Asunto(s)
Endocarditis Bacteriana/microbiología , Gonorrea/complicaciones , Neisseria gonorrhoeae/aislamiento & purificación , Absceso/etiología , Adulto , Antibacterianos/uso terapéutico , Artritis Infecciosa/etiología , Cardiotónicos/uso terapéutico , Endocarditis Bacteriana/tratamiento farmacológico , Endocarditis Bacteriana/etiología , Endocarditis Bacteriana/cirugía , Resultado Fatal , Gonorrea/tratamiento farmacológico , Gonorrea/microbiología , Implantación de Prótesis de Válvulas Cardíacas , Humanos , Contrapulsador Intraaórtico , MasculinoRESUMEN
The results of a retrospective study of patients over 70 years of age admitted to the cardiology department of Meaux Hospital for cardiac failure in 1997 are reported. The cases of 143 patients were analysed with respect to two age groups: 70-79 years, and over 80 years of age. The principal aetiology of cardiac failure in all ages was ischaemic heart disease. Hypertensive heart disease was observed in younger patients and valvular heart disease in the more elderly. No significant gender differences were observed in those affected by this pathology or by left ventricular systolic or diastolic dysfunction between the younger and older patients, men having more systolic dysfunction than women. The main causal factor of decompensation in all ages was supraventricular arrhythmias. From the therapeutic point of view, the prescription of ACE inhibitors was relatively common but at low doses. Re-hospitalisation for cardiac failure was common and observed mainly in patients with low ejection fractions. The average hospital stay was 12.58 days. The hospital mortality was high: 15%. Two year survival was 41% with no difference between patients with systolic or diastolic dysfunction. Pluridisciplinary management should reduce the number of re-hospitalisation, improve the quality of life and, perhaps, improve survival.
Asunto(s)
Arritmias Cardíacas/complicaciones , Insuficiencia Cardíaca/terapia , Enfermedades de las Válvulas Cardíacas/complicaciones , Hospitalización/estadística & datos numéricos , Factores de Edad , Anciano , Anciano de 80 o más Años , Inhibidores de la Enzima Convertidora de Angiotensina/uso terapéutico , Arritmias Cardíacas/epidemiología , Femenino , Insuficiencia Cardíaca/epidemiología , Insuficiencia Cardíaca/etiología , Enfermedades de las Válvulas Cardíacas/epidemiología , Mortalidad Hospitalaria/tendencias , Humanos , Tiempo de Internación/estadística & datos numéricos , Masculino , Readmisión del Paciente/estadística & datos numéricos , Pronóstico , Calidad de Vida , Estudios RetrospectivosRESUMEN
The authors report a case of aortic valve myxoma discovered in a 35 years-old patient who suffered a transient ischemic attack. At operation a helicoidal gelatinous mass was found attached to the ventricular side of the right coronary cusp of the aortic valve by a pedicle. Through a mini-sternotomy approach the mass was excised and the cusp was repaired. Recovery was uneventful.
Asunto(s)
Válvula Aórtica/cirugía , Neoplasias Cardíacas/cirugía , Mixoma/cirugía , Adulto , Válvula Aórtica/patología , Procedimientos Quirúrgicos Cardiovasculares/métodos , Neoplasias Cardíacas/patología , Humanos , Ataque Isquémico Transitorio/etiología , Masculino , Mixoma/patologíaRESUMEN
BACKGROUND: Epsilon waves, rarely observed in clinical practice, result from late potentials favoring the development of ventricular rhythm disorders by reentry. CASE REPORT: A 53-year-old man with sequellar myocardial infarction experienced a syncope. The surface ECG recorded an epsilon wave. Programmed ventricular stimulation before and after anti-arrhythmia drugs triggered ventricular tachycardia which was hemodynamically poorly tolerated. A defibrillator was implanted and confirmed retrospectively the rhythmic origin of the syncope. DISCUSSION: The association of an epsilon wave and syncope should guide the etiology search towards severe ventricular rhythm disorders such as ventricular tachycardia. An electophysiologic study is required in order to determine the appropriate therapy and thus help avoid possibly fatal recurrence.
Asunto(s)
Electrocardiografía , Infarto del Miocardio/diagnóstico , Síncope/etiología , Taquicardia por Reentrada en el Nodo Atrioventricular/diagnóstico , Estimulación Cardíaca Artificial , Desfibriladores Implantables , Ventrículos Cardíacos/fisiopatología , Hemodinámica/fisiología , Humanos , Masculino , Persona de Mediana Edad , Infarto del Miocardio/fisiopatología , Procesamiento de Señales Asistido por Computador , Síncope/prevención & control , Taquicardia por Reentrada en el Nodo Atrioventricular/fisiopatología , Taquicardia por Reentrada en el Nodo Atrioventricular/terapiaRESUMEN
The authors report a case of aortic valve myxoma discovered in a 34-year-old patient who had suffered a transient ischemic attack. At operation, a heliocoidal gelatinous mass was found attached to the ventricular side of the right coronary cusp of the aortic valve via a pedicle. Through a ministernotomy approach the mass was excised and the cusp was repaired. Recovery was uneventful.
Asunto(s)
Neoplasias Cardíacas/diagnóstico , Mixoma/diagnóstico , Adulto , Válvula Aórtica/diagnóstico por imagen , Válvula Aórtica/cirugía , Neoplasias Cardíacas/complicaciones , Humanos , Ataque Isquémico Transitorio/etiología , Masculino , Mixoma/complicaciones , UltrasonografíaRESUMEN
Doppler ultrasound investigation of cervical and aorto-iliac arteries, performed in 248 patients investigated by coronary angiography (including 80% with coronary heart disease: 23% single-vessel, 23% two-vessel and 34% three-vessel disease) confirmed the frequency of dissemination of the atheromatous process (in the cervical vessels: non-stenotic atheroma: 45%, significant single- or multi-vessel stenoses: 16%, in the aorto-iliac vessels: non-stenotic atheroma: 32.8%, significant stenoses: 17.2%), which has been known for a long time. The unreliability of clinical examination, the reliability, safety and low cost of ultrasound, the discovery of a considerable number of critical, potentially dangerous arterial lesions, some of which may require a surgical procedure or angioplasty (3.4%), the value of assessing, either before coronary angiography or before cardiac surgery, certain specific arterial territories such as the aortic bifurcation and subclavian vessels, justify systematic use of this examination in coronary patients, particularly before coronary angiography and always before coronary surgery.
Asunto(s)
Aorta/diagnóstico por imagen , Arteriosclerosis/diagnóstico por imagen , Enfermedad de la Arteria Coronaria/diagnóstico por imagen , Ecocardiografía Doppler , Arteria Ilíaca/diagnóstico por imagen , Cuello/irrigación sanguínea , Adulto , Anciano , Anciano de 80 o más Años , Arteriosclerosis/etiología , Enfermedad de la Arteria Coronaria/complicaciones , Femenino , Humanos , Masculino , Persona de Mediana Edad , Cuello/diagnóstico por imagen , Estudios Prospectivos , Reproducibilidad de los Resultados , Estudios RetrospectivosRESUMEN
Post-infarction interventricular fistula (IVF) is a complication with a poor prognosis, particularly when it occurs very early after myocardial necrosis, when it is wide in diameter and even more so if it is at a posterior site, and if there are associated lesions which require surgery. An operation is often considered as contraindicated in cases where the patient is elderly. The authors report on the case of an 81-year-old diabetic patient operated for a wide post-infarctus posterior IVF and aorto-coronary artery bypass surgery. The operation is still a clinical success after 23 months of follow-up, showing that old age is not an absolute contraindication for surgery in cases of post-infarction IVF.