[A myocardial infarction complicated with mitral anterior papillary muscle rupture during long-term corticotherapy]. / Un infarctus du myocarde compliqué d'une rupture du pilier antérieur de la valve mitrale au cours d'une corticothérapie prolongée.

The authors report anterolateral papillary muscle rupture, occurring in a 67-year-old patient admitted for acute coronary syndrome. Mitral regurgitation, a rare but dramatic complication of myocardial infarction, is most often a consequence of posterior papillary muscle rupture. The 'protection' of the anterior papillary muscle is associated with vascularization via a dual coronary artery supply. Possible myocardial weakening associated with long-term corticotherapy is otherwise discussed in this observation.

[Left auricle myxoma, a rare cause of myocardial infarction]. / Le myxome de l'oreillette gauche, une cause rare d'infarctus du myocarde.

INTRODUCTION: The association of left auricle myxoma and myocardial infarction is exceptional. Nevertheless, a causal relationship exists between the 2 affections. OBSERVATION: A 54 year-old woman was hospitalised in a rush for myocardial infarction. Sonography revealed a voluminous tumoral formation in the left auricle. The diagnosis of myxoma was confirmed by the anatomopathological examination. DISCUSSION: Although systemic embolism represents the most frequent causal link between left auricle myxoma and myocardial infarction, hypercoagulability is another possible cause. This can be explained by the secretion of interleukins 6 and 8 by the myxoma.

[Coronary angioplasty using 5 or 6 F guide catheters. Results of a comparative, monocentric, prospective randomized study]. / Angioplasties coronaires par cathéters guides 5 ou 6 F. Résultats d'une étude comparative, monocentrique, prospective, randomisée.

Improvement of balloon and stent profile allows to use smaller-diameter catheters to avoid vascular complications by reduce the size of puncture site. First studies using 5 F guiding catheters showed good results in term of safety and feasibility. The authors performed a prospective, randomised study to define exactly the place of such small catheter compared to 6 F approach. One hundred forty eight patients were randomised, 77 in the 5 F group. The success rate per lesions was not significantly different but was less in the 5 F group (91.1 vs 96.5%). The crossover to 6 F allows good results in mainly cases. Limitations are unstable back up, worse opacification, and inability to use covered stent and to treat bifurcation lesions. There are no advantages in term of vascular complications. So, these catheters seem to be limited to treat simple lesion, allowing using the same sheath immediately after coronarography, but these results must be confirmed in a large, multicentric study.

[Screening of the abdominal aortic aneurysms during an echocardiography]. / Dépistage d'un anévrisme de l'aorte abdominale sous-rénale lors d'une échocardiographie.

We examined the abdominal aorta by ultrasound in 1106 patients during transthoracic echocardiography, whatever the reason of the echocardiography, to track abdominal aortic aneurysms. The study group comprised 822 men and 284 women. We found 88 patients having an abdominal aorta with a diameter of more than 23 mm and 11 patients with a diameter of more than 35 mm. Ninety sixteen per cent of the patients having an aortic ecstasy are more than fifty years old. Ther are more smokers among the patients having an aortic ecstasy. In conclusion, the track of the ecstasies and the abdominal aortic aneurysms is easily realizable during an echocardiography and presents a good rentability.

[Alcohol and rhythm disorders]. / Alcool et troubles du rythme.

Cardiovascular disease is the main cause of mortality in chronic alcoholics. There is a clear association between excessive alcohol consumption and the risk of sudden cardiac death. The pro-arrhythmogenic effect of ethanol could be responsible for some of these cases of arrhythmia and sudden death in subjects with an alcoholic cardiomyopathy and also in those with an apparently normal heart. In any case of supraventricular or ventricular arrhythmia in a chronic alcoholic or in an occasional heavy drinker, the potential role of alcohol consumption in the initiation of these disorders should be considered. In all cases, patient management consists of detoxification and abstaining from alcohol consumption, but the withdrawal period is particularly critical as regards the risk of ventricular arrhythmias.

Oxaliplatin-induced haemolytic anaemia.

A case of haemolytic anaemia after therapy with oxaliplatin, an anticancer chemotherapeutic agent, was investigated. Haemolytic anaemia has been associated with cisplatin and carboplatin, two related drugs, but not with oxaliplatin.