[Primary meningococcal pericarditis caused by meningococcus serogroup C]. / Pericarditis meningocócica primaria por serogrupo C.

We report the case of a 15-year-old female, with no previous medical history, who presented cardiac tamponade secondary to purulent pericarditis caused by Neisseria meningitidis serogroup C. This microorganism is the etiologic agent in 6-16% of the cases of purulent pericarditis, most in association with previous or concomitant central nervous system involvement (meningitis). Exceptionally, as in this case, the pericarditis is not accompanied by meningitis (Primary Meningococcal Pericarditis). The patient was treated with antibiotics, pericardiocentesis and steroids with excellent response. It is important to point out that meningococcal disease may present in unusual forms which may lead to diagnostic and therapeutics difficulties.

[Infectious endocarditis of prosthetic valves due to Staphylococcus capitis: a new case]. / Endocarditis infecciosa sobre válvulas protésicas causada por Staphylococcus capitis: un nuevo caso.

We present the case of a male patient with aortic and mitral valve bioprostheses who developed infectious endocarditis due to Staphylococcus capitis, which has recently been described as an agent producing infectious endocarditis in native and prosthetic cardiac valves. The patient's course evolved unfavorably, despite specific antibiotic treatment, leading to the surgical replacement of the valve, which completely resolved the problem. This case points out that, although rare, in infectious endocarditis due to Staphylococcus capitis its pathogenicity is significant.

[The adult respiratory distress syndrome as a complication of the APSAC treatment of acute myocardial infarct. Apropos a case]. / Síndrome de distrés respiratorio del adulto como complicación del tratamiento del infarto agudo de miocardio con APSAC. A propósito de un caso.

Thrombolytic therapy has shown to be effective in acute myocardial infarction, and its benefits on left ventricular function and later survival are well known. However it is not a therapy free of complications and side effects. Allergic reactions, anafilaxia, hypotension, and several kinds of hemorrhages have been reported. Adult respiratory distress syndrome after streptokinase administration has been also described, and one case, recently communicated, after APSAC therapy. We present the case of a male with acute myocardial infarction who developed adult respiratory distress syndrome after APSAC therapy, with different outcome than the first case published in the literature. Finally, we discussed the mechanisms by means these drugs can produce such a complication.

[Acute myocardial infarct in a cocaine-addicted young man]. / Infarto de miocardio agudo en un joven cocainómano.

We present a case of acute myocardial infarction in a 22 year old cocaine user. The absence of coronary artery stenotic lesions, as was seen in the coronary arteriography, and the absence of personal past cardiovascular or family history, suggest a cocaine-induced coronary spasm as responsible for the acute myocardial event.

[A-V conduction block at His bundle level; as the cause of syncopal crisis in patients with normal ECG (author's transl)]. / Bloqueos A-V completos intermitentes de localización intrahisiana, como causa de crisis sincopales con ECG de base normal.

The history, clinical evolution and complementary studies used to identify the diagnostic etiology of syncopal crisis in a series of 5 patients are presented. The crisis consisted of advanced disturbances of the A-V conduction at the level of the His bundle. It is pointed out that although the evolution of the disturbance was intermittent, the surface ECG was normal and neither A-V block nor broadening of the QRS complex were seen. The importance of continued monitorization, whether as out-patients (Holter system) or, in some cases in an Intensive Care Unit, as well as the need to practice electrophysiologic studies in all these cases as the only way of establishing a firm diagnosis, are underlined. The fact that these disturbances do not always lead to an advanced blockage of A-V conduction is discussed as being reminiscent of the prospective and retrospective studies in the similar case of bi-fascicle block.

[Latent chronic constrictive pericarditis. Rapid filling overload for an accurate hemodynamic diagnosis (author's transl)]. / Pericarditis crónica constrictiva latente. Confirmación diagnóstica hemodinámica con sobrecarga volumétrica rápida.

Chest roentgenogram showed a pericardial calcification in a patient with inconspicuous signs of cardiac disease and normal basal pressures in the right cavities. A typical hemodynamic tracing of chronic constrictive pericarditis was obtained with rapid filling overload. The uncommeness of silent chronic constrictive pericarditis is mentioned and the usefulness of rapid filling overload for an accurate hemodynamic diagnosis of this condition is emphasized. Denomination of "latent" chronic constrictive pericarditis for similar cases to this reported is proposed.