RESUMO
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.
Assuntos
Coração Triatriado/diagnóstico por imagem , Ecocardiografia Transesofagiana , Hipertensão Pulmonar/etiologia , Adulto , Velocidade do Fluxo Sanguíneo , Calcinose/diagnóstico por imagem , Coração Triatriado/fisiopatologia , Coração Triatriado/cirurgia , Átrios do Coração/diagnóstico por imagem , Humanos , Masculino , SístoleRESUMO
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.
Assuntos
Insuficiência Cardíaca/etiologia , Hipocalcemia/complicações , Hipoparatireoidismo/complicações , Adulto , Cálcio/administração & dosagem , Cardiomiopatia Dilatada/tratamento farmacológico , Cardiomiopatia Dilatada/etiologia , Feminino , Insuficiência Cardíaca/tratamento farmacológico , Humanos , Hidroxicolecalciferóis/administração & dosagem , Hipocalcemia/tratamento farmacológico , Hipoparatireoidismo/tratamento farmacológicoRESUMO
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.
Assuntos
Tamponamento Cardíaco/etiologia , Neoplasias Cardíacas/complicações , Neurilemoma/complicações , Neurofibromatose 1/complicações , Adulto , Tamponamento Cardíaco/patologia , Diagnóstico Diferencial , Ecocardiografia , Neoplasias Cardíacas/diagnóstico , Humanos , Masculino , Neurilemoma/diagnóstico , Neurofibromatose 1/diagnóstico , Derrame Pericárdico/complicaçõesAssuntos
Cardiomiopatia Restritiva/etiologia , Insuficiência Cardíaca/etiologia , Mieloma Múltiplo/complicações , Mieloma Múltiplo/diagnóstico , Biópsia , Exame de Medula Óssea , Eletrocardiografia , Evolução Fatal , Hemodinâmica , Humanos , Masculino , Pessoa de Meia-Idade , Mieloma Múltiplo/tratamento farmacológicoRESUMO
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.