RESUMEN
Trauma inflicted by sharp penetrating objects can cause unusual and complex injuries to the heart. We present a case where penetrating trauma caused an unusual ventricular laceration that filleted the ventricular septum into two separate sections creating an artificial chamber in between. The ventricular septal defect was clearly displayed with echocardiography and required special cardiac surgical intervention.
Asunto(s)
Defectos de los Tabiques Cardíacos/diagnóstico por imagen , Defectos de los Tabiques Cardíacos/etiología , Heridas Punzantes/complicaciones , Heridas Punzantes/diagnóstico por imagen , Adulto , Humanos , Masculino , UltrasonografíaRESUMEN
Given their low incidence, mechanical complications of AMI represent a diagnostic and therapeutic challenge for the EP. When the panoply of medical interventions has reached its limitation, surgical treatment plays a role in the management of the patient who has AMI. For patients who have CS and severe compromise of myocardial reserve, surgical intervention might represent the only means of restoring blood flow to the myocardium. For patients who have mechanical complications, correction of the defect before the onset of terminal organ failure might provide long-term survival.
Asunto(s)
Servicio de Urgencia en Hospital , Rotura Cardíaca/etiología , Infarto del Miocardio/complicaciones , Rotura Cardíaca/diagnóstico , Rotura Cardíaca/fisiopatología , Rotura Cardíaca/terapia , Ventrículos Cardíacos/fisiopatología , Ventrículos Cardíacos/cirugía , Humanos , Infarto del Miocardio/terapia , Músculos Papilares/fisiopatología , Músculos Papilares/cirugía , Transferencia de Pacientes/normas , Factores de RiesgoRESUMEN
Patients with aortic valve disease (AVD) typically have a cardiac murmur that radiates to the neck and may be indistinguishable from a cervical bruit secondary to carotid artery occlusive disease. The purpose of this report was to determine the prevalence of significant asymptomatic carotid artery occlusive disease in patients undergoing aortic valve replacement (AVR). All patients scheduled for AVR were prospectively studied. Preoperative carotid artery color-flow duplex was performed in all patients. A total of 204 patients were included in the study and significant carotid disease (>50% stenosis of the internal carotid artery) was found in 17 (8%). In patients with isolated aortic valve disease, 4/129 (3%) had significant stenosis. Of the patients with concurrent aortic valve and coronary artery disease, 13/75 (17%) had significant stenosis. The incidence of significant carotid stenosis in patients with aortic valve disease was over five fold higher in patients with concurrent coronary artery disease (3% vs. 17%, p <0.001). The yield of routine carotid duplex scanning for patients undergoing isolated AVR is low. However, in the subset of patients with concurrent coronary disease, the yield is higher. This finding supports the use of routine carotid duplex scanning in patients with coexistent aortic valve and coronary artery disease.