Asunto(s)
Apéndice Atrial , Fibrilación Atrial , Estenosis de la Válvula Mitral , Cardiopatía Reumática , Apéndice Atrial/diagnóstico por imagen , Ecocardiografía Transesofágica , Atrios Cardíacos/diagnóstico por imagen , Humanos , Estenosis de la Válvula Mitral/diagnóstico por imagen , Cardiopatía Reumática/complicaciones , Cardiopatía Reumática/diagnóstico por imagenRESUMEN
A 36-year-old woman presented with dyspnoea on exertion for 5 years. She was evaluated elsewhere and diagnosed to have severe mitral stenosis. She was referred for mitral valve replacement to our centre. Echocardiography revealed a thickened aortic valve with mild aortic regurgitation, with transaortic gradient suggestive of mild aortic stenosis, in addition to severe rheumatic mitral stenosis. Detailed echocardiographic analysis and cardiac catheterisation revealed features suggestive of moderate to severe aortic stenosis. Detailed assessment of aortic valve needs to be done in patients with coexistent mitral stenosis. Each modality for assessment of aortic stenosis has its own limitations and a decision regarding treatment needs to be taken based on combined analysis of all the parameters. Dimensionless velocity index is a relatively less time-consuming, flow independent measure of aortic stenosis. Prompt recognition of this concealed aortic stenosis helps to avoid repeat valve surgery. Subsequently, patient was sent for dual valve replacement.
Asunto(s)
Estenosis de la Válvula Aórtica/diagnóstico por imagen , Estenosis de la Válvula Aórtica/etiología , Insuficiencia de la Válvula Mitral , Cardiopatía Reumática/complicaciones , Adulto , Estenosis de la Válvula Aórtica/tratamiento farmacológico , Estenosis de la Válvula Aórtica/cirugía , Ecocardiografía , Femenino , Humanos , Insuficiencia de la Válvula Mitral/diagnóstico por imagen , Insuficiencia de la Válvula Mitral/tratamiento farmacológico , Insuficiencia de la Válvula Mitral/fisiopatología , Resultado del TratamientoRESUMEN
A 27-year-old woman presented with breathlessness on exertion of 3 months duration and was treated as dilated cardiomyopathy elsewhere. On evaluation, she was found to have left ventricular hypertrophy with ventricular dysfunction. CT angiogram revealed a peripheral-enhancing mass with central necrosis in the aortocaval region. Elevated serum metanephrine and uptake in 131iodine metaiodobenzylguanidine scan lead to the diagnosis of paraganglioma. Patient underwent open surgical excision of the tumour. Left ventricular function became normal and left ventricular hypertrophy resolved after surgery.
Asunto(s)
Paraganglioma Extraadrenal/complicaciones , Paraganglioma Extraadrenal/diagnóstico , Disfunción Ventricular Izquierda/complicaciones , Disfunción Ventricular Izquierda/diagnóstico , Adulto , Angiografía por Tomografía Computarizada , Ecocardiografía , Femenino , Humanos , Paraganglioma Extraadrenal/cirugía , Recuperación de la Función , Neoplasias Vasculares/complicaciones , Neoplasias Vasculares/diagnóstico , Neoplasias Vasculares/cirugía , Disfunción Ventricular Izquierda/cirugía , Función Ventricular IzquierdaRESUMEN
A 50-year-old woman presented with complaints of palpitations and breathlessness of 6 months' duration. She was being treated elsewhere as a case of dilated cardiomyopathy. On evaluation she had racoon eyes, poor progression of R wave on ECG and low-voltage complexes in the limb leads. Echocardiography revealed biventricular hypertrophy, diastolic dysfunction and moderate systolic dysfunction. Cardiac MRI showed features suggestive of amyloidosis. Bone marrow biopsy revealed raised plasma cell count, and endomyocardial biopsy showed amyloid deposits in the myocardium. Free lambda light chain levels were elevated, even though serum and urine electrophoresis did not show any monoclonal band. In this 'text book case of cardiac amyloidosis', apart from cardiovascular system no other organ system was affected, which is uncommon in primary light chain amyloidosis. The patient was started on CyBorD (cyclophosphamide, bortezomib and dexamethasone) regimen.
