Takotsubo Cardiomyopathy Following Complete Avalanche Burial: A Case Report.

Libersa, Marie, Louis Marxer, Ken Zafren, Stephane Oggier, Lorenzo Pucci, and Mathieu Pasquier. Takotsubo cardiomyopathy following complete avalanche burial: a case report. High Alt Med Biol. 24:149-151, 2023.-Takotsubo cardiomyopathy is a transient left ventricular dyskinesia triggered by a stressful physical or emotional event. We report a case of mid-ventricular Takotsubo stress cardiomyopathy in an avalanche victim. The patient was a 41-year-old woman who was completely buried under 1.2 m of snow for 30 minutes. On arrival at the hospital, she was conscious and hypothermic (core temperature 33.7°C). Her ECG showed rapid atrial fibrillation (142 beats/min) that converted to sinus rhythm after rewarming and administration of crystalloids. Echocardiography showed akinesia of the left mid-ventricle with a left ventricular ejection fraction of 41%. At 48-hour follow-up, echocardiography showed an almost complete recovery. During her hospital stay the patient was diagnosed with an acute stress disorder with symptoms of dissociation. She was discharged home after 5 days. At 2-week follow-up echocardiography was normal. Psychological follow-up was normal at 7 months. The physical and psychological stress of the avalanche, as well as hypothermia, were all possible triggers of Takotsubo cardiomyopathy.

[Alveolar proteinosis: a cause of immunodeficiency]. / Protéinose alvéolaire: une maladie fascinante et un facteur d'immunosuppression peu connu.

Alveolar proteinosis is a rare disease, characterized by accumulation of surfactant in alveoli. Various forms have been identified (congenital, secondary or auto-immune). Treatment is to be reserved for patients that experience moderate to severe symptoms. It requires whole lung lavages, in order to clear the alveoli from the proteinaceous material. Macrophages dysfunction plays a crucial role in the development of the disease and causes immunodeficiency, which in turn can promote opportunistic infections, in patients a priori thought to be immunocompetent.