RESUMO
Cardiac involvement has rarely been reported in West Nile (WNV) infection. We report a fatal case of WNV encephalitis associated with an acute anteroseptal ST elevation myocardial infarction. The patient was hospitalized with a fever, headache, nausea and vomiting. The physical examination revealed positive meningeal signs and an altered level of consciousness. High levels of cardiac enzymes (creatine phosphokinase/MB fraction, lactate dehydrogenase, myoglobin and cardiac troponin I) and ST elevation on electrocardiogram were found. Both CSF and urine samples were positive for WNV RNA. This case highlights the need of awareness of the possibility of a WNV-related myocardial infection, including myocardial infarction.
Assuntos
Infarto do Miocárdio com Supradesnível do Segmento ST , Febre do Nilo Ocidental , Idoso , Croácia , Eletrocardiografia , Enzimas/sangue , Evolução Fatal , Feminino , Humanos , Infarto do Miocárdio com Supradesnível do Segmento ST/complicações , Infarto do Miocárdio com Supradesnível do Segmento ST/enzimologia , Febre do Nilo Ocidental/sangue , Febre do Nilo Ocidental/complicações , Febre do Nilo Ocidental/diagnóstico , Febre do Nilo Ocidental/enzimologia , Vírus do Nilo Ocidental/fisiologiaRESUMO
Detection of an intracardiac mass always represents a clinical challenge. We present a 61-year-old female patient with symptoms of New York Heart Association class III. Two-dimensional transthoracic echocardiography revealed a hypoechogenic mass in the cavity of the dilated right ventricle (RV). Cardiac MRI described a pathologic structure of the RV free wall with pedunculated tumor in its cavity. Three months later, on a repeated echocardiography, there were three individual masses. The patient underwent surgery and the pathohistologic report demonstrated thrombotic masses. During the postoperative period, after reviewing all medical records, the conclusion was arrhythmogenic RV cardiomyopathy. © 2016 Wiley Periodicals, Inc. J Clin Ultrasound 45:362-369, 2017.
Assuntos
Displasia Arritmogênica Ventricular Direita/diagnóstico , Trombose Coronária/diagnóstico por imagem , Trombose Coronária/cirurgia , Ecocardiografia , Disfunção Ventricular Direita/diagnóstico por imagem , Displasia Arritmogênica Ventricular Direita/complicações , Displasia Arritmogênica Ventricular Direita/cirurgia , Trombose Coronária/complicações , Feminino , Ventrículos do Coração/diagnóstico por imagem , Ventrículos do Coração/fisiopatologia , Ventrículos do Coração/cirurgia , Humanos , Pessoa de Meia-Idade , Disfunção Ventricular Direita/complicações , Disfunção Ventricular Direita/cirurgiaRESUMO
The number of coronary interventions increased substantially in the recent years. Although of great benefit to patients, these procedures can subject patients to considerable radiation doses. There is a legal framework for patient dose measurements in Croatia during radiological procedures, but in practice, it applies only occasionally. A quality control manual, established at the University Hospital Osijek, was accepted by other major cardiology centres in Croatia; besides checking the technical characteristics of the device, it provides constant measurement and analysis of patient doses in interventional cardiology. It also includes patient examination for radiation skin injuries in case of dose of >2 Gy. The aim of the study was to determine and compare patient radiation doses during cardiological interventions measured within 4 y in four major cardiology centres with the values proposed by the European Commission and other professional bodies. The local reference dose levels were also set.
