[Right hemitruncus in adulthood: an unusual finding]. / Hemitruncus derecho en la vida adulta: un hallazgo poco usual.

Hemitruncus arteriosus is a rare congenital heart disease characterized by the abnormal origin of one of the branches of the pulmonary artery from the ascending aorta. In most cases, its diagnosis is made during childhood; in addition, due to its high morbidity and mortality, its asymptomatic evolution and survival to adulthood is extremely unusual. We present the case of a 30-year-old male patient, with a history of surgical closure of patent ductus arteriosus during childhood, who was asymptomatic until a year ago, in whom hemitruncus arteriosus was diagnosed after recurrent episodes of hemoptysis.

[Clinical profile and therapeutic strategies in patients with arrhythmogenic cardiomyopathy treated in a national reference institute]. / Perfil clínico y estrategias terapéuticas en pacientes con miocardiopatía arritmogénica tratados en un instituto de referencia nacional.

Objective: To determine the epidemiological, clinical, electrocardiographic, imaging characteristics and main therapeutic strategies performed in patients with arrhythmogenic cardiomyopathy treated in a national reference cardiovascular institute. Materials and methods: Observational, descriptive and retrospective study that attempts to identify the clinical characteristics, complementary tests and therapeutic strategies performed in patients with arrhythmogenic cardiomyopathy treated at the Instituto Nacional Cardiovascular - INCOR EsSalud in Lima, Peru. Results: Thirteen patients were found with arrhythmogenic cardiomyopathy. The median age at which the diagnosis was made was 38.2 years and 69.3% were male. The most frequent clinical manifestations were tachycardic palpitations (92.3%), presyncope (84.6%) and heart failure (69.2%). 23% of the patients suffered a cardiac arrest. All the patients presented at least one episode of ventricular tachycardia, 92.3% with complete left bundle branch block morphology and upper axis. 76.9% received an implantable cardioverter defibrillator (ICD), 15.3% underwent ablation and 15.3% received a heart transplant. 84.6% of the patients live to this day. Conclusions: Arrhythmogenic cardiomyopathy predominantly affected the young and male population. All the patients had a potentially fatal ventricular arrhythmia. Biventricular disease by echocardiography and cardiac magnetic resonance occurred in 69.2% and 100% of the cases, respectively. The therapeutic strategies used were antiarrhythmic medical treatment, placement of an ICD as secondary prevention, ablation, and heart transplantation. To date, 84.6% of patients survive.

[Cardiac Tamponade due to Rupture of a Giant Coronary Aneurysm over Coronary Fistulas: Report of an Unusual Case]. / Taponamiento Cardíaco por Ruptura de Aneurisma Coronario Gigante sobre Fístulas Coronarias: Reporte de un Caso Inusual.

Coronary artery fistulas are rare clinical entities and their association with giant coronary aneurysms is even more unusual. Most fistulas are asymptomatic, but aneurysms could develop symptoms depending on their diameter. We present a patient with chest pain and cardiac arrest, who later developed cardiac tamponade that needed emergency surgery, due to rupture of a giant coronary aneurysm developed from confluent coronary artery fistulas from two coronary arteries to pulmonary artery.