RESUMO
We present the case of a 69-year-old female with a long history of apical hypertrophic cardiomyopathy progressing to midcavitary obstruction and apical aneurysm development. A coronary angiogram showed no stenotic lesions in the epicardial coronary arteries and myocardial perfusion imaging showed no perfusion defects in the left ventricular apex, with the latter being an extremely uncommon finding. This case suggests that apical aneurysm may not be exclusively caused by ischemia and eventually different or coexisting factors are probably involved.
Assuntos
Cardiomiopatia Hipertrófica/complicações , Aneurisma Cardíaco/etiologia , Obstrução do Fluxo Ventricular Externo/etiologia , Idoso , Feminino , HumanosRESUMO
Clinically apparent pulmonary embolism is a rare complication of permanent transvenous pacing catheters. Here we report an unusual case of a 71-year-old man who developed massive pulmonary embolism 12 hours after a permanent transvenous pacemaker implantation in the absence of any patient-related predisposing factor. Transesophageal echocardiography showed a large thrombus within the right atrium closely attached to the pacemaker lead. Anticoagulation with heparin, followed by warfarin therapy, led to a complete resolution of the thrombus.
Assuntos
Marca-Passo Artificial/efeitos adversos , Embolia Pulmonar/etiologia , Trombose/etiologia , Idoso , Ecocardiografia , Ecocardiografia Transesofagiana , Eletrocardiografia , Átrios do Coração/diagnóstico por imagem , Átrios do Coração/patologia , Ventrículos do Coração/diagnóstico por imagem , Ventrículos do Coração/patologia , Humanos , Hipertrofia Ventricular Esquerda/cirurgia , Masculino , Insuficiência da Valva Mitral/cirurgia , Complicações Pós-Operatórias/diagnóstico , Complicações Pós-Operatórias/etiologia , Embolia Pulmonar/diagnóstico , Trombose/diagnóstico , Fatores de Tempo , Tomografia Computadorizada por Raios X , Falha de TratamentoRESUMO
Fungal infections involving the pacemaker pocket after pacemaker implantation procedure are extremely rare. This report describes the case of a 53-year-old woman with pacemaker pocket infection due to acremonium species. The authors emphasize that this patient did not have any predisposing factors to fungal infections.
Assuntos
Acremonium/isolamento & purificação , Micoses/etiologia , Marca-Passo Artificial/efeitos adversos , Infecções Relacionadas à Prótese/microbiologia , Infecção da Ferida Cirúrgica/microbiologia , Antifúngicos/uso terapêutico , Feminino , Fluconazol/uso terapêutico , Humanos , Pessoa de Meia-Idade , Micoses/tratamento farmacológico , Infecções Relacionadas à Prótese/tratamento farmacológico , Síndrome do Nó Sinusal/terapia , Infecção da Ferida Cirúrgica/tratamento farmacológicoRESUMO
Congenital coronary artery fistulas (CAFs) constitute an unusual cardiovascular anomaly. The aneurysmal appearance of CAFs is not uncommon and depends on the shunt size. However, few cases of ectatic coronary arteries (type III according to Markis et al. classification-diffuse ectasia in one vessel) supplying the fistulas have been reported. Below, we report the case of a 65-year-old woman, who referred to our department because of worsening exertional dyspnea. Echocardiographic evaluation, both transthoracic and transesophageal, performed after admission disclosed a giant tortuous ectatic right coronary artery with a fistulous connection to the coronary sinus. The presence of the CAF was confirmed by cardiac catheterization. In addition, we discuss the pathophysiology of the above congenital anomaly, as well as its management.
