RESUMEN
A 42-year-old woman was admitted with chest pain. Coronary angiography did not reveal any significant stenosis, but left ventriculography showed akinesis and ballooning of the apex with a hyperkinetic basal segment indicating Takotsubo cardiomyopathy. Cerebral embolism occurred after one and a half years because of a left ventricular thrombus. The apical akinesis had worsened to a left ventricular aneurysm (maximum diameter 43 mm). The left ventricle was reconstructed to avoid repeated thrombus formation and cerebral infarction despite anticoagulant therapy. A pathological assessment revealed a fibrotic myocardium, but the cause of the cardiac aneurysm remained unknown. Although the outcome of Takotsubo cardiomyopathy is relatively good, careful observation and appropriate treatment are needed considering the possibility of aggravation.
Asunto(s)
Aneurisma Cardíaco/cirugía , Ventrículos Cardíacos/cirugía , Cardiomiopatía de Takotsubo/cirugía , Disfunción Ventricular Izquierda/cirugía , Adulto , Anuloplastia de la Válvula Cardíaca , Femenino , Aneurisma Cardíaco/etiología , Humanos , Cardiomiopatía de Takotsubo/complicaciones , Disfunción Ventricular Izquierda/etiologíaRESUMEN
We experienced 2 patients who died early after emergency cardiac operation because of malignant diseases. In one case, we operated on a 67-year-old woman for infective endocarditis and performed aortic valve replacement, but she died of terminal pancreatic cancer on the 26 postoperative day. In the other case, a 53-year-old woman underwent emergency operation for cardiac tumor of the left atrium. However, the tumor was diagnosed as cardiac sarcoma during the operation, and it could not be completely resected. The sarcoma recurred after 2 months and she passed away. An emergency cardiac operation without enough preoperative examinations sometimes causes a poor prognosis.
Asunto(s)
Procedimientos Quirúrgicos Cardíacos , Urgencias Médicas , Neoplasias Cardíacas/diagnóstico , Neoplasias Pancreáticas/diagnóstico , Sarcoma/diagnóstico , Anciano , Válvula Aórtica/cirugía , Puente de Arteria Coronaria , Femenino , Atrios Cardíacos , Neoplasias Cardíacas/cirugía , Humanos , Persona de Mediana EdadRESUMEN
The gap junction protein, connexin 43 (Cx43) might be involved in the development of atherosclerosis. However, little is known about Cx43 expression in human arteries. We histologically analyzed the distal portions of radial (RA) and internal thoracic arteries (ITAs) obtained from 29 patients undergoing coronary artery bypass graft surgery. The medial smooth muscle cells of RA expressed Cx43, the intensity of which correlated with nuclear factor kappa B (NFκB) activation. In contrast, the expression of Cx43 in ITA did not correlate with NFκB activation. Cx43 appears to be involved in the pathogenesis of atherosclerosis especially in muscular arteries.