RESUMO
Although uncommon, Libman-Sack endocarditis is the most characteristic cardiac manifestation of Systemic Lupus Erythematosus (SLE). It forms vegetations made of inflammatory tissue on the cardiac valves, leading them to malfunction. Here we present a case of a young woman who presented with severe mitral valve regurgitation in need for a valve replacement. Integral evaluation of the patient revealed the diagnosis of SLE, which was aggressively treated in an outpatient setting with immunosuppressive therapy. Only after achieving medical stabilization of the underlying disease, she was able to undergo surgical mitral valve replacement. After the surgery, the patient no longer suffered from mitral regurgitation, and with a mechanical prosthesis in place, the risk of Libman-Sacks endocarditis recurrence is thought to be minimal.
RESUMO
We present the case of a patient with myocardial infarction and COVID-19 disease who developed hemorrhagic pericardial effusion and cardiac tamponade. The differential diagnosis included post-infarction pericarditis and mechanical complications, thrombolysis, Dressler syndrome, and viral pericarditis. The histopathologic examination of the pericardial tissue sample and electron microscopic examination established the diagnosis. (Level of Difficulty: Advanced.).
RESUMO
Benign primary cardiac tumours are rare, with lipomas accounting for <9% of them. Their presentation varies depending on the size and location of the tumour, with the majority of the cases being asymptomatic. We are presenting a case of an extremely rare primary heart-tumour infiltrating the right ventricle (RV) compromising its function. RV lipomas are so unusual that there are no clear treatment guidelines. In this case, we decided to treat the patient with surgical resection of the tumour. Although a total resection was not possible, due to the tumoural proximity to vital structures, a great portion of the tumour was removed, alleviating the patient's symptoms.
Assuntos
Procedimentos Cirúrgicos Cardíacos/métodos , Neoplasias Cardíacas/cirurgia , Lipoma/cirurgia , Feminino , Neoplasias Cardíacas/diagnóstico , Ventrículos do Coração , Humanos , Lipoma/diagnóstico , Adulto JovemRESUMO
Malignant primary tumors of the heart are among the most unusual forms of cancer. Cardiac malignancy accounts for about 20% of all primary cardiac tumors, with most arising from the atria and less frequently the ventricles; very unusual locations include the great vessels and the cardiac valves. A rare case is presented of a young female that arrived at the authors' emergency room in pulmonary edema and circulatory collapse secondary to a true tumor of the mitral leaflets that caused severe mitral valve stenosis. On pathological examination this proved to be a mitral leaflet angiosarcoma.
Assuntos
Neoplasias Cardíacas/patologia , Neoplasias Cardíacas/cirurgia , Hemangiossarcoma/patologia , Hemangiossarcoma/cirurgia , Valva Mitral/patologia , Valva Mitral/cirurgia , Feminino , Humanos , Estenose da Valva Mitral/etiologia , Edema Pulmonar/etiologia , Choque/etiologia , Adulto JovemRESUMO
Hypertrophic cardiomyopathy (HCM) is characterized by the presence of an abnormal hypertrophy of the left ventricle (LV), without dilation, and in the absence of any condition or another cardiac or systemic disease capable of inducing such hypertrophy. This primary or idiopathic hypertrophy can occur with or without dynamic obstruction (induced by exercise) of the LV outflow tract, so in its natural history two fundamental aspects are highlighted: the production of symptoms by blocking the LV outflow tract and the occurrence of sudden cardiac death secondary to ventricular arrhythmias. This revision includes the work of different Iberoamerican investigators, who contributed in an important way to lay the groundwork of what we know nowadays as HCM. It also includes the main anatomopathological characteristics, from its initial description to the new perspective we have concerning the myofiber disarray as the main histopathologic feature.
Assuntos
Cardiomiopatia Hipertrófica/patologia , Cardiomiopatia Hipertrófica/etiologia , Cardiomiopatia Hipertrófica/fisiopatologia , Morte Súbita Cardíaca/etiologia , Ventrículos do Coração/patologia , HumanosRESUMO
BACKGROUND: Progress in radiology and pathology for diagnosing mediastinal tumors has R been made in recent decades, thanks to the use of fine needle aspiration biopsy (FNAB) guided by computed tomography, which has replaced mediastinoscopy and open biopsies. CASE: A 66-year-old male had a history o productive coughing with mucopurulent expectoration, progressive dyspnea, arthralgias, myalgias, astenia and adynamia for the previous 3 months. A CT scan and magnetic resonance imaging revealed a poorly limited tumor mass ofheterogeneous den sity in the anterior mediastinum. FNAB of the tumor mass showed malignant cells compatible with liposarcoma. CONCLUSLON: Of the several types of mesenchymal mediastinal neoplasms, liposarcoma is the most important. Many of them are seen in adults, and <10 cases have been diagnosed in children. The symptoms are related to compression of the nearby airways. Usually liposarcomas are yellow, lobed tumors without capsules that infiltrate adjacent organs and tissues. Microscopically, they have the same histologic spectrum as tumors originating in other sites. Thus, it is common to observe all the histologic varieties of soft tissue liposarcomas. The identification of lipoblasts is the key to the correct diagnosis in FNAB material.