ABSTRACT
Left ventricular pseudoaneurysm is a rare complication of myocardial infarction and represent a myocardial rupture contained within a pericardial space limited by adhesions. Differentiating it from a left ventricular aneurysm can be a real diagnostic challenge. We report a case of a 50-year-old man admitted for symptoms of left heart failure. Transthoracic echocardiography and cardiac computed tomography scan incidentally showed a large lateral left ventricular pseudoaneurysm measuring 75/50 mm in diameter. Patch closure was carried out under cardiopulmonary bypass. Postoperative follow up was uneventful. This case demonstrates the increasing detection of «incidental¼ left ventricular pseudoaneurysm with more frequent use of multimodality imaging techniques including cardiac CT scan.
ABSTRACT
Endomyocardial fibrosis (EMF) is a rare and often underdiagnosed form of restrictive cardiomyopathy. Prognosis is generally unfavorable. Early diagnosis, along with surgical and medical intervention, is crucial for improved outcomes. We report the case of a 15-year-old girl from Guinea who presented with suspected Ebstein's anomaly and severe right heart failure. Multimodal cardiac imaging revealed right ventricular EMF. Despite counseling on prognosis, the family declined surgery. The patient experienced cardiac arrest two months later.
ABSTRACT
A 70-year-old woman was referred to our cardiology department for the management of dyspnoea. Cardiovascular examination revealed a loud P2, with no sign of right-sided heart failure. Chest X-ray showed a convex left medium cardiac border and a double contour along the right cardiac border. Transthoracic echocardiogram revealed a cystic mass attached to the right ventricle apex. Computed tomography scan showed cyst with fluid density on the apex of the right ventricle; and a honeycomb-like aspect cyst with partial occlusion in the left pulmonary artery. Cardiac magnetic resonance imaging revealed the presence of hydatic intrapericardial cyst that compresses the right ventricular apex; associated with intraluminal left pulmonary artery cyst. Hydatic serology was positive. The patient refused surgery and was discharged on a regimen of Albendazole. She has been followed up closely with a good outcome.
ABSTRACT
In multi-vessel coronary artery disease, concomitant ST-segment elevation myocardial infarction (STEMI) in simultaneous two culprit lesions have been rarely reported. In this regard, the recurrence in a short period of time of a STEMI in a different coronary artery is also rare. We describe the case of a 56-year-old male smoker, who was presented with an anterior STEMI. The coronary angiography demonstrated a significant lesion in the left main coronary (LMC) and an occlusion of the left anterior descending artery (LAD), and was referred for surgery. Four days later, he experienced symptoms of acute ischemia of the inferior territory. A newly formed culprit lesion of the circumflex artery (Cx) was detected and benefited from angioplasty. The patient expired the next day from sudden arrythmia. This case report shows two consecutive STEMI situations in separate coronary arteries, which commonly can occur in atherosclerotic patients with very poor prognosis.
ABSTRACT
Patients with rheumatic mitral stenosis (MS) often present complications such as atrial fibrillation and thrombus formation with significant morbi-mortality. Rarely, a free-floating 'ball thrombus' is found with possible catastrophic outcomes. We describe three cases of documented left atrial 'ping-pong' shaped 'thrombus ball' within MS: a 51 year old presented with acute heart failure with a fatal outcome due to the huge round thrombus closing the tight mitral valve, a 67-year-old and a 68-year-old male who were both urgently rushed to the operating room after accidental finding. The surgery was successful and consisted on mitral valve repair and thrombectomy. Our aim is to show that gigantic unattached thrombus ball within neglected rheumatism MS is a rare life-threatening entity, thus highlighting the importance of early diagnosis of such conditions present in endemic countries. A prompt surgery should be considered to avoid an eventual embolization and sudden death.
ABSTRACT
Coronary artery fistulas (CAF) are rare anomalies that pose a significant diagnostic and therapeutic challenge. Most of them originate from the right coronary artery and are congenital. They are often associated with coronary aneurysms. We report the case of a 38-year-old Black man who presented with exertion dyspnea. Transthoracic echocardiography found what was thought to be a bi-atrial hydatid cyst, alongside a right atrial shunt. Cardiac magnetic resonance imaging showed a cystic lesion hypointense on T1 and T2 sequences, located next to the left atrium as well as an aneurysmal circumflex artery shunting in the right atrium. Coronary angiography and computed tomography angiography confirmed the bilobed circumflex saccular aneurysm and CAF. The patient underwent a successful surgery, which consisted of closure of the fistula using two patches. He was discharged after an uneventful postoperative course. Our case report illustrates the diagnostic difficulty of CAF and the importance of multimodal imaging.
ABSTRACT
Scimitar syndrome has been repaired by different surgical procedures including intracardiac baffle technique, reimplantation of scimitar vein (SV) to the right atrium or the left atrium (LA). However, several anatomical variations such as short venous collector coursing deeply within the lung hilum with infradiaphragmatic drainage make the repair more challenging with conventional repair techniques. We present an alternative method for repair using a tube graft to connect the SV to the LA.