Cardiac involvement in cancer patients under chemotherapy and diagnosed with COVID-19: case report and literature review.

Many cases of severe cardiac complications due to Coronavirus disease 2019 (COVID-19) were reported. Cancer and chemotherapy appear to be risk and prognostic factors for COVID-19. A 49-year-old Female, with a history of breast cancer treated by tumorectomy and anthracycline-based chemotherapy was admitted with acute respiratory distress syndrome (ARDS) confirmed as COVID-19. She also had elevated troponin I level (up to 43 g/L), and diffuse myocardial hypokinesia along with severe left ventricle dysfunction on echocardiography. Initial treatment included hydroxychloroquine, azithromycin, corticosteroids and mechanical ventilation. The evolution was marked by QT interval prolongation (QTc=523 ms) and occurrence of cardiogenic shock. The patient died of hemodynamic instability reluctant to resuscitation measures at the 2ndday of hospitalization. COVID-19 patients may develop severe cardiac complications such as myocarditis and heart failure. Receiving chemotherapy especially anthracyclines may be a precipitating and prognostic factor of cardiac manifestations in COVID-19 cancer patients.

[Case study of ruptured gastroduodenal artery aneurysm revealed by hematemesis]. / Anévrisme rompu de l'artère gastroduodénale révélé par des hématémèses: à propos d'un cas.

Gastroduodenal artery aneurysm is a rare vascular lesion, asymptomatic in the majority of cases. However, ruptured aneurysm is associated with poor prognosis and mortality can achieve a 40% rate. We here report the case of an 83-year-old patient with abrupt onset of non-specific abdominal pain associated with hematemesis. Endoscopy showed beating formation compressing the duodenal bulb with active bleeding. Abdominal computed tomography (CT) scan was performed which objectified gastro duodenal artery aneurysms involving the artery ostium and making endovascular treatment impossible to perform. Thus, the patient underwent open surgery based on flattening associated with aneurysm exclusion and then complemented by bulb plasty. Post-operative CT scan confirmed total exclusion of the aneurysm with preservation of hepatic circulation.