ABSTRACT
Splenic abscess is a well-described but rare complication of infective endocarditis. Rapid diagnosis and treatment are essential as its course can be fatal. We present three case reports that describe the management of splenic abscesses in patients initially diagnosed with infective endocarditis. In all cases, the diagnosis was based on the findings of abdominal computed tomography [CT] scan or magnetic resonance imaging [MRI]. In two of the cases, splenectomy was performed before valve surgery; while in the third case, the spleen was removed after cardiac surgery. All three patients recovered fully, with satisfactory follow-up as outpatients. Immediate splenectomy, combined with appropriate antibiotics and valve replacement surgery alongside multi-disciplinary team work could be the treatment of choice in this clinical scenario
ABSTRACT
Metastatic cardiac tumors are far more common than primary tumors, and benign primary cardiac tumors are common than malignant tumors. We report a 22-year-old Saudi woman with right femur osteosarcoma who was found to have a large right ventricular mass by transthoracic and transesophageal echocardiography. Diagnosis was highly suggestive by cardiac magnetic resonance imaging [MRI] and fluorodeoxyglucose positron emission tomography/computed tomography [FDG PET/CT] scan. We performed a review of the literature for metastatic osteosarcoma of the right ventricle
Subject(s)
Humans , Female , Heart Ventricles/pathology , Heart Neoplasms/secondary , Neoplasm Metastasis , Bone Neoplasms/complications , Femur , Femoral Neoplasms , Magnetic Resonance Imaging , Positron-Emission TomographyABSTRACT
Coronary artery fistulae are rare congenital or acquired connections between the coronary vessels and the cardiac chambers or other vascular structures. We present two consecutive cases of coronary fistulae between the proximal left anterior descending artery [LAD] and the main pulmonary artery. Both cases where admitted with history of acute coronary syndromes and had multivessel coronary disease along with coronary pulmonary fistulae. The two cases were managed by coronary artery bypass grafting [CABG] and repair of the fistulae.
ABSTRACT
Elevated plasma brain natriuretic peptide [BNP] levels have been demonstrated in patients with chronic valvular disease. We designed the present study to assess whether changes in N-terminal pro-brain natriuretic peptide [NT-proBNP] levels after mitral, aortic and double mitral and aortic valve replacement reflect changes in heart failure [HF] symptoms including New York Heart Association [NYHA] class and changes in left atrium [LA] size, left ventricle [LV] size and LV function. A prospective observational nonrandomized study among consecutive patients under-going mitral and/or aortic valve replacement in our center. The study population consisted of 24 patients [mean [SD] age of 55.3 [16.2] years, 58% were males] who underwent surgical mitral valve replacement [12 patients], aortic valve replacement [8 patients] and combined mitral and aortic valve replacement [4 patients]. NT-proBNP measurement, transthoracic echocardiography and NYHA class assessments were performed before and 6 months after surgery. The decrease in NT-proBNP was associated with decrease in left atrial dimension [r = 0.73, P<.002], LV and end-diastolic dimension [r=0.65, P=.001], LV end-systolic dimension [r=0.53, P=.036], and increase in ejection fraction [r=-0.65, P=.001] after 6 months postoperatively. Furthermore, a decreasing NT-proBNP was associated with improvement in NYHA class. NT-proBNP levels after mitral, aortic and double valve replacement correlates with changes in HF manifestations as well as changes in LA size and LV dimension and function. Thus, we hypothesize that interval measurement of the NT-proBNP level at clinic visits can allow early detection of any clinical deterioration as well as the possibility of assessment of the long-term outcome of those patients