RESUMEN
Although aortocaval fistula is mostly encountered as a complication of abdominal aortic aneurysms, it may also arise as a complication of lumbar disc surgery. Great arteriovenous shunts especially may lead to high-output heart failure in due time. In this paper, we aim to present a case of high-output heart failure secondary to aortocaval fistule caused by lumbar disc surgery.
Asunto(s)
Enfermedades de la Aorta/diagnóstico , Fístula Arteriovenosa/diagnóstico , Insuficiencia Cardíaca/diagnóstico , Laminectomía/efectos adversos , Adulto , Aorta Abdominal , Enfermedades de la Aorta/etiología , Fístula Arteriovenosa/etiología , Diagnóstico Diferencial , Femenino , Insuficiencia Cardíaca/etiología , Humanos , Desplazamiento del Disco Intervertebral/cirugía , Vértebras Lumbares , Venas CavasRESUMEN
BACKGROUND: The link between arteriosclerotic disease in the carotid or coronary artery and chronic hepatitis C virus (HCV) infection has been shown in some studies although other studies have produced contrary results. However, the effect of chronic HCV infection on the extension or severity of coronary artery disease (CAD) has not been determined so the aim of the present study was to determine the effect of HCV infection on the severity of CAD. METHODS AND RESULTS: The study group comprised 139 HCV seropositive and 225 HCV seronegative patients with angiographically documented CAD. A modified scoring system of Reardon et al was used. There were no significant differences between groups in terms of sex, age, hypertension, diabetes mellitus, smoking or family history. Levels of C-reactive protein and fibrinogen were significantly higher in the HCV seropositive group (p<0.001) and the Reardon severity score was higher (8.75+/-1.69 vs 6.01+/-1.80, p<0.001). After adjustment, HCV seropositivity still represented an independent predictor for severity of coronary atherosclerosis demonstrated by higher Reardon severity score with an odds ratio of 2.018 (95% confidence interval 1.575-2.579, p<0.001). CONCLUSION: HCV infection is an independent predictor for increased coronary atherosclerosis, as demonstrated by higher Reardon severity score.
Asunto(s)
Enfermedad de la Arteria Coronaria/virología , Hepatitis C Crónica/complicaciones , Anciano , Biomarcadores/sangre , Proteína C-Reactiva/metabolismo , Estudios de Casos y Controles , Angiografía Coronaria , Enfermedad de la Arteria Coronaria/sangre , Enfermedad de la Arteria Coronaria/diagnóstico por imagen , Femenino , Fibrinógeno/metabolismo , Anticuerpos contra la Hepatitis C/sangre , Hepatitis C Crónica/sangre , Hepatitis C Crónica/inmunología , Humanos , Modelos Lineales , Modelos Logísticos , Masculino , Persona de Mediana Edad , Oportunidad Relativa , Medición de Riesgo , Factores de Riesgo , Índice de Severidad de la Enfermedad , TurquíaRESUMEN
There are up to 3 prominent trabeculations in the normal left ventricle. Sometimes, left ventricle has excessive trabeculations and intertrabecular recesses. This appearance is called as noncompaction or hypertrabeculation. It may be together with other structural cardiac abnormalities (non-isolated) or without them (isolated). Here we present a rare case with isolated noncompaction of the left ventricular myocardium. Rarity comes from its coexistence with essential thrombocythemia. In addition, it was complicated by thromboembolic cerebrovascular accident.