Case Report: Mitral valve obstruction by metastatic malignant phyllodes tumor.

Cardiac metastases from phyllodes tumors (PTs) are rare. Herein, we report a case of a 37-year-old female patient with a history of borderline breast PTs, admitted to the cardiology department for acute cardiac failure revealing concomitant cardiac and pulmonary metastases of malignant PTs. Cardiac metastasis occurred through direct extension from pulmonary metastasis to the left atrium via the right inferior pulmonary vein, causing severe mitral valve obstruction. Although the metastasis was surgically removed, the patient had an uncommon complication, which led to acute heart failure and huge relapse resulting in her death.

Mid-term subclinical myocardial injury detection in patients recovered from COVID-19 according pulmonary lesion severity.

BackgroundSevere acute respiratory syndrome coronavirus 2 (SARS-CoV 2) may cause damage of the cardiovascular system during the acute phase of infection. However, Recent studies described a mid and long-term subtle cardiac injuries after recovery from acute Coronavirus disease 19 (COVID-19).The aim of this study was to determine the relationship between the severity of chest computed tomography (CT) lesions and the persistence of subtle myocardial injuries at mid-term follow-up of patients recovered from COVID-19 infection. MethodsAll COVID-19 patients were enrolled prospectively in this study. Sensitive troponin T (hsTnT) and chest CT scan was performed in all patients at the acute phase of Covid-19 infection. At the mid-term follow up, conventional transthoracic echocardiograph and global longitudinal strain (GLS) of left and right ventricles (LV and RV) were determined and compared between patients with chest CT scan lesions less than 50% (Group 1) and those with severe chest CT scan greater or equal to 50% (Group 2). ResultsThe mean age was 55 more or less than 14 years. Both LV GLS and RV GLS were significantly decreased in the group 2 (p=0.013 and p=0.011, respectively). LV GLS value more than -18% was noted in 43% of all the patients and RV GLS value more than -20% was observed in 48% of them. The group with severe chest CT scan lesions included more patients with reduced LV GLS and reduced RV GLS than the group with mild chest CT scan lesions (G1:29% vs. G2:57%, p=0.002) and (G1:36% vs. G2:60 %, p=0.009) respectively). ConclusionPatients with severe chest CT scan lesions are more likely to develop subclinical myocardial damage. TTE could be recommended in patients recovering from COVID-19 to detect subtle LV and RV lesions. Trial registrationThe cohort of patients is a part of the research protocol (IORG 00093738 N{degrees}102/OMB 0990-0279) approved by the Hospital Ethics Committee.

[Abnormalities of haemostasis in myocardial infarction with normal coronary artery]. / Anomalies de l'hemostase dans l'infarctus du myocarde sur coronaires angiographiquement saines: a propos de 39 cas.

UNLABELLED: Myocardial infarction with normal coronary artery is ussually inaugural, with electric and clinical characteristics similar to those with atheroma. The role of constitutional or acquired abnormalities of haemostasis has been more incriminated in the pathogenesis of myocardial infarction with normal coronary. The aim of our study was to research abnormalities of haemostasis in patients with myocardial infarction and angiographically absolutely normal coronary arteries. PATIENTS AND METHODS: Thirty nine patients with myocardial infarction and normal coronary arteries where included in our study. They were 33 males and 6 females aged between 22 and 75 years (44 + 13 years), in whom the deficiency in protein C and S. antithrombin, activated protein C resistance and antiphospholipid antibodies were assessed. RESULTS: Concurrent abnormalities of haemostasis were found in 10 patients: Antiphospholipid antibodies, found in 5 patients constitute the most frequent abnormality. The other abnormalities were deficiency in protein C in two cases, deficiency in protein S 2 cases, deficiency in antithrombin in 2 ceses and activated protein C resistance in 3 cases . CONCLUSION: In our study. in face of the high prevalence of these abnormalities, it seems reasonable to research them, especially in young patients with myocardial infarction with normal coronary artery. This should have an impact on the management of these patients.