ABSTRACT
Purpose: Familial retinal arterial macroaneurysm (FRAM) is a rare genetic disorder caused by a gene mutation in the insulin-like growth factor binding protein 7 (IGFBP7). Observations: We report a 30-year-old male with FRAM and IGFBP7 gene mutation who presented with an acute coronary syndrome (ACS). Invasive coronary angiography revealed a large aneurysm at the proximal part of the left anterior descending (LAD) artery. Conclusions and Importance: Few cases with systemic vascular involvement in patients with FRAM have been described before; however, our case represents the first documentation of a LAD artery aneurysm in a patient with FRAM and IGFBP7 gene mutation.
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
Left ventricular pseudoaneurysms occur as a consequence of left ventricular free wall rupture contained by pericardium. This clinical situation is an uncommon but lethal complication of acute myocardial infarction. Surgery usually is the preferred therapeutic option but is associated with significant perioperative risk. We present a case of successful percutaneous closure of left ventricular ruptured pseudoaneurysm post myocardial infarction in a patient who failed two previous surgical repairs.