Non-hodgkin's lymphoma presenting as constrictive pericarditis: a rare case report

Constrictive pericarditis [CP] is an uncommon post inflammatory disorder. It is described as pericardial thickening, myocardial constriction, and impaired diastolic filling. The most common etiologies are idiopathy, mediastinal radiotherapy, and prior cardiac surgery. Less common etiologies include viral infections, collagen vascular disorders, renal failure, sarcoidosis, tuberculosis, and blunt chest trauma. CP can less commonly be caused by malignancy. We report a very rare case of non-Hodgkin's lymphoma [NHL] presenting twice with attacks of decompensated heart failure. Echocardiography revealed that CP was responsible for the patient's symptoms as the first manifestation of NHL. Chest computed tomography scan and biopsy findings were compatible with the diagnosis of NHL. The patient received R-CHOP [cyclophosphamide, hydroxydaunorubicin, Oncovin®, and prednisone or prednisolone, combined with the monoclonal antibody rituximab] chemotherapy. Three months later, there was significant improvement in the patient's symptoms and considerable decrease in pericardial thickness

relationship between serum level of manganese and severity of coronary atherosclerosis

Trace elements such as manganese have an important role in the maintenance of the normal structure and physiology of cells. Manganese is involved in many biological processes. Therefore, an evaluation of the manganese in the atherosclerotic disease is important. In this cross sectional study, 334 subjects, without recent cardiac event and history of collagen vascular or infectious disease were investigated. All patients divided into 4 groups to evaluate severity of coronary artery disease according to Syntax scoring system. All groups were matched in cardiovascular risk factors. The serum level of manganese in normal coronary group was 1.47 +/- 0.23 micro g/L and in total atherosclerotic groups was 1.06 +/- 0.37 micro g/L. The serum level of manganese was significantly lower in total atherosclerotic groups than normal group [p=0.001] and significantly decreased with severity of atherosclerosis. The serum level of manganese was significantly lower in sever atherosclerosis patients than mild and moderate coronary artery disease groups [p=0.001]. The finding indicated that the serum level of manganese is lower in atherosclerotic patients and it decreases with severity of atherosclerosis

Infective Left Atrial Dissecting Flap after Cardiac Surgery

Left atrial dissection (LatD), defined as the forced separation of the left atrial (LA) wall layers by blood, is a rare and severe complication of cardiac surgery. It is most frequently associated with atrioventricular junction injuries. We report a case of infected LatD after coronary artery bypass graft, mitral valve replacement, aortic valve replacement and ascending aortic root replacement. The patient was presented with septicemia and disseminated intravascular coagulation. To the best of our knowledge, this is the first case report of LA dissecting flap concomitant with attached infective vegetations identified by transesophageal echocardiography.