ST-elevation myocardial infarction complicated by ventricular tachycardia revealing coronary artery ectasia: a case report.

BACKGROUND: Coronary artery ectasia is a rare angiographic finding and results from a disease process that compromises the integrity of the vessel wall. Its prevalence ranges between 0.3% and 5% of patients undergoing coronary angiography (Swaye et al. in Circulation 67:134-138, 1983). Coronary artery ectasia in patients with ST-elevation myocardial infarction is associated with an increased risk of cardiovascular events and death after percutaneous coronary intervention. CASE PRESENTATION: We report the case of a 50-year-old male Caucasian patient, admitted for ventricular tachycardia at 200 beats per minute hemodynamically not tolerated that was reduced by external electric shock. Electrocardiogram after cardioversion showed a sinus rhythm with anterior ST-elevation myocardial infarction. Thrombolytic therapy was chosen after exposure to dual antiplatelet therapy and heparin since the expected time to percutaneous coronary intervention was greater than 120 minutes from first medical contact and the patient presented within 12 hours of onset of ischemic symptoms. The electrocardiogram after thrombolysis showed the resolution of the ST segment. The echocardiogram showed a dilated left ventricle with severe dysfunction with left ventricle ejection fraction at 30%. Coronary angiography revealed non-obstructive giant ecstatic coronaries without any thrombus. A check-up to look for possible etiologies for coronary artery ectasia was carried out and returned normal. Since no etiology for coronary artery ectasia was found at the limit of available exams in our center, the patient was discharged with antiplatelet therapy (aspirin 100 mg once a day) and heart failure treatment with an indication for an implantable cardiac defibrillator. CONCLUSIONS: Coronary artery ectasia in the context of acute myocardial infarction is a rare condition that may have dangerous complications, especially when an optimal treatment for ecstatic culprit vessels is still controversial.

Isolated pericardial hydatid cyst: a case report.

Hydatid cysts are most commonly found in the liver and lungs but rarely in the heart. Most heart hydatid cysts are located in the left ventricle and the interventricular septum. Few cases of isolated pericardial hydatid cysts have been reported in the literature. Cardiac involvement can have serious consequences and can be fatal if the cyst perforates. Methods for diagnosing cardiac hydatid cysts include serological tests and noninvasive imaging tests such as transthoracic echocardiography, computed tomography, and magnetic resonance imagery. Case presentation: Here we report a rare case of an isolated pericardial hydatid cyst in a young woman who complained of sternal chest pain, palpitations, and shortness of breath. The diagnosis of pericardial hydatic cyst in our case was confirmed by serologic tests for hydatidosis and the results of echocardiography and tomography. No other localizations were found after realizing a body scan. The patient was started on oral albendazole and then was referred to surgery for the resection of the cardiac mass. Conclusion: Cardiac hydatid cyst represents a rare disease, frequently associated with fatal complications, which makes its early diagnosis and treatment an urgent priority.