[The scimitar syndrome. A clinical contribution and review of the literature (author's transl)]. / La "sindrome della scimitarra." Contributo clinico e revisione della letteratura.

The scimitar syndrome groups a combination of several congenital anomalies in the right lung with an abnormal right pulmonary venous drainage in the inferior vena cava or the right atrium. After a survey of 130 cases in the literature, clinical, angiografic and hemodynimac features of the syndrome are defined. The Authors report two new cases diagnosed in adults, characterised by a clean discordance between the clinical features and the angiographic ones. The former case is completely asymptomatic and the radiographic feature is typical, while the latter shows a characteristic symptomatology but there isn't a clean "scimitar image". But notwithstanding the absence of this "scimitar image", the Authors think that the anomalous pulmonary drainage in the right atrium and the several anomalies in the right lung can be attributed to the scimitar syndrome, physiopatologically.

[Cardiac rupture: a not infrequent complication of acute myocardial infarction. Report of five cases (author's transl)]. / La rottura di cuore: una non rara complicanza dell'infarto miocardico acuto. Descrizione di 5 casi.

Five cases of cardiac rupture (CR) in acute myocardial infarction (AMI) (four men and one woman aged between 49 and 86 years, mean 64) are described. The incidence of CR was 4,7% of 106 cases of AMI and 20,8% of causes of death. In all cases, pathologic observations well agreed with electrocardiographic site of infarction. All patients had ECG pattern of transmural AMI: postero-inferior (2 cases), anterior (1 case); none of them had myocardial infarction in the past. Two patients had systolic hypertension on admission, during and immediately before death, and 3 patients were normotensive during the whole course of illness. All patients had severe, prolonged and resistant to opiate therapy chest pain, which reexacerbated immediately before death in two cases. 4 patients died within 24 hours after the onset of symptoms. Terminal ECG pattern was similar in these four cases: sudden sinus bradycardia and/or idio-ventricular rhythm, with a progressive slowing of heart rate and changes of QRS patterns of "agonic" type, preceded electrical activity cessation. In one patient, who died at the seventh day of illness, ventricular fibrillation was observed. The AA. stress the importance of the early recognition of clinical findings suggesting an impeding CR in order to relieve cardiac tamponade with pericardiocentesis and to perform, as soon as possible, surgical treatment.