Assuntos
Radiologistas , Humanos , Vietnã , Radiologistas/provisão & distribuição , Mão de Obra em SaúdeRESUMO
Libman-Sacks endocarditis accounts for 6-11 percent of systemic lupus erythematosus patients and is associated with varying degrees of valvular dysfunction, increased risk for stroke and transient ischemic attacks, and increased mortality. In previous studies, left-sided valvular Libman-Sacks vegetations were more frequently detected than right sided vegetations; reported cases of bilateral involvement is very rare. A comprehensive clinical assessment and the multimodality imaging is of utmost importance in the management of systemic lupus erythematosus. In this case report, we describe a 31-year-old female patient with uncontrolled systemic lupus erythematosus initially presented with gastrointestinal symptoms but eventually had a vegetation-like structure on the posterior leaflet of the mitral valve which was revealed during routine echocardiography. Two-dimensional/three-dimensional transthoracic and transesophageal echocardiography, cardiac magnetic resonance, and cardiac computed tomography further characterized the mitral valve vegetation and revealed an additional vegetation of the pulmonary valve. Echocardiography remains the cornerstone for the detection of Libman-Sacks vegetations. Cardiac MRI and cardiac CT are useful in characterizing lesion size and effects and may prove particularly helpful in the assessment of right-sided or multivalvular endocarditis. The presence of focal brain lesions on brain MRI prompted antithrombotic therapy.
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Introduction: The manifestations of cardiac metastases are extremely variable depending on their location and extension. Case presentation: A 62-year-old man was admitted to the cardiac emergency department presenting with chest pain, worsening shortness of breath and palpitations. He had a history of esophageal squamous cell carcinoma treated with chemoradiotherapy, and he was not diagnosed with cardiovascular disease before. The electrocardiogram showed significant ST-segment elevations in leads II, III, and aVF. Initially, the patient was diagnosed with ST-segment elevation myocardial infarction. A cardiac point-of-care ultrasound was performed immediately revealing two large heterogeneous masses in the left ventricular wall and the apex, which changed the diagnosis and the management strategy. There was no significant change in serial cardiac biomarkers in the setting of persistent STE. Thoracic computed tomography and cardiac magnetic resonance confirmed that the patient was suffering from cardiac and lung metastases. Conclusion: ECG findings of localized and prolonged STE without Q waves or changes in biomarkers may suggest myocardial tumor invasion, especially in the cancer setting. Cardiac point-of-care ultrasound is an effective, convenient, noninvasive imaging modality to guide real-time clinical decision-making.
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Dye-sensitized Solar Cells (DSCs) based on ruthenium complex N719 as sensitizer have received much attention due to their affordability and high efficiency. However, their best performance is only achieved when using volatile organic solvents as electrolyte solutions, which are unstable under prolonged thermal stress. Thus, we developed a new series of 1-alkenyl-3-methylimidazolium trifluoromethanesulfonate ionic liquids used as robust DSC electrolytes. These ionic liquids exhibit low viscosity, high conductivity, and thermal stability. The implementation of 1-but-3-enyl-3-methyl-imidazolium trifluoromethanesulfonate, [ButMIm]OTf, into DSCs gave the best photovoltaic performance. The results are fairly comparable to those reports for other popular ionic liquid electrolytes currently used in DSC field. An insightful discussion on the relationship between the structure of these new ionic liquids and the J-V characterization as well as electrochemical impedance measurement of DSCs will give more interesting information. The results are useful for large-scale outdoor application of DSCs.
