[Ventricular tachycardia in a patient with mid-ventricular hypertrophic myocardiopathy and apical aneurysm]. / Taquicardias ventriculares sostenidas en un paciente con miocardiopatía hipertrófica medioventricular y aneurisma apical.

A case is presented of a 77-year-old patient who was admitted with a pattern of sustained ventricular tachycardia and diagnosed with midventricular hypertrophic myocardiopathy with apycal aneurysm. Under treatment with amiodarone at low doses, the patient is asymptomatic with no recurrence of the arrhytmias at one year. The association of midventricular hypertrophic myocardiopathy with apycal aneurysm and of those with sustained ventricular tachycardia are reviewed in conjunction with their treatment.

[Subtotal thyroidectomy. A treatment to keep in mind in amiodarone-induced thyrotoxicosis]. / Tiroidectomía subtotal. Un tratamiento a tener en cuenta en la tirotoxicosis inducida por amiodarona.

Amiodarone is an antiarrhythmic drug, frequently used in cardiology, which may produce secondary effects on the thyroid function. These effects can range from subtle changes in peripheral hormones without clinical manifestations, to severe forms of hypothyroidism or hyperthyroidism. The evolution of amiodarone-induced-hyperthyroidism can be mild, requiring only the withdrawal of the drug, or very severe, requiring an aggressive therapy with multiple drugs which may in some cases be fatal in spite of this therapy. Recently, the increase in the usage of this drug has produced reports of severe amiodarone-induced-thyrotoxicosis requiring surgery in some cases (subtotal or total thyroidectomy). A case of amiodarone-induced-thyrotoxicosis in its more aggressive form, which required intensive pharmacological treatment ultimately combined with surgery, is presented here.

[Pulmonary thromboembolism with mobile thrombus in the right atrium. Presentation of a case diagnosed with bidimensional echocardiography and review of the literature]. / Tromboembolismo pulmonar con trombo móvil en aurícula derecha. Presentación de un caso diagnosticado por ecocardiografía bidimensional y revisión de la literatura.

A case is presented of a pulmonary thromboembolism secondary to detachment of an elongated and mobile thrombus in right atrium, identified by bidimensional echocardiography in a patient without previously identified cardiac pathology. The presence of pulmonary thromboembolism in this patient was confirmed by lung angiography. In-spite of anticoagulant treatment, the patient died four days later due to massive pulmonary embolism, before a surgery could be carried out, coinciding with the disappearance of the right atrium thrombus by bidimensional echocardiography. The echocardiographic characteristics of right atrium thromboembolisms are described as well as their differential diagnosis and the most appropriate therapeutic attitude in these cases based in a literature review.