ABSTRACT
Mid-aortic syndrome (MAS) is a rare vascular disease that usually leads to renovascular hypertension. With the predominant manifestations being intractable arterial hypertension and lower extremity arterial insufficiency, it has rarely been associated with dilated cardiomyopathy. We report a young girl with congestive heart failure, where the cause was initially attributed to dilated cardiomyopathy. A repeated echocardiogram 6 months later brought the physician's suspicion of MAS because of the abnormal colour of Doppler from the subcostal view. Further assessment using CT angiography revealed discrete thoracic coarctation at the level of T10, with the narrowest diameter of 2.1 mm, thus confirming the diagnosis. Her inflammatory markers and connective tissue screening were negative. She underwent successful stenting of coarctation of the aorta, which later caused improvement in her cardiac function. We highlighted the importance of looking for treatable causes of dilated cardiomyopathy and vigilant clinical and echocardiogram assessment with high suspicion to diagnose MAS.
Subject(s)
Aortic Coarctation , Cardiomyopathy, Dilated , Humans , Cardiomyopathy, Dilated/diagnosis , Cardiomyopathy, Dilated/diagnostic imaging , Cardiomyopathy, Dilated/complications , Female , Aortic Coarctation/complications , Aortic Coarctation/diagnosis , Aortic Coarctation/diagnostic imaging , Computed Tomography Angiography , Echocardiography , Stents , Diagnosis, Differential , Syndrome , Heart Failure/etiologyABSTRACT
Supracardiac total anomalous pulmonary venous drainage is commonly associated with a left-sided ascending vein draining into innominate vein. We present a case of a newborn with a right-sided ascending vein, draining into the right superior caval vein with stenosis at the SVC-ascending vein junction, posing a surgical dilemma in corrective surgery. Usage of three-dimensional computed tomographic scan was essential in delineating the anatomy and aiding surgery. The case demonstrates the rarity of this type of cardiac disease and the complications that develop.
Subject(s)
Pulmonary Veins , Scimitar Syndrome , Brachiocephalic Veins/diagnostic imaging , Brachiocephalic Veins/surgery , Drainage , Humans , Infant, Newborn , Pulmonary Veins/diagnostic imaging , Pulmonary Veins/surgery , Scimitar Syndrome/diagnostic imaging , Scimitar Syndrome/surgery , Vena Cava, Superior/diagnostic imaging , Vena Cava, Superior/surgeryABSTRACT
The diagnosis of nonbacterial thrombotic endocarditis (NTBE) is rarely made during life. This report describes a child who had high-grade non-Hodgkin's lymphoma with NTBE and multiple systemic embolism. The transthoracic echocardiographic findings of mitral valve leaflet vegetations and progressive regurgitation led to surgical resection of the vegetations. A high index of suspicion is needed when a clinician is faced with a patient who has malignancy, systemic embolic phenomena, and persistent negative blood cultures.
