Electrical storm following pregnancy in systemic scleroderma: A case report.

INTRODUCTION: Systemic sclerosis (SSc) is a rare connective tissue disease characterized by immune dysfunction, vascular damage, and fibrosis affecting the skin and multiple internal organs, such as the cardiovascular and respiratory systems. In some women with preexisting SSc, pregnancy is associated with negative maternal outcomes. Tachyarrhythmia is a common clinical manifestation of cardiovascular damage in SSc patients. However, few studies have reported the use of catheter ablation and an implantable cardioverter defibrillator (ICD) in patients with SSc complicated by ventricular tachycardia (VT). CASE: A 19-year-old woman known case of SSc referred to our center with recurrent VT during pregnancy and after delivery. Two-dimensional Echocardiogram showed severe systolic dysfunction with a left ventricular ejection fraction (LVEF) of 30%. Considering, recurrent VT despite medical treatment and the progressive nature of systemic sclerosis radiofrequency catheter (RF) ablation and ICD implantation were performed. CONCLUSION: We report a case of systemic sclerosis complicated by VT and left ventricular (LV) dysfunction during pregnancy that was successfully treated with RF ablation.

Quantification of aortic valve area: comparison of different methods of echocardiography with 3-D scan of the excised valve.

Accurate determination of severity of aortic valve stenosis (AS) by aortic valve area (AVA) is essential for choosing the best treatment strategy. We compared AVA quantified by 4 different in vivo echocardiographic methods with AVA measured by 3D ex vivo scanning of the excised AV. The data on 38 patients who underwent aortic valve replacement were assessed. The AVA was determined by 4 echocardiographic methods of planimetry in 2D transesophageal echocardiography [planimetry (2D-TEE)], plainemetry by multiplanar reconstruction approach in 3D transesophageal echocardiography [MPR (3D-TEE)], and two continuity equation (CE) approaches; conventional CE (2D-TTE) in which left ventricular outflow tract [LVOT] area derived by LVOT diameter obtained in 2D transthoracic echocardiography and CE (3D-TEE) in which LVOT area obtained by 3D MPR. After the surgical removal of the AV, AVA was determined by 3D ex vivo scanning. Lowest AVA mean difference with 3D ex vivo scanning was found between CE (2D-TTE), followed by CE (3D-TEE). Planimetry (2D-TEE) in male patients as well as severely and non-severely calcified valves revealed a significant higher AVA mean difference with 3D ex vivo scanning than CE (2D-TTE) and CE (3D-TEE) methods. However, with a nonsignificant effect, CE (2D-TTE) and planimetry (2D-TEE) had the least mean difference with 3D ex vivo scanning possibly due to less frequent bicuspid AV in females. CE (2D-TTE) was more accurate than other methods of AVA calculation. Moreover, CE (3D-TEE) and MPR (3D-TEE) methods had acceptable accuracy in comparison with planimetry (2D-TEE) for definition of AS severity.

Sudden cardiac death in COVID-19 patients, a report of three cases.

The mortality rate of coronavirus disease-19 (COVID-19) has been reported as 1-6% in most studies. The cause of most deaths has been acute pneumonia. Nevertheless, it has been noted that cardiovascular failure can also lead to death. Three COVID-19 patients were diagnosed based on reverse transcriptase-polymerase chain reaction of a nasopharyngeal swab test and radiological examinations in our hospital. The patients received medications at the discretion of the treating physician. In this case series, chest computed tomography scans and electrocardiograms, along with other diagnostic tests were used to evaluate these individuals. Sudden cardiac death in COVID-19 patients is not common, but it is a major concern. So, it is recommended to monitor cardiac condition in selected patients with COVID-19.

Recovery of severely ill COVID-19 patients by intravenous immunoglobulin (IVIG) treatment: A case series.

INTRODUCTION: During the recent months, COVID-19 has turned to a global crisis claiming high mortality and morbidity among populations. Despite the high prevalence of the disease, it has currently no definitive treatment. We here reported the effects of intravenous immunoglobulin (IVIG) administration in severely ill COVID-19 patients diagnosed based on PCR and radiology tests. CASE PRESENTATION: Five severely ill COVID-19 patients in whom standard treatments failed were administrated with IVIG which prevented the deterioration of clinical symptoms. All the patients were treated with high-dose IVIG (0.3-0.5 g/kg) for 5 consecutive days so that no patient would receive lower than 25 g of the drug. All the patients showed a desirable therapeutic response and were discharged from the hospital with a stable clinical condition after being recovered. CONCLUSION: Treatment with IVIG at the therapeutic dose of 0.3-0.5 g/kg can improve the clinical condition and O2 saturation and prevent the progression of pulmonary lesions in COVID-19 patients with severe symptoms in whom standard treatments have failed.

What thought to be a cardiac tumor turns out to be a remnant of former surgery.

BACKGROUND: A textiloma is a rare retained surgical swab with probable serious post-operation complications. CASE REPORT: Here, we reported an asymptomatic patient who had past history of coronary artery bypass grafting (CABG) fourteen months ago and referred to our institute for left atrial mass removal. Echocardiography and chest computed tomography (CT) scan revealed a non-homogenous non-mobile mass and a heterogeneous lesion with low-density as well as high-density areas with spot calcification and gas bubbles at left atrium level, respectively. CONCLUSION: Despite being rare after CABG, textiloma should be considered in the differential diagnosis in case of any suspicious chest mass even in asymptomatic patients.