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Teaching Point: Terminal ileal diverticulitis is an uncommon cause of right lower abdominal pain.
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We present the case of a 22-year-old man with a congenital mixed aortic valve dysfunction who underwent cardiac Magnetic Resonance Imaging (MRI) for the assessment of aortic valve morphology and function prior to valve replacement. Cardiac MRI showed a four-leaf-clover aortic valve morphology, the typical presentation of a quadricuspid aortic valve. The patient underwent a successful Bentall procedure to replace the aortic valve, aortic root and ascending aorta. This case report illustrates the MRI findings of a quadricuspid aortic valve with associated aortic stenosis and regurgitation.
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OBJECTIVE: To compare the organ doses and lifetime-attributable risk of cancer for electrocardiogram-triggered sequential and high-pitch helical scanning in a clinical patient population. METHODS: Phantom thermoluminiscence dosimeter measurements were used as a model for the organ dose assessment of 314 individual patients who underwent coronary computed tomographic angiography. Patient-specific lifetime-attributable cancer risks were calculated. RESULTS: Phantom measurements showed that heart rate had a significant influence on the delivered radiation exposure in sequential mode, and calcium scoring and contrast bolus tracking scans make a nonnegligible contribution to patients' dose. Therefore, they should be taken into account for patients' organ dose estimations. Median cancer induction risks are low, with 0.008% (0.0016%) and 0.022% (0.056%) for high-pitch and sequential scanning for men (women), respectively. CONCLUSIONS: The use of high-pitch helical scanning leads to 65% and 72% lower lifetime-attributable risk values for men and women, respectively, compared with sequential scanning.
Assuntos
Angiografia Coronária/métodos , Doses de Radiação , Tomografia Computadorizada Espiral/métodos , Técnicas de Imagem de Sincronização Cardíaca , Estudos de Coortes , Feminino , Coração , Frequência Cardíaca , Humanos , Masculino , Imagens de Fantasmas , Interpretação de Imagem Radiográfica Assistida por Computador , Estudos Retrospectivos , Risco , Dosimetria Termoluminescente/estatística & dados numéricosRESUMO
Angiotensin-converting enzyme (ACE) inhibitors are standard medication in treating hypertension, heart failure and diabetic nephropathy. The most common side effects are cough and angioneurotic oedema of the upper airways. A less familiar side effect is the ACE inhibition-induced visceral angioedema. We report the case of a young female patient with recent diagnosis of heart failure (dilated cardiomyopathy due to viral myocarditis), who developed angioedema of the small intestine three weeks after initiating treatment with lisinopril. Symptoms resolved within days once administration of the drug was stopped.
