RESUMO
A 63-year-old male presented with a 6-month history of worsening exertional dyspnea and was found to have three-vessel coronary artery disease. Transesophageal echocardiography revealed a filamentous structure attached to the anterior mitral valve leaflet, which was confirmed during surgery as filamentous network. To our knowledge, this is the first report to describe such a network attached to the mitral valve.
Assuntos
Ecocardiografia Transesofagiana , Cardiopatias Congênitas/diagnóstico por imagem , Valva Mitral/anormalidades , Valva Mitral/diagnóstico por imagem , Cardiopatias Congênitas/cirurgia , Humanos , Achados Incidentais , Masculino , Pessoa de Meia-Idade , Valva Mitral/cirurgia , Resultado do TratamentoRESUMO
We report a child in whom a fistula connected the descending thoracic aorta to the right atrium. This is a previously unreported cardiac malformation. The patient was initially misdiagnosed as having a patent ductus arteriosus (PDA). On clinical examination and auscultation, the problem was different from PDA in that the continuous machinery murmur was better heard on the right parasternal area and posteriorly on the left. Surgical ligation of the fistula through a left thoracotomy abolished the murmur.
Assuntos
Aorta Torácica , Doenças da Aorta/congênito , Doenças da Aorta/diagnóstico , Fístula/congênito , Fístula/diagnóstico , Cardiopatias Congênitas/diagnóstico , Fístula Vascular/congênito , Fístula Vascular/diagnóstico , Pré-Escolar , Feminino , HumanosRESUMO
A 24-year-old man presented with a 24-hour history of pain and numbness in his left arm. The patient's clinical presentation of peripheral embolism was corroborated by angiography. Echocardiographic study showed masses in both right and left atria. Pathologic specimen from the embolus confirmed the diagnosis of aspergillosis.
Assuntos
Aspergilose/imunologia , Aspergilose/microbiologia , Aspergillus fumigatus , Imunocompetência/imunologia , Adulto , Aspergilose/diagnóstico , Ecocardiografia , Ecocardiografia Transesofagiana , Átrios do Coração/diagnóstico por imagem , Átrios do Coração/microbiologia , Humanos , Hospedeiro Imunocomprometido , Masculino , Tomografia Computadorizada por Raios XRESUMO
Heparin-induced thrombocytopenia HIT is a potentially devastating complication of heparin therapy. The severe form of HIT has been associated with both venous and arterial thrombosis manifested by myocardial infarction, cerebrovascular occlusion, skin necrosis or limb ischemia. Several agents are now available as alternatives to heparin in patients with suspected HIT, including the thrombin specific inhibitors lepirudin and argatroban as well as the low molecular weight heparinoid known as danaparoid. When lacking these agents, here we report the use of plasmapheresis to create an artificial state of anticoagulation; exchanging patient's plasma with albumin rather than fresh frozen plasma, to allow the safe introduction of warfarin.