[Unique monoblock lung right-left, unique pleural cavity]. / Plamân monobloc dreapta-stânga. Cavitate pleurala unica. Plamîn hipoplazic stâng. Caz clinic.

A 34-year-old female with WPW syndrome has been under surgical treatment in our clinic with left basal chronic pleural empyema. During the surgical intervention multiple anatomical anomalies were detected, like unique pleural cavity, monoblock lung left-right, hypoplasic left lung, no scissures on the left side, no left pulmonary arteria with an aberrant arteria for the left lung derived from the right pulmonary arteria, the same for the bronchis. The pleural-pulmonary shelling proceeded without incidents and it has been finalized with the drainage of the whole pleural cavity.

[Effectiveness of prostaglandin treatment in idiopathic pulmonary hypertension]. / Eficienta tratamentului cu prostaglandine in hipertensiunea pulmonara idiopatica.

UNLABELLED: Calcium channel blockers are the only vasodilators that proved their efficiency in idiopathic pulmonary hypertension (IPH). However, not every patient is responsive to this therapy. Only in isolated cases of IPH was proved the good effect of prostaglandins in lowering the pulmonary pressure by inhibiting the proliferation of smooth muscle cells. The follow up of a patient, male, 66 years, with IPH, NYHA IV class global cardiac decompensation, mostly the right heart, cyanotic, with 85% SaO2 at rest, massive edema, with "hair cut" aspect of pulmonary circulation, cardiomegaly assessed radiologically (CTI 0.55) and echocardiographically (important dilation of right heart chambers, RV 50/44 mm, compressing the left heart chambers, IVth grade tricuspid insufficiency and 160/90 mmHg pulmonary pressure) is presented. It was excluded a secondary cause of pulmonary hypertension, both by echocardiography and by cardiac catheterization, which eventually confirms the angiographic diagnosis of IPH (dilation of pulmonary artery and its branches, with no peripheral circulation). The progress was spectacular after introducing iloprost as therapy (two i.v. sessions at one month interval (28 days))--excellent clinical amelioration until IInd NYHA class, 96% SaO2 at rest, disappearance of pleural and pericardial effusion, with the diminishing of heart dimensions in radiological (CTI 0.44) and echography exams (RV 46/38 mm), amelioration of tricuspid regurgitation (grade II) and also the significant decrease of pulmonary pressure (90/60 mmHg). CONCLUSION: The therapy with iloprost is particularly effective in treating IPH.

[Postinfarction left ventricular saccular aneurysm]. / Anevrism sacular gigant al ventriculului stâng, postinfarct.

Postinfarction ventricular aneurysms may be either true or false, each with apparently definite diagnostic criteria on imaging techniques. We present the case of a 69 year-old male admitted to our hospital 6 weeks after an acute anterior myocardial infarction, for progressive exertional dyspnea. Transthoracic echocardiography demonstrated a large cystic cavity, 10 cm in diameter, communicating with the left ventricle's apex through an orifice of 5 cm diastolic diameter. The echocardiographic diagnosis was of a large, saccular aneurysm. Contrast ventriculography confirmed the existence of a large cavity connected to the apex of the left ventricle, 12 cm in diameter, with sluggish flow of contrast within it and features suggestive of pseudoaneurysm. The patient was referred for surgery because of continued symptoms and a preoperative diagnosis of either a large ventricular aneurysm or pseudoaneurysm. At the time of surgery a true aneurysm was found. We present this case because the rarity of a saccular configuration of a postinfarction left ventricular aneurysm, because of the unusual large size of it and to point on the possible disagreement between the conclusions of imaging modalities in differentiating a true from a false aneurysm.

[Adult onset Still's disease with normal level of serum ferritin]. / Boala Still a adultului cu manifestari aterosclerotice sistemice severe.

We present a case of an adult onset Still's disease: a 51 year old men presented with one month history of high spiking fever, asymmetric migratory polyarthritis and a previous history of pharyngitis. The diagnostic was based upon clinical criteria and laboratory findings, and necessitated the exclusion of infectious, neoplastic, and other "autoimmune" disease. The systemic involvement in our case induced us to comment therapy with corticosteroid. Patients with systemic disease have a favorable prognosis, with only rare serious complications from the disease (pericarditis, tamponade, diffuse intravascular coagulation, amyloidosis, hepatic disease, and respiratory failure) or the treatment (infections, gastrointestinal bleeding etc.).

[Acute myocardial infarction--a possible complication in polycythemia vera. Case report]. / Infarctul miocardic acut--o posibila complicatie în policitemia vera. Prezentare de caz.

A 66-year-old woman with Polycythemia Vera suffered an postero-inferior acute myocardial infarction: this is a relative rare association. The association between primary coronary angioplasty with stent implantation and anti-aggregant and myelosuppressive treatment was followed by important clinical benefits for the patient. To our knowledge, there are rare reports in the literature relating the triad of Polycythemia Vera, acute myocardial infarction and primary coronary angioplasty with stent implantation.