Leiomioma con extensión intracardiaca que condiciona insuficiencia cardiaca aguda: Reporte de caso / Leiomyoma with intracardiac extensión leading to acute heart failure: (case report)

Son raros los casos de leiomiomas intravenosos con extensión intracardiaca. En pacientes con manifestaciones de sobrecarga de cavidades derechas o quienes debutan con síntomas de insuficiencia cardiaca aguda y cuyos síntomas no mejoran con el manejo convencional, se debe considerar esta entidad, y es importante evaluar de forma integral con estudios de gabinete como electrocardiograma, ecocardiograma, tomografía o resonancia magnética. Reportamos el caso de una mujer de 46 años que manifiesta síntomas de insuficiencia cardiaca aguda e inadecuada respuesta a los fármacos convencionales. Con hallazgos ecocardiográficos de tumoración en atrio derecho que protruye a ventrículo derecho y causa insuficiencia tricuspídea. Por estudio tomográfico se confirma la extensión del tumor a vena cava inferior y ventrículo derecho; se resuelve de forma quirúrgica con resección radical y se confirma la extirpación histológica mediante estudio anatomopatológico.

Cases of intravenous leiomyoma with intracardiac extension are rare. Patients with signs of right-sided overload who present symptoms of acute heart failure and whose symptoms do not improve with conventional management, we must consider this entity. It is important to comprehensively assess with imaging studies such as electrocardiogram, echocardiogram, Tomography (CT scan) or magnetic resonance. The following is a report of the case of a 46 year old woman with symptoms of acute heart failure and inadequate response to conventional drugs. The echocardiographic show findings of a tumor in the right atrium, protruding to the right ventricle causing tricuspid regurgitation. The CT scan confirmed the extent of the tumor to the inferior vena cava and right ventricle, and was resolved surgically with radical resection and histology lineage confirmed by pathologic examination.

Pericarditis purulenta: presentación de un caso y diagnósticos diferenciales / Purulent pericarditis. Case report

Purulent pericarditis is an infrequent disease which affects the pericardium and has a high mortality rate. The diagnosis is suspected in a febrile patient with right cardiac failure and a primary infectious source. However, not all patients present in this form therefore the diagnosis and treatment can be difficult and a real challenge. This report is of a patient with this disease and other etiologic possibilities are discussed.