[Emergency implantation of intracoronary stent after acute occlusion of the common trunk of the left coronary artery]. / Implantación emergente de stent intracoronario tras oclusión aguda del tronco común de la coronaria izquierda.

Nowadays, the implantation of coronary endoprosthesis within the left main coronary artery is not considered as an absolute contraindication. Here, we show a case of acute occlusion within the left main coronary artery. This was resolved by implanting a stent during a programmed cardiac catheterization. It should be stressed that this problem was occurred without manipulating the left coronary tree. In addition, the patient was in cardiac arrest when the stent was implanted. Cardiopulmonary resuscitation was applied because of this condition.

[Aneurysm of the left main coronary artery caused by thoracic trauma]. / Aneurisma del tronco común de la arteria coronaria izquierda secundario a traumatismo torácico.

A 30 years-old female patient, presented with a clinical picture of acute pulmonary edema associated with anterior myocardial necrosis following a car accident with mild blunt chest injury. The coronary angiogram showed the existence of an aneurysm in the left main coronary artery (LMCA) causing extrinsic compression of the artery. Subsequent angiograms showed a complete disappearance of the aneurysm. The patient remains symptom-free three years after the accident. Blunt chest injury is a potential cause of heart damage. Although the coronary arteries may be damaged, the development of an aneurysm has been reported on very few occasions and always in connection with the anterior descending coronary artery. Our case is the first case described with the location of the aneurysm in the left main artery.

[Differential diagnosis of obstructions to left ventricular outflow (author's transl)]. / Obstrucciones del tracto de salida del ventrículo izquierdo. Diagnóstico diferencial.

A total of 127 patients with different forms of obstruction to left ventricular outflow are studied. There were eight cases with supravalvular aortic stenosis, 79 with valvular aortic stenosis, 25 with hypertrophic subaortic stenosis, and 15 with subvalvular aortic stenosis. Clinical findings and electrocardiographic, radiographic, and angiohemodynamic data corresponding to these groups are reported, as well as the differential characteristics for each category from a clinical, electrocardiographic and radiographic point of view. The presence of a typical face, asymmetrical carotid and brachial pulses, absence of aortic ejection click and little or no aortic button on the chest roentgenogram reveals a supravalvular aortic stenosis. Valvular aortic stenosis shows aortic ejection click, poststenotic dilation of the ascending aorta, electrocardiographic signs of left ventricular hypertrophy and associated aortic regurgitation. Hypertrophic subaortic stenosis is characterized by a typical arterial pulse, marked "a" wave in the jugular venous pulse, double apical impulse on palpation and appearance or modification of the systolic ejection sound with Valsalva's maneuver.

[Isolated rheumatic tricuspid insufficiency (author's transl)]. / Insuficiencia tricúspide reumática aislada.

Insufficiency on the tricuspid valve alone due to cardioarticular rheumatism is a rare condition. A 12-year-old boy had had six episodes of rheumatic fever over the previous 5 years. The only damage done to the heart was insufficiency of the tricuspid valve; none of the other valves were affected. The phonocardiographic response to the amyl nitrate and methoxamine tests as well as the correct evaluation of the jugular phlebogram confirmed the diagnosis of this valve pathology. The study of this heart condition was completed with the diagnosis of rheumatic fever (Jones' criteria, modified) and an angiohemodynamic evaluation of the patient (which must include left and right ventriculography using a Bourassa catheter on the right). This pathology is extremely rare and we have found no reference to it in the literature in this country.