RESUMEN
BACKGROUND: Patient symptoms and primary investigational methods may be misleading at some points in patient management and can consume a lot of time. Sarcomas are rare malignancies and contribute 1% of all cancers of adult. CASE PRESENTATION: A rare case of primary cardiac angiosarcoma is presented, who was first treated because of lung tuberculosis and then with only slight improvement in symptoms, further investigations were done showing right ventricular enlargement and pericardial effusion. Eventually, after ruling out pulmonary embolism and constrictive pericarditis, investigations lead to the diagnosis of primary cardiac angiosarcoma. The patient went under surgery to remove the tumor but he still had residual mass left, leading to chemotherapy and then radiotherapy. Although the tumor has a poor prognosis, our patient has managed to survive a year by now and is doing good for 6 months after radiotherapy. CONCLUSION: The case describes the importance of having in mind different differential diagnosis in managing patients and the role of multi-modality imaging in guiding diagnosis and treatment.
RESUMEN
BACKGROUND: Atrial fibrillation is an arrhythmia that results from abnormal depolarization of the atrium. Atrial fibrillation occurs in 5-40% of patients with cardiovascular bypass surgery, usually occurs on 2 to 4 days postoperatively. The aim of this study was Effect of variability of central venous pressure values to prevent atrial fibrillation after coronary bypass grafting. METHODS: The present clinical trial study was performed on 150 patients undergoing cardiac surgery referred to Ayatollah Rohani Hospital of Babol. Patients were divided into 3 groups, with normal range pressure (8 to 12 mmHg), low pressure (less than 8), high pressure (greater than 12) based on central venous pressure measurements. Patients were evaluated every 4 hours to 72 hours for central venous pressure, AF incidence and urine output. Finally, the data are analyzed by spss statistical software. RESULTS: In this study 79 (52.7%) patients were male and 71 (47.3%) were female. In examining changes in central venous pressure, the time effect also significantly increased central venous pressure. The results of independent t-test showed that the mean of central venous pressure changes in subjects with at day 16, second day at 16, 20, 24, third day at 4, 8, 12, 16, 20 and 24 hours Atrial fibrillation. Significantly more than those without atrialfibrillation (P<0.05). CONCLUSION: In the study, central venous pressure changes the effect of time significantly increases the central venous pressure. Individuals with atrial fibrillation also had significantly greater central venous pressure changes than those without atrial fibrillation.
