[Obstructive left triatrial heart in the adult. Echocardiographic appearances]. / Coeur triatrial obstructif gauche chez l'adulte. Aspects échocardiographiques.

The authors report the case of a 23-year old man who presented with signs of pulmonary hypertension due to an obstructive left triatrial heart in adulthood. Transthoracic and transoesophageal echocardiography showed a partially calcified intra-left atrial membrane perforated in its centre. Doppler analysis of flow through the membrane showed continuous systolo-diastolic flow at high velocity indicating haemodynamic obstruction. The systolic pulmonary artery pressure was estimated at 80 mmHg. The patient was treated by surgical excision of the intra-left atrial membrane.

[Hypocalcemic dilated cardiomyopathy: rare cause of heart failure]. / Une cause rare d'insuffisance cardiaque: la cardiomyopathie dilatée hypocalcémique.

Hypocalcemic dilated cardiomyopathy is a rare cause of heart failure in adults. We report a case in a 19-year-old woman who developed congestive heart failure induced by severe chronic hypocalcemia disclosing primary hypoparathyroidism. Complete regression of the clinical signs was achieved with vitamin-calcium treatment, but left ventricular systolic dysfunction persisted eight months after treatment.

[Malignant mediastinal schwannoma in Recklinghausen's disease presenting as cardiac tamponade. Report of two cases]. / Tamponnade cardiaque révélatrice de schwannome malin médiastinal au cours de la maladie de Recklinghausen. A propos de deux observations.

The authors report two cases of Recklinghausen's disease admitted for cardiac tamponade. Two-dimensional echocardiography showed a pericardial tumour in addition to a compressive pericardial effusion. After pericardial drainage, the outcome was rapidly fatal. Histological examination confirmed the diagnosis of a malignant intrapericardial schwannoma. A review of the literature revealed the scarcity of mediastinal malignant schwannoma. Associated with Von Reckinghausen's disease in 2 to 13% of cases, the prognosis is poor. The presentation of malignant mediastinal schwannoma with cardiac tamponade remains very rare.

[Cardiac tamponade and transient ischemia revealing a syndrome of primary antiphospholipid antibodies]. / Tamponnade cardiaque et accident ischémique transitoire révélant un syndrome des anticorps antiphospholipides primitif.

The authors report a case of echocardiographically confirmed cardiac tamponade, which required emergency pericardial aspiration, and a transient ischaemic attack revealing an underlying primary antiphospholipid antibody syndrome in a 29-year-old patient. The test for antiphospholipid antibodies was positive on 2 occasions (IgG > 91.41 micrograms/l). The diagnosis of systemic lupus erythematosus was eliminated. A favourable course was observed after 3 months of corticosteroids and platelet antiaggregants. Any case of cardiac tamponade or transient ischaemic attack with an unexplained aetiology in a young patient must suggest the diagnosis of antiphospholipid antibody syndrome.