[Meadows syndrome: Pathogeny and therapeutic perspectives]

Meadows syndrome or peripartum cardiomyopathy [PPCM], is a rare affection characterized with a heart failure on an apparently primitive, dilated cardiomyopathy [DCM], arising during the last month of the pregnancy or in the six months following the delivery, at women with healthy known heart. The incidence of PPCM seems rare. The literature indicate the infections and the auto-immune origin, but without a formal proof of it. The purpose of the treatment is to reduce the preload, to decrease vascular resistances and to increase myocardic contractility. The measures of secondary prevention require a rigorous contraception. We report a retrospective analysis concerning aetiopathogenesis hypothesis, risk factors and therapeutic modalities of this affection

[Bidirectional tachycardia: aetiology, mechanism and treatment-a case report]

Unusual tachyarrhythmia is characterized by a beat-to-beat alternation of the axis of the QRS complexes, the bidirectional tachycardia have multiple mechanisms and aetiologies. We report the observation of a 75-year-old man having a hypertensive dilated cardiomyopathy with chronic atrial fibrillation and treated by diuretics, digitalis and platelets antiaggregants. He presented with a global congestive cardiac failure. The electrocardiogram revealed a bidirectional tachycardia with a regular alternation of the QRS axis within the frontal plane. Laboratory results showed especially a hypokaliemia at 2.1 mEq/1. Digitalics withdrawal and kaliemia correction allowed the resolution of the tachycardia. The patient was treated with diuretics, Amiodarone and platelets antiaggregants. No further episodes of bidirectional tachycardia were observed

[Diagnosis of restrictive cardiomyopathy: place of the bidimensional echocardiography]

The restrictive cardiomyopathies are sporadic diseases, their diagnosis is often made tardively. Their main differential diagnosis is the chronic pericardiac constriction. The non invasive diagnostic techniques don't permit always to differentiate this two pathologies of different prognosis and treatment. The target of our work is to specify the place of the echocardiography in the diagnosis of the restrictive cardiomyopathies [RCM]. We collected between January 1993 and January 2005 four patients presenting a RCM. The circumstance of discovery was in any case a global cardiac insufficiency. The echocardiography showed a dilatation of the atrium in all patients, whereas the ventricles were of normal size three times. The study of the endocardium showed an apical fill in all patients, whereas the endocardic calcifications had not been recovered except one time, All patients had a valvular thickening. The systolic function was normal three times over four

[ long term autcome of tetralogy of Fallot]

Tetralogy of Fallot is the most common cyanotic congenital heart disease. The surgical treatment that is palliative or complete repair has allowed to transform the preview of this heart disorder. We suggests to study the long term outcome in patients undergoing surgical repair of tetralogy of Fallot, by emphasizing the quality of their lives, the complications, as well as the mortality. Ventricular arrhythmia and sudden cardiac death after repair of tetralogy of Fallot are devastating complications in adults survivors and their prediction remains difficult