RESUMO
Early diagnosis of the spiked helmet sign is challenging. This ST-elevation myocardial infarction mimic was first described in 2011 by Littmann and colleagues and was linked to severe non-coronary pathologies, with a high risk of mortality. We present a case of a 60-year-old female patient who developed severe erysipelas with sepsis associated with severe hypokalemia. She had a spiked helmet sign on her routine electrocardiogram at hospital admission. We performed a coronary angiogram that showed no culprit artery. She developed afterward an ischemic stroke. Through intensive management of the patient's sepsis and electrolyte disturbance, she had a favorable outcome.
Assuntos
Erisipela , Infarto do Miocárdio com Supradesnível do Segmento ST , Sepse , Humanos , Feminino , Pessoa de Meia-Idade , Dispositivos de Proteção da Cabeça , Infarto do Miocárdio com Supradesnível do Segmento ST/diagnóstico , Eletrocardiografia , Sepse/diagnósticoRESUMO
Metastases to the heart and pericardium are much more common than primary malignant neoplasms. Primary malignant pericardial mesothelioma is a rare tumor that arises from the mesothelial cells of the pericardium. It is usually characterized by a delayed diagnosis, a low response to treatment, and a poor prognosis with an overall survival up to six months after the onset of symptoms. We report a rare case of a 32-year-old woman with primary pericardial malignant mesothelioma that was diagnosed 4 months after the onset of pericardial effusion as the first clinical manifestation.
Assuntos
Neoplasias Cardíacas/diagnóstico , Mesotelioma Maligno/diagnóstico , Derrame Pericárdico/diagnóstico , Adulto , Diagnóstico Tardio , Diagnóstico Diferencial , Feminino , Neoplasias Cardíacas/complicações , Humanos , Mesotelioma Maligno/complicações , Derrame Pericárdico/etiologia , Derrame Pericárdico/patologia , Pericardite/diagnóstico , Pericardite/etiologia , Pericárdio/patologia , Radiografia Torácica , Taquicardia/diagnóstico , Taquicardia/etiologiaRESUMO
Behçet's disease (BD) is a multisystemic chronic vasculitis characterized by its clinical polymorphism. It concerns mainly young men and generally appears between the third and the fourth decades. Cardiac involvement in Behçet's disease is rare but represents a major prognostic factor. We report the case of a young man admitted in our department for the management of an acute coronary syndrome revealing a Behçet's disease. Coronary angiography had shown a giant thrombosed aneurysm of the left coronary artery. Surgical treatment was successfully performed and the patient had a left anterior descending coronary artery bypass using the left internal mammary artery graft.
