Coronaro Cameral Fistula: Literature Review, Diagnosis and Management, about a Case

A coronary fistula is defined as a direct connection between a coronary artery and a heart chamber, great vessel, or other vascular structure that "bypasses" the myocardial capillary bed. This is a rare pathology that is usually not discovered until later in life, and exceptionally not during childhood. We report the case of a young patient who was hospitalized for chest pain and shortness of breath and who was found to have a coronary fistula on angiography. A 66-year-old patient. Hypertension on dual therapy for 16 years and diabetes on OAD (Oral Antidiabetic) for 4 years. He was hospitalized with typical angina pectoris and dyspnea, and the stress test was positive. Laboratory examination revealed a good general condition with NYHA stage 3 dyspneic angina pectoris extending to the upper extremities and no evidence of heart failure. Looking at the balance, we see a slight increase in troponin. ECG returns to regular sinus rhythm, with electrical LVH (left ventricular hypertrophy) and ambient negative waves, no rhythm or conduction abnormalities. Transthoracic echocardiography (TTE) reverses hypertensive heart disease with good global and partial contractility without significant valvular disease associated with systolic pulmonary arterial pressure (SPAP) at 35 mmHg. Coronary angiography is performed and shows evidence of minor involvement of the central CX artery and a coronary camera fistula from the first diagonal artery draining into the left ventricle. Management was about optimizing medical care. The patient received an appointment and was declared discharged. Coronary camera fistulae are rare, found in approximately 0.3% of coronary angiographic studies performed. Most are congenital and may occur primarily due to trauma, erosive infection of the vessel wall, or iatrogenicity during transluminal coronary angioplasty, myocardial biopsy, or valve replacement. In many cases, simple but complex forms can be described. The gold standard for confirming the diagnosis remains coronary angiography, which highlights both the affected arteries and drainage sites. Cardiac scanners occupy an increasingly important position, especially as they provide morphologically accurate information. Surgical or percutaneous treatment of the fistula with a coil is recommended in symptomatic adult patients, especially those with significant or complicated right-to-left shunts. The authors suggest treatment with ?-blockers when multiple sinusoidal fistulas associated with ventricular wall hypertrophy are present. Close monitoring is recommended for asymptomatic small fistula. Corneal fistula is a rare congenital or acquired condition that is mostly asymptomatic and discovered in adulthood. Coronary angiography and heart scan can be used to confirm the diagnosis. Treatment is usually surgical or endovascular. However, in some cases, drug treatment with beta-blockers may help.

Thrombus intraventriculaire gauche chez un jeune patient atteint de COVID-19 / Left intraventricular thrombus in a young patient with COVID-19

La COVID-19 est associée à un état d'hypercoagulabilité. L'incidence du thrombus intraventriculaire gauche est relativement faible en absence d'une cardiopathie hypokinétique sévère avec altération de la fraction d'éjection. Nous rapportant le cas d'un homme de 37 ans infecté par le SARS-CoV-2 présentant un thrombus intraventriculaire gauche en absence de cardiopathie connue. Le décès était survenu suiteà un arrêt cardiaque.

Structural characteristics and functional evaluation of right ventricule / 军事医学

The right ventricle owns a complex geometry chamber and a special anatomical structure , which makes it dif-ficult to precisely assess its function .Right ventricular function has been found to be important in the development of cardi -ovascular diseases .This review summarizes recent progress in the characteristics and elevation of right heart function .

Color Doppler echocardiographic characteristics of bilocular heart and associated cardiac malformations / 中华超声影像学杂志

Objective To probe into the color Doppler echocardiographic characteristics of bilocular heart (BH) and associated malformations. Methods Twenty patients of BH were examined with color Doppler echocardiography (CDE) and the characteristics were observed. All the CDE results were compared with angiocardiography and 14 were confirmed by operation. Results Nineteen cases were properly diagnosed based on the CDE characteristics,1 case were misdiagnosed as mitral atresia. CDE characteristics of BH were obvious:① Apical four-chamber view of two-dimensional echocardiography (2DE) showed total echo dropout in both the interatrial septum and the interventricular septum and disappearance of the intracardiac "cross". The common atrioventricular valve closed during systole and appeared as figure "8", named 2DE "8" sign. During diastole, the common atrioventricular valve opened to a common ventricle. ② Color Doppler flow imaging (CDFI) showed common intra-atrial flow signal entereda common ventricle through common atrioventricular valve during diastole in all patients and colorful reflux through common atrioventricular valve during systole in 15 cases. ③ Among the 20 eases, 16 of the common atria were situs solitus,4 were situs inversus; 10 of the common ventricles were type A,2 were type B and 8 were type C. According to the spatial relationship of the great arteries,there were 4 type Ⅰ ,7 type Ⅱ and 9 type Ⅲ.There were 18 pulmonary stenosis and 2 pulmonary hypertension. ④ In the presence of pulmonary stenosis, CDFI showed colorful shunt signals through pulmonary artery during systole. Conclusions BH and associated malformations have obvious echocardiographic characteristics. CDE has a specific value in diagnosing BH and associated malformations.

A Case of Papillary Fibroelastoma of the Left Ventricular Outflow Tract Causing Stroke

Cardiac papillary fibroelastoma rarely occurs. A 63-year-old otherwise healthy man presented with sudden loss of consciousness and right hemiparesis. Echocardiography showed a small freely movable round mass attached to the septal side of the left ventricular outflow tract. At surgery, it was revealed to be a small round mass with a thin elongated stalk resembling a cherry. The pathologic findings were characteristics of a papillary fibroelastoma.

Effect of carboxymethyl chitosan on ATP-sensitive K~+ currents in single ventricular myocyte of rat / 中国海洋药物

Objective To investigate the effect of carboxymethyl chitosan on ATP-sensitive K+ currents(IKATP) in single ventricular myocyte of rat.Methods Single ventricular myocyte of rat was isolated with enzymatic dissociation technique.Whole-cell patch clamp technique was used.The stimulating protocol was:holding potential-40 mV,command potential-100 mV to +50 mV,step potential + 10 mV,duration 200 ms,stimulating interval 6 s.Results Carboxymethyl chitosan inhibited the ATP-sensitive K+ channel(KATP channel) in a dose-dependent manner.When holding potential was-60 mV and stimulating potential was + 50 mV,carboxymethyl chitosan(0.1%,0.2%,0.3%) decreased the amplitude values of IKATP to 66.1%?9.9%,50.3%?13.3%and 39.8%?9.5%(n=7)of control,respectively.The changes of IKATP under other command potentials were consistent with this.Conclusion Carboxymethyl chitosan inhibits KATP channel in single ventricular myocyte of rat in a dose-dependent manner,and may be one of the mechanisms of antiarrhythmia.