc4.avi" "ficheroTamanyo" => 698604 "Video" => array:2 [ "flv" => array:5 [ "fichero" => "mmc4.flv" "poster" => "mmc4.jpg" "tiempo" => 0 "alto" => 0 "ancho" => 0 ] "mp4" => array:2 [ "fichero" => "mmc4.m4v" "poster" => "mmc4.jpg" ] ] ] ] 8 => array:5 [ "identificador" => "fig0005" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => false "mostrarDisplay" => true "figura" => array:1 [ 0 => array:4 [ "imagen" => "mmc5.jpeg" "Alto" => 836 "Ancho" => 750 "Tamanyo" => 64233 ] ] ] 9 => array:5 [ "identificador" => "fig0010" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => false "mostrarDisplay" => true "figura" => array:1 [ 0 => array:4 [ "imagen" => "mmc6.jpeg" "Alto" => 626 "Ancho" => 1500 "Tamanyo" => 88644 ] ] ] 10 => array:5 [ "identificador" => "fig0015" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => false "mostrarDisplay" => true "figura" => array:1 [ 0 => array:4 [ "imagen" => "mmc7.jpeg" "Alto" => 605 "Ancho" => 1000 "Tamanyo" => 108231 ] ] ] 11 => array:5 [ "identificador" => "fig0020" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => false "mostrarDisplay" => true "figura" => array:1 [ 0 => array:4 [ "imagen" => "mmc8.jpeg" "Alto" => 578 "Ancho" => 953 "Tamanyo" => 71739 ] ] ] ] ] "idiomaDefecto" => "en" "url" => "/21742049/0000003200000002/v1_201305171228/S2174204913000470/v1_201305171228/en/main.assets" "Apartado" => array:4 [ "identificador" => "9915" "tipo" => "SECCION" "en" => array:2 [ "titulo" => "Images in cardiology" "idiomaDefecto" => true ] "idiomaDefecto" => "en" ] "PDF" => "https://static.elsevier.es/multimedia/21742049/0000003200000002/v1_201305171228/S2174204913000470/v1_201305171228/en/main.pdf?idApp=UINPBA00004E&text.app=https://revportcardiol.org/" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2174204913000470?idApp=UINPBA00004E" ]
| Year/Month | Html | Total | |
|---|---|---|---|
| 2024 November | 7 | 4 | 11 |
| 2024 October | 29 | 25 | 54 |
| 2024 September | 38 | 22 | 60 |
| 2024 August | 55 | 25 | 80 |
| 2024 July | 36 | 31 | 67 |
| 2024 June | 42 | 26 | 68 |
| 2024 May | 48 | 25 | 73 |
| 2024 April | 59 | 22 | 81 |
| 2024 March | 65 | 20 | 85 |
| 2024 February | 31 | 33 | 64 |
| 2024 January | 33 | 28 | 61 |
| 2023 December | 32 | 28 | 60 |
| 2023 November | 32 | 18 | 50 |
| 2023 October | 53 | 12 | 65 |
| 2023 September | 48 | 17 | 65 |
| 2023 August | 33 | 16 | 49 |
| 2023 July | 42 | 8 | 50 |
| 2023 June | 41 | 11 | 52 |
| 2023 May | 54 | 19 | 73 |
| 2023 April | 38 | 6 | 44 |
| 2023 March | 40 | 18 | 58 |
| 2023 February | 29 | 20 | 49 |
| 2023 January | 41 | 5 | 46 |
| 2022 December | 51 | 19 | 70 |
| 2022 November | 41 | 32 | 73 |
| 2022 October | 48 | 24 | 72 |
| 2022 September | 31 | 26 | 57 |
| 2022 August | 43 | 24 | 67 |
| 2022 July | 46 | 23 | 69 |
| 2022 June | 28 | 17 | 45 |
| 2022 May | 29 | 29 | 58 |
| 2022 April | 46 | 38 | 84 |
| 2022 March | 38 | 25 | 63 |
| 2022 February | 41 | 14 | 55 |
| 2022 January | 32 | 14 | 46 |
| 2021 December | 23 | 24 | 47 |
| 2021 November | 37 | 31 | 68 |
| 2021 October | 38 | 46 | 84 |
| 2021 September | 27 | 23 | 50 |
| 2021 August | 35 | 33 | 68 |
| 2021 July | 23 | 27 | 50 |
| 2021 June | 28 | 19 | 47 |
| 2021 May | 30 | 42 | 72 |
| 2021 April | 52 | 27 | 79 |
| 2021 March | 78 | 10 | 88 |
| 2021 February | 53 | 9 | 62 |
| 2021 January | 28 | 9 | 37 |
| 2020 December | 12 | 7 | 19 |
| 2020 November | 30 | 6 | 36 |
| 2020 October | 29 | 6 | 35 |
| 2020 September | 27 | 16 | 43 |
| 2020 August | 14 | 7 | 21 |
| 2020 July | 33 | 6 | 39 |
| 2020 June | 23 | 0 | 23 |
| 2020 May | 21 | 4 | 25 |
| 2020 April | 32 | 6 | 38 |
| 2020 March | 31 | 6 | 37 |
| 2020 February | 84 | 27 | 111 |
| 2020 January | 26 | 5 | 31 |
| 2019 December | 22 | 6 | 28 |
| 2019 November | 15 | 6 | 21 |
| 2019 October | 34 | 4 | 38 |
| 2019 September | 15 | 6 | 21 |
| 2019 August | 21 | 4 | 25 |
| 2019 July | 34 | 10 | 44 |
| 2019 June | 22 | 7 | 29 |
| 2019 May | 25 | 8 | 33 |
| 2019 April | 24 | 13 | 37 |
| 2019 March | 34 | 8 | 42 |
| 2019 February | 39 | 10 | 49 |
| 2019 January | 15 | 6 | 21 |
| 2018 December | 25 | 7 | 32 |
| 2018 November | 58 | 5 | 63 |
| 2018 October | 151 | 11 | 162 |
| 2018 September | 29 | 8 | 37 |
| 2018 August | 35 | 5 | 40 |
| 2018 July | 27 | 6 | 33 |
| 2018 June | 41 | 8 | 49 |
| 2018 May | 53 | 12 | 65 |
| 2018 April | 52 | 7 | 59 |
| 2018 March | 63 | 9 | 72 |
| 2018 February | 54 | 1 | 55 |
| 2018 January | 56 | 6 | 62 |
| 2017 December | 68 | 15 | 83 |
| 2017 November | 54 | 12 | 66 |
| 2017 October | 37 | 13 | 50 |
| 2017 September | 24 | 5 | 29 |
| 2017 August | 46 | 12 | 58 |
| 2017 July | 33 | 9 | 42 |
| 2017 June | 28 | 9 | 37 |
| 2017 May | 38 | 5 | 43 |
| 2017 April | 35 | 3 | 38 |
| 2017 March | 55 | 64 | 119 |
| 2017 February | 50 | 4 | 54 |
| 2017 January | 50 | 0 | 50 |
| 2016 December | 55 | 11 | 66 |
| 2016 November | 33 | 2 | 35 |
| 2016 October | 43 | 3 | 46 |
| 2016 September | 82 | 7 | 89 |
| 2016 August | 49 | 4 | 53 |
| 2016 July | 29 | 4 | 33 |
| 2016 June | 45 | 2 | 47 |
| 2016 May | 31 | 4 | 35 |
| 2016 April | 20 | 2 | 22 |
| 2016 March | 18 | 7 | 25 |
| 2016 February | 42 | 11 | 53 |
| 2016 January | 26 | 8 | 34 |
| 2015 December | 33 | 3 | 36 |
| 2015 November | 20 | 6 | 26 |
| 2015 October | 32 | 8 | 40 |
| 2015 September | 34 | 9 | 43 |
| 2015 August | 26 | 6 | 32 |
| 2015 July | 15 | 5 | 20 |
| 2015 June | 15 | 3 | 18 |
| 2015 May | 18 | 2 | 20 |
| 2015 April | 27 | 10 | 37 |
| 2015 March | 23 | 3 | 26 |
| 2015 February | 22 | 3 | 25 |
| 2015 January | 28 | 6 | 34 |
| 2014 December | 22 | 4 | 26 |
| 2014 November | 22 | 5 | 27 |
| 2014 October | 26 | 2 | 28 |
| 2014 September | 35 | 3 | 38 |
| 2014 August | 27 | 5 | 32 |
| 2014 July | 39 | 15 | 54 |
| 2014 June | 21 | 3 | 24 |
| 2014 May | 26 | 4 | 30 |
| 2014 April | 26 | 5 | 31 |
| 2014 March | 41 | 9 | 50 |
| 2014 February | 47 | 6 | 53 |
| 2014 January | 50 | 9 | 59 |
| 2013 December | 37 | 7 | 44 |
| 2013 November | 27 | 11 | 38 |
| 2013 October | 53 | 8 | 61 |
| 2013 September | 31 | 15 | 46 |
| 2013 August | 53 | 13 | 66 |
| 2013 July | 44 | 13 | 57 |
| 2013 June | 35 | 4 | 39 |
| 2013 May | 30 | 6 | 36 |
| 2013 April | 57 | 18 | 75 |
| 2013 March | 39 | 9 | 48 |
Show all
