RESUMO
BACKGROUND: Coronary artery spasm (CAS) is an underdiagnosed disease especially in heart transplant patients, and in those patients the etiology and pathophysiology remain largely unknown, although it has been associated with cardiac allograft vasculopathy or graft rejection. CASE PRESENTATION: We report the case of a heart-transplant patient whose cardiac graft experienced two coronary vasospasms: the first before transplantation, and the other at one-month of a postoperative course complicated by primary graft failure. CONCLUSION: Our case illustrates that a transplanted heart predisposed with coronary vasospasm may suffer from early relapse in the recipient despite of complete post-surgical autonomic denervation. Exacerbated endothelial dysfunction of the donor heart after transplant, with the addition of systemic factors in the recipient may be involved in the genesis of this puzzling phenomenon.
Assuntos
Vasoespasmo Coronário/etiologia , Transplante de Coração/efeitos adversos , Disfunção Primária do Enxerto/etiologia , Vasoespasmo Coronário/diagnóstico por imagem , Vasoespasmo Coronário/fisiopatologia , Vasoespasmo Coronário/terapia , Humanos , Masculino , Pessoa de Meia-Idade , Disfunção Primária do Enxerto/diagnóstico por imagem , Disfunção Primária do Enxerto/fisiopatologia , Disfunção Primária do Enxerto/terapia , Recuperação de Função Fisiológica , Recidiva , Fatores de Risco , Fatores de Tempo , Resultado do TratamentoRESUMO
This report summarises three cases of Churg-Strauss syndrome (CSS) illustrating the diagnostic challenges associated with the cardiac manifestation of this disease. Here, we illustrate the role of cardiac magnetic resonance (CMR) for diagnosis and follow-up of CSS with a focus on new non-contrast T2-weighted imaging sequences for quantification of myocardial scar tissue and quantitative T2 mapping techniques, which allow the detection of myocardial edema.
Assuntos
Síndrome de Churg-Strauss/diagnóstico por imagem , Cardiopatias/diagnóstico por imagem , Imagem Cinética por Ressonância Magnética/tendências , Adulto , Síndrome de Churg-Strauss/complicações , Feminino , Seguimentos , Cardiopatias/complicações , Humanos , Masculino , Pessoa de Meia-IdadeRESUMO
This article reports the case of a 31 years old man who suffered from an acute pulmonary oedema after laryngospasma following extubation. This pathology, better known by anesthesiologists than internists, results primarly from a rapid rise in negative intrapleural pressure. It is not associated with previous cardio-pulmonary illness and has a begnin course with resolution within 48 hours with oxygen and positive end expiratory pressure support.
