Asunto(s)
Enfermedad de la Arteria Coronaria , Anomalías de los Vasos Coronarios , Fístula , Cardiopatías Congénitas , Fístula Vascular , Angiografía Coronaria , Anomalías de los Vasos Coronarios/complicaciones , Anomalías de los Vasos Coronarios/diagnóstico por imagen , Anomalías de los Vasos Coronarios/cirugía , Ventrículos Cardíacos/diagnóstico por imagen , Humanos , Fístula Vascular/diagnóstico por imagenRESUMEN
A 14-year-old boy of Asian origin presented with a history of bluish discolouration of the finger and toenail bed with associated mild fatiguability on exertion since early childhood. Clinical examination revealed bilaterally symmetric uniform central cyanosis with no associated clubbing. Cardiovascular and respiratory system examination was normal. Pulse oximetry revealed an oxygen saturation of 87% in all four limbs. Transthoracic and transoesophageal echocardiography showed no evidence of shunt lesions. In view of the past diagnosis of pulmonary arteriovenous fistulae made at 4 years of age, a repeat cardiac catheterisation study was done, which revealed no shunt at any level. Interestingly, arterial oxygen tension of the chocolate-brown blood was normal in all the samples, suggesting the possibility of methaemoglobinaemia. Co-oximetry revealed methaemoglobin levels of 36%, confirming the diagnosis. Secondary causes were ruled out. The family was counselled about the hereditary nature of the condition.
Asunto(s)
Antioxidantes/uso terapéutico , Ácido Ascórbico/uso terapéutico , Cianosis/etiología , Metahemoglobina/metabolismo , Metahemoglobinemia/congénito , Uñas Malformadas/patología , Adolescente , Análisis de los Gases de la Sangre , Cateterismo Cardíaco , Color , Consejo Dirigido , Fatiga , Pruebas Genéticas , Humanos , Masculino , Metahemoglobinemia/diagnóstico , Metahemoglobinemia/tratamiento farmacológico , Oximetría , Resultado del TratamientoRESUMEN
Endocrine disorders manifest as a disturbance in the milieu of multiple organ systems. The cardiovascular system may be directly affected or alter its function to maintain the state of homeostasis. In this article, we aim to review the pathophysiology, diagnosis, clinical features and management of cardiac manifestations of various endocrine disorders.
Asunto(s)
Carcinoma/complicaciones , Carcinoma/secundario , Neoplasias Cardíacas/complicaciones , Neoplasias Cardíacas/secundario , Neoplasias Pulmonares/patología , Cuidados Paliativos , Intervención Coronaria Percutánea , Obstrucción del Flujo Ventricular Externo/cirugía , Biopsia , Carcinoma/tratamiento farmacológico , Progresión de la Enfermedad , Ecocardiografía , Resultado Fatal , Neoplasias Cardíacas/tratamiento farmacológico , Humanos , Inmunohistoquímica , Neoplasias Pulmonares/tratamiento farmacológico , Imagen por Resonancia Magnética , Masculino , Persona de Mediana Edad , Intervención Coronaria Percutánea/instrumentación , Tomografía Computarizada por Tomografía de Emisión de Positrones , Stents , Resultado del Tratamiento , Obstrucción del Flujo Ventricular Externo/diagnóstico por imagen , Obstrucción del Flujo Ventricular Externo/etiología , Obstrucción del Flujo Ventricular Externo/fisiopatologíaRESUMEN
PURPOSE: To report the initial use of antegrade transseptal ascending aortic access to perform transcatheter embolization of a proximal type I endoleak associated with bird-beak configuration of an endograft in the proximal aortic arch. CASE REPORT: A 61-year-old man underwent endovascular repair of a large, symptomatic aortic arch aneurysm located distal to the left common carotid artery using a fenestrated endograft. Completion angiography showed bird-beak configuration of the proximal endograft and a large type Ia endoleak. In a separate procedure, the endoleak was embolized with cyanoacrylate glue via an antegrade ascending aortic access obtained through a transseptal sheath stabilized by an indwelling arteriovenous wire loop. This approach provided straight-line access into the endoleak with requisite catheter support, and complete thrombosis of the aneurysm sac was achieved. The patient's symptoms abated, and at 1-year follow-up, there was no endoleak, and the aneurysm sac had shrunken markedly. CONCLUSION: Antegrade transseptal ascending aortic access facilitates transcatheter embolization of type Ia endoleak in the proximal aortic arch.
Asunto(s)
Aneurisma de la Aorta Torácica/cirugía , Tabique Interatrial , Implantación de Prótesis Vascular/efectos adversos , Cateterismo Cardíaco/métodos , Embolización Terapéutica/métodos , Endofuga/terapia , Procedimientos Endovasculares/efectos adversos , Aneurisma de la Aorta Torácica/diagnóstico , Aortografía/métodos , Prótesis Vascular , Implantación de Prótesis Vascular/instrumentación , Endofuga/diagnóstico , Endofuga/etiología , Procedimientos Endovasculares/instrumentación , Humanos , Masculino , Persona de Mediana Edad , Diseño de Prótesis , Punciones , Stents , Tomografía Computarizada por Rayos X , Resultado del TratamientoRESUMEN
A 52-year-old man presented with recurrent postprandial abdominal pain, sitophobia, and progressive weight loss. Chronic mesenteric ischemia (CMI) due to subtotal occlusion of the superior mesenteric artery (SMA) and flush occlusion of the celiac artery (CA) was diagnosed. Retrograde recanalization of the CA by way of a collateral channel from the SMA was performed using contemporary recanalization equipment. The CA and SMA were then stented, resulting in sustained resolution of CMI-related symptoms.
Asunto(s)
Angioplastia de Balón/métodos , Arteria Celíaca/diagnóstico por imagen , Arteria Mesentérica Superior/diagnóstico por imagen , Oclusión Vascular Mesentérica/terapia , Stents , Dolor Abdominal/diagnóstico , Dolor Abdominal/etiología , Angioplastia de Balón/instrumentación , Enfermedad Crónica , Estudios de Seguimiento , Humanos , Masculino , Oclusión Vascular Mesentérica/diagnóstico por imagen , Persona de Mediana Edad , Radiografía , Índice de Severidad de la Enfermedad , Circulación Esplácnica/fisiología , Resultado del Tratamiento , Grado de Desobstrucción Vascular/fisiologíaRESUMEN
Despite diagnostic and therapeutic advances, mortality and morbidity associated with infective endocarditis (IE) remains high. Congestive heart failure and complications such as septic embolization and aortic root abscess are the main causes. Although aortic root abscess is a common complication of IE involving the aortic valve, acute myocardial infarction (AMI) is a rare complication in patients with endocarditis, whether in the acute or later phase of infection. In most cases, the infarction is either anterior or anterolateral. To the best of the present authors' knowledge, only one case of infarction at a purely inferior site has been reported previously. In the present case, IE with an aortic root abscess presented clinically as an acute inferior wall myocardial infarction.