Insuficiencia cardíaca aguda irreversible debido a hemocromatosis cardíaca secundaria a transfusiones múltiples / Irreversible acute heart failure caused by cardiac hemochromatosis secondary to multiple transfusions

We report a 64 years old male, admitted for dyspnea and edema of two weeks duration. A sideroblastic anemia, requiring multiple transfusions, was diagnosed four years earlier. The chest X-ray showed an enlarged heart and right pleural effusion. A low left ejection fraction was evidenced by echocardiogram. Doppler analysis of the mitral flow revealed a restrictive hemodynamic pattern. A diagnosis of secondary cardiac hemochromatosis deposit was made. Nine days after admission the patient died due to heart failure. The clinical presentation of cardiac hemochromatosis as a sudden and irreversible heart failure, as well as the importance of early diagnosis and surveillance of high-risk patients is emphasized

Derrame pericárdico masivo y taponamiento cardíaco como forma de presentación de hipotiroidismo / Massive pericardial effusion and cardiac tamponade as the presentation form of hypothyroidism: report of 1 case

We report a 43 years old female, admitted due to fatigability, asthenia and diffuse adbominal pain. On admission, obesity, slowness of thinking, bradicardia, distention of jugular veins and ascites were observed on physical examination. Laboratory showed undetectable thyroid hormone levels, a chest X ray showed bilateral pleural effusion and an enlarged heart. An echocardiography showed a massive pericardial effusion with collapse of the right atrium and dilatation of both caval veins. A pericardial tap was performed, draining 350 ml. Thyroid hormone substitution was started and after 12 months of follow up, the heart size decreased and a control echocardiogram showed a minimal pericardial effusion

Implantación de stent coronario por angina de pecho recurrente secundaria a puente muscular / Coronary stent placement for recurrent angina secondary to myocardial bridging: report of two cases

Myocardial bridging of the epicardic coronary arteries is not an uncommon finding in angiographic or necropsic studies. Patients who have symptoms usually improve with medical treatment. However, in refractory patients a surgical myotomy of overlying myocardium and/or a coronary bypass may be needed. We report two patients with long myocardial bridges in the mid-left anterior descending coronary artery, who had recurrent angina refractory to conventional treatment. In both patients two consecutive coronary stents were successfully implanted. At five and six months follow-up they are asymptomatic and with good exercise tolerance