ABSTRACT
We report the case of an 80-year-old woman with symptomatic postural hypoxaemia caused by a right-to-left shunt through a patent foramen ovale. The hypoxaemia was enhanced by the supine position and disappeared in upright position. Potential mechanisms underlying postural variations of the shunt seemed to be similar to those describe in platypnea-orthodeoxia syndrome. Patient became asymptomatic after shunt resolution.
Subject(s)
Foramen Ovale, Patent/diagnosis , Hypoxia/etiology , Hypoxia/physiopathology , Posture/physiology , Aged, 80 and over , Echocardiography , Female , Foramen Ovale, Patent/complications , Foramen Ovale, Patent/surgery , Humans , Hypocapnia/physiopathology , Syndrome , Tilt-Table TestABSTRACT
We report the case of a 41-year-old woman, non-smoker, without cardiovascular risk, hospitalised for acute ST elevation myocardial infarction. The coronarography showed no significant coronary stenosis and a methylergometrine test performed was positive. After the discovery of a moderate chronic hypereosinophilia, a review of the literature about eosinophile and coronary pathology was realised in order to make a link between hypereosinophilia and coronary spasm.
Subject(s)
Coronary Vasospasm/etiology , Eosinophilia/complications , Adult , Coronary Vasospasm/complications , Female , Humans , Myocardial Infarction/etiologySubject(s)
Cardiomyopathies/diagnosis , Stress, Psychological/complications , Ventricular Dysfunction, Left/diagnosis , Acute Disease , Cardiomyopathies/psychology , Echocardiography , Female , Heart Ventricles/diagnostic imaging , Humans , Male , Middle Aged , Troponin/blood , Ventricular Dysfunction, Left/psychologyABSTRACT
Myocardial bridge is often considered to be a simple anatomical variation often observed during coronary angiography. The responsibility of this condition for myocardial ischaemia is however uncommon and the physiopathological mechanisms are not well understood. The authors report 6 cases of myocardial bridge associated with myocardial infarction of unstable angina. The main features of this condition are discussed with respect to a review of the literature. Patients are usually young and male; the left anterior descending artery is the most commonly affected vessel: factors triggering ischaemia are discussed: coronary spasm, tachycardia and thrombosis at the site of the myocardial bridge. The diagnosis can only be made by coronary angiography showing reduction of the systolic diameter of the artery which may be accentuated by certain pharmacological tests such as injection of glyceryl trinitrate as used in the series.
