Your browser doesn't support javascript.
loading
Mostrar: 20 | 50 | 100
Resultados 1 - 20 de 7.078
Filtrar
2.
BMJ Case Rep ; 14(1)2021 Jan 11.
Artigo em Inglês | MEDLINE | ID: mdl-33431455

RESUMO

Takayasu's arteritis (TA) is a vasculitis with a predilection for young women. Left ventricular pseudoaneurysm (PSA) in TA is a rare phenomenon. We report a 36 years old Filipina who presented with heart failure symptoms. Years prior, she had a recurrent fever, headache, myalgia and left arm claudication. On workup, a 2D echo revealed a left ventricular PSA with mural thrombus and moderate mitral regurgitation. Cardiac MRI further characterised the PSA with a sac diameter of 8×7.5×8.4 cm (CC×T×AP). Carotid Duplex Scan revealed total occlusion of the mid to distal right common carotid artery and left subclavian artery. She was started on immunosuppresants and guideline-directed medical therapy (GDMT) for heart failure and subsequently underwent successful endoventricular patch closure and mitral valve repair. This case highlights the importance of actively searching for cardiac complications of TA which although very rare, can dominate the clinical picture and may carry a dismal prognosis if left untreated.


Assuntos
Falso Aneurisma/diagnóstico , Aneurisma Cardíaco/diagnóstico , Insuficiência Cardíaca/etiologia , Insuficiência da Valva Mitral/diagnóstico , Arterite de Takayasu/diagnóstico , Adulto , Falso Aneurisma/etiologia , Falso Aneurisma/cirurgia , Ecocardiografia Doppler em Cores , Eletrocardiografia , Feminino , Aneurisma Cardíaco/etiologia , Aneurisma Cardíaco/cirurgia , Insuficiência Cardíaca/terapia , Ventrículos do Coração/diagnóstico por imagem , Ventrículos do Coração/patologia , Ventrículos do Coração/cirurgia , Humanos , Imunossupressores/uso terapêutico , Imagem por Ressonância Magnética , Insuficiência da Valva Mitral/etiologia , Insuficiência da Valva Mitral/cirurgia , Imagem de Perfusão do Miocárdio , Arterite de Takayasu/complicações , Arterite de Takayasu/tratamento farmacológico , Arterite de Takayasu/imunologia
3.
World J Pediatr Congenit Heart Surg ; 12(1): 131-132, 2021 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-33407034

RESUMO

Our division wishes to share interesting case images of a giant aneurysm of the left atrial appendage in an infant. He was asymptomatic and was diagnosed incidentally. The aneurysm was excised uneventfully. Left atrial appendage aneurysms are commonly reported in adults, but they are quite rare in the infant population.


Assuntos
Apêndice Atrial/diagnóstico por imagem , Procedimentos Cirúrgicos Cardíacos/métodos , Ecocardiografia/métodos , Aneurisma Cardíaco/diagnóstico , Apêndice Atrial/cirurgia , Aneurisma Cardíaco/cirurgia , Humanos , Lactente , Masculino , Tomografia Computadorizada por Raios X
4.
J Comput Assist Tomogr ; 45(1): 157-165, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-33475319

RESUMO

ABSTRACT: Mycobacterium infection remains a leading cause of morbidity and mortality worldwide. Although rare, thoracic cardiovascular complications are associated with devastating consequences if not promptly diagnosed using computed tomography. Intrapulmonary complications include tuberculous aortitis, Rasmussen aneurysms, involvement of bronchial and nonbronchial systemic arteries, and thromboembolic events. Extrapulmonary complications include pericarditis, myocarditis, endocarditis, involvement of coronary arteries, annular-subvalvular left ventricle aneurysms and mediastinal fibrosis. This article will review these complications and their computed tomography features.


Assuntos
Doenças Cardiovasculares/diagnóstico por imagem , Tuberculose Pulmonar/complicações , Doença da Artéria Coronariana/diagnóstico por imagem , Endocardite/diagnóstico por imagem , Aneurisma Cardíaco/diagnóstico por imagem , Humanos , Mediastinite/diagnóstico por imagem , Pericardite/diagnóstico por imagem , Esclerose/diagnóstico por imagem , Tomografia Computadorizada por Raios X , Tuberculose Pulmonar/diagnóstico por imagem
6.
J Cardiothorac Surg ; 15(1): 297, 2020 Oct 02.
Artigo em Inglês | MEDLINE | ID: mdl-33008444

RESUMO

BACKGROUND: While the aneurysms of the membranous septum (AVS) are rare, the possibility that they lead to obstruction is even rarer. To the best of our knowledge, 11 similar cases have been reported since 1982. CASE PRESENTATION: Initially, the five-year-old boy was evaluated for dyspnoea that had been present since birth. He did not receive any medical treatment until the previous year. At the age of four, the transthoracic echocardiography showed a large aneurysm extending to the right ventricular outflow tract (RVOT) and causing RVOT stenosis. Complete surgical resection of the aneurysmal tissue was performed, and the boy was discharged home in satisfactory condition. CONCLUSIONS: As the occurrence of RVOT obstruction by a membranous ventricular septal aneurysm is very rare, we are reporting the second case in which an aneurysm of the membranous septum dynamically obstructed the RVOT in a child. We are also reviewing all the previously reported similar cases in the literature. Further studies are needed to obtain a more comprehensive understanding of aneurysms of the membranous septum (AVS).


Assuntos
Aneurisma Cardíaco/cirurgia , Cardiopatias Congênitas/cirurgia , Comunicação Interventricular/cirurgia , Septo Interventricular/cirurgia , Pré-Escolar , Dispneia/etiologia , Ecocardiografia , Aneurisma Cardíaco/complicações , Cardiopatias Congênitas/complicações , Comunicação Interventricular/complicações , Ventrículos do Coração , Humanos , Masculino
8.
J Cardiovasc Med (Hagerstown) ; 21(11): 874-881, 2020 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-32941325

RESUMO

AIMS: The aim of this study was to report the prevalence, clinical features and outcomes of patients with ST-elevation myocardial infarction (STEMI) hospitalized during the Corona-Virus Disease 2019 (COVID-19) outbreak compared with those admitted in a previous equivalent period. METHODS AND RESULTS: Eighty-five patients admitted for STEMI at a high-volume Italian centre were included. Patients hospitalized during the COVID-19 outbreak (21 February-10 April 2020) (40%) were compared with those admitted in pre-COVID-19 period (3 January-20 February 2020) (60%). A 43% reduction in STEMI admissions was observed during the COVID-19 outbreak compared with the previous period. Time from symptom onset to first medical contact (FMC) and time from FMC to primary percutaneous coronary intervention (PPCI) were longer in patients admitted during the COVID-19 period compared with before [148 (79-781) versus 130 (30-185) min; P = 0.018, and 75 (59-148)] versus 45 (30-70) min; P < 0.001]. High-sensitive troponin T levels on admission were also higher. In-hospital mortality was 12% in the COVID-19 phase versus 6% in the pre-COVID-19 period. Incidence of the composite end-point, including free-wall rupture, severe left ventricular dysfunction, left ventricular aneurysm, severe mitral regurgitation and pericardial effusion, was higher during the COVID-19 than the pre-COVID-19 period (19.6 versus 41.2%; P = 0.030; odds ratio = 2.87; 95% confidence interval 1.09-7.58). CONCLUSION: The COVID-19 pandemic had a significant impact on the STEMI care system reducing hospital admissions and prolonging revascularization time. This translated into a worse patient prognosis due to more STEMI complications.


Assuntos
Infecções por Coronavirus , Aneurisma Cardíaco , Ruptura Cardíaca Pós-Infarto/epidemiologia , Pandemias , Intervenção Coronária Percutânea , Derrame Pericárdico , Pneumonia Viral , Infarto do Miocárdio com Supradesnível do Segmento ST , Betacoronavirus , Infecções por Coronavirus/epidemiologia , Infecções por Coronavirus/prevenção & controle , Testes Diagnósticos de Rotina/estatística & dados numéricos , Feminino , Aneurisma Cardíaco/epidemiologia , Aneurisma Cardíaco/etiologia , Mortalidade Hospitalar , Hospitalização/estatística & dados numéricos , Humanos , Itália/epidemiologia , Masculino , Pessoa de Meia-Idade , Avaliação de Processos e Resultados em Cuidados de Saúde , Pandemias/prevenção & controle , Intervenção Coronária Percutânea/efeitos adversos , Intervenção Coronária Percutânea/métodos , Derrame Pericárdico/epidemiologia , Derrame Pericárdico/etiologia , Pneumonia Viral/epidemiologia , Pneumonia Viral/prevenção & controle , Prevalência , Infarto do Miocárdio com Supradesnível do Segmento ST/diagnóstico , Infarto do Miocárdio com Supradesnível do Segmento ST/mortalidade , Infarto do Miocárdio com Supradesnível do Segmento ST/cirurgia , Tempo para o Tratamento/estatística & dados numéricos
10.
Am J Cardiol ; 133: 32-38, 2020 10 15.
Artigo em Inglês | MEDLINE | ID: mdl-32807388

RESUMO

There are limited data on the prevalence and an outcome of left ventricular (LV) aneurysms following acute myocardial infarction (AMI). Using the National Inpatient Sample during 2000 to 2017, a retrospective cohort of AMI admissions was evaluated for LV aneurysms. Complications included ventricular arrhythmias, mechanical, cardiac arrest, pump failure, LV thrombus, and stroke. Outcomes of interest included in-hospital mortality, temporal trends, complications, hospitalization costs, and length of stay. A total 11,622,528 AMI admissions, with 17,626 (0.2%) having LV aneurysms were included. The LV aneurysm cohort was more often female, with higher comorbidity, and admitted to large urban hospitals (all p < 0.001). In 2017, compared with 2000, there was a slight increase in LV aneurysms prevalence in those with (adjusted odds ratio [aOR] 1.57 [95% confidence interval {CI} 1.41 to 1.76]) and without (aOR 1.13 [95% CI 1.00 to .127]) ST-segment-elevation AMI (p < 0.001 for trend). LV aneurysms were more commonly noted with anterior ST-segment-elevation AMI (31%) compared with inferior (12.3%) and other (7.9%). Ventricular arrhythmias (17.6% vs 8.0%), mechanical complications (2.6% vs 0.2%), cardiac arrest (7.1% vs 5.0%), pump failure (26.3% vs 16.1%), cardiogenic shock (10.0% vs 4.8%) were more common in the LV aneurysm cohort (all p < 0.001). Those with LV aneurysms had comparable in-hospital mortality compared with those without (7.4% vs 6.2%; aOR 1.02 [95% CI 0.90 to 1.14]; p = 0.43). The LV aneurysm cohort had longer length of hospital stay, higher hospitalization costs, and fewer discharges to home. In conclusion, LV aneurysms were associated with higher morbidity, more frequent complications, and greater in-hospital resource utilization, without any differences in in-hospital mortality in AMI.


Assuntos
Aneurisma Cardíaco/epidemiologia , Infarto do Miocárdio/complicações , Idoso , Idoso de 80 Anos ou mais , Feminino , Aneurisma Cardíaco/diagnóstico , Aneurisma Cardíaco/terapia , Ventrículos do Coração , Mortalidade Hospitalar , Hospitalização , Humanos , Masculino , Pessoa de Meia-Idade , Infarto do Miocárdio/mortalidade , Infarto do Miocárdio/terapia , Razão de Chances , Prevalência , Estudos Retrospectivos , Fatores de Risco , Taxa de Sobrevida , Fatores de Tempo
11.
Asian Cardiovasc Thorac Ann ; 28(8): 504-506, 2020 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-32757654

RESUMO

Congenital left ventricular aneurysm or diverticulum is very rare. Most congenital left ventricular aneurysms are asymptomatic but some cause systemic embolization, left ventricular free wall rupture, or ventricular arrhythmias causing sudden cardiac death. A 29-year-old woman with congenital left ventricular aneurysm and nonsustained ventricular tachycardia underwent surgical plication of the aneurysm with left ventricular reshaping to improve heart failure symptoms, prevent rupture of the aneurysm wall and the possibility of thrombus formation, and excise the fibrotic tissue of the left ventricular aneurysm, which could be a trigger for left ventricular aneurysm arrhythmias. The postoperative course was unremarkable.


Assuntos
Aneurisma Cardíaco/congênito , Miocárdio Ventricular não Compactado Isolado/complicações , Adulto , Feminino , Aneurisma Cardíaco/diagnóstico por imagem , Aneurisma Cardíaco/cirurgia , Insuficiência Cardíaca/etiologia , Humanos , Miocárdio Ventricular não Compactado Isolado/diagnóstico por imagem , Miocárdio Ventricular não Compactado Isolado/cirurgia , Taquicardia Ventricular/etiologia , Resultado do Tratamento , Disfunção Ventricular Esquerda/etiologia
13.
J Card Surg ; 35(8): 2103-2105, 2020 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-32652642

RESUMO

A 59-year-old man with acute mitral regurgitation due to papillary muscle rupture after myocardial infarction was admitted to our hospital. He underwent emergent mitral valve replacement with a mechanical valve by median sternotomy. Although postoperative echocardiography showed no sign of a ventricular aneurysm, echocardiography performed 5 weeks after the surgery showed enlarging left ventricular pseudoaneurysm of the inferior to the posterior cardiac wall. He underwent dacron patch closure of the orifice by fifth intercostal left thoracotomy. The postoperative course was uneventful and he was discharged on postoperative day 10. The patient was successfully treated for two life-threatening complications occurring subsequently after myocardial infarction.


Assuntos
Falso Aneurisma/cirurgia , Aneurisma Cardíaco/cirurgia , Ruptura Cardíaca Pós-Infarto/cirurgia , Implante de Prótese de Valva Cardíaca , Ventrículos do Coração/cirurgia , Valva Mitral/cirurgia , Infarto do Miocárdio/complicações , Músculos Papilares , Complicações Pós-Operatórias , Toracotomia/métodos , Falso Aneurisma/etiologia , Aneurisma Cardíaco/etiologia , Humanos , Masculino , Pessoa de Meia-Idade , Resultado do Tratamento
16.
J Card Surg ; 35(7): 1636-1637, 2020 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-32557864

RESUMO

Urgent surgery is generally indicated for left ventricular (LV) pseudoaneurysms, especially for large or expanding lesions. However, management of pseudoaneurysms complicated by acute intracerebral hemorrhage is controversial. This case of a giant LV pseudoaneurysm followed a successful postoperative course after 4 weeks of conservative management followed by surgical repair and may suggest a safe and efficient management.


Assuntos
Falso Aneurisma/terapia , Hemorragia Cerebral/terapia , Tratamento Conservador/métodos , Complicações Pós-Operatórias/terapia , Idoso , Falso Aneurisma/diagnóstico por imagem , Falso Aneurisma/etiologia , Procedimentos Cirúrgicos Cardíacos/métodos , Hemorragia Cerebral/diagnóstico por imagem , Hemorragia Cerebral/etiologia , Aneurisma Cardíaco/etiologia , Aneurisma Cardíaco/cirurgia , Ventrículos do Coração , Humanos , Masculino , Infarto do Miocárdio/complicações , Complicações Pós-Operatórias/diagnóstico por imagem , Complicações Pós-Operatórias/etiologia , Procedimentos Cirúrgicos Reconstrutivos , Trombectomia , Fatores de Tempo , Tomografia Computadorizada por Raios X
17.
Mem Inst Oswaldo Cruz ; 115: e200056, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32556037

RESUMO

BACKGROUND: Left ventricular aneurysm (LVA) is indicator of high morbidity in Chagas' disease. A cross-sectional study performed identified LVA in 18.8% of the chronic chagasic patients (CCP). OBJECTIVE: Determine the risk of death of patients with chronic chagasic cardiopathy (CCC) and LVA in 24-year interval. MATERIAL AND METHODS: In 1995 a cohort of 298 CCP was evaluated by anamnesis, physical examination, EKG and ECHO and classified in groups: G0 = 86 without cardiopathy; G1 = 156 with cardiopathy without LVA and G2 = 56 with cardiopathy and LVA. 38 patients of G0 and G1 used benznidazole. Information about the deaths was obtained in the notary, death certificates, hospital records and family members. FINDINGS: Were registered 113 deaths (37.9%): 107 (35.9%) attributed to cardiopathy and 6 (2.0%) to other causes (p < 0.05). Amongst these 107 deaths, 10 (11.6%) occurred in G0; 49 (31.4%) occurred in G1 and 48 (85.7%) occurred in G2 (p < 0.05). The risk of death was 2.7 and 7.4 times significantly higher in G2, than in G1 and G0, respectively. CONCLUSION: Chronic chagasic patients with LVA and ejection fraction < 45% have a higher risk of death than those without.


Assuntos
Cardiomiopatia Chagásica/mortalidade , Aneurisma Cardíaco/mortalidade , Ventrículos do Coração/patologia , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Causas de Morte , Cardiomiopatia Chagásica/complicações , Doença Crônica , Estudos Transversais , Eletrocardiografia , Feminino , Aneurisma Cardíaco/complicações , Humanos , Masculino , Pessoa de Meia-Idade , Adulto Jovem
18.
Can J Cardiol ; 36(8): 1326.e9-1326.e11, 2020 08.
Artigo em Inglês | MEDLINE | ID: mdl-32599017

RESUMO

A wide spectrum of cardiovascular manifestations has been documented in patients suffering from coronavirus disease-2019 (COVID-19). Usually associated with a poor prognoses, these manifestations include thromboembolic events, acute coronary syndrome, heart failure, and cardiogenic shock. We describe a patient with COVID-19 who presented with subacute myocardial infarction, biventricular thrombi, and bilateral pulmonary emboli. Biventricular thrombi are rare, and their presence raises concern for an underlying prothrombotic condition.


Assuntos
Betacoronavirus/isolamento & purificação , Infecções por Coronavirus , Aneurisma Cardíaco , Ventrículos do Coração , Pandemias , Pneumonia Viral , Embolia Pulmonar , Infarto do Miocárdio com Supradesnível do Segmento ST , Trombose , Anticoagulantes/administração & dosagem , Reanimação Cardiopulmonar/métodos , Deterioração Clínica , Angiografia Coronária/métodos , Infecções por Coronavirus/complicações , Infecções por Coronavirus/diagnóstico , Infecções por Coronavirus/fisiopatologia , Evolução Fatal , Feminino , Aneurisma Cardíaco/diagnóstico , Aneurisma Cardíaco/etiologia , Parada Cardíaca/etiologia , Parada Cardíaca/terapia , Ventrículos do Coração/diagnóstico por imagem , Ventrículos do Coração/patologia , Humanos , Pessoa de Meia-Idade , Pneumonia Viral/complicações , Pneumonia Viral/diagnóstico , Pneumonia Viral/fisiopatologia , Embolia Pulmonar/diagnóstico , Embolia Pulmonar/etiologia , Infarto do Miocárdio com Supradesnível do Segmento ST/diagnóstico , Infarto do Miocárdio com Supradesnível do Segmento ST/fisiopatologia , Infarto do Miocárdio com Supradesnível do Segmento ST/terapia , Trombose/diagnóstico , Trombose/tratamento farmacológico , Trombose/etiologia , Tomografia Computadorizada por Raios X/métodos , Disfunção Ventricular Esquerda/diagnóstico , Disfunção Ventricular Esquerda/etiologia
19.
Artigo em Inglês | MEDLINE | ID: mdl-32520449

RESUMO

Left ventricular aneurysm is a late mechanical complication of untreated acute myocardial infarction. It has become relatively rare since the development of percutaneous cardiac intervention.  Most aneurysms are located at the anterior ventricular wall, and are caused by total occlusion of the left anterior descending artery. Usually, the anterior and apical walls initially become akinetic; this can sometimes evolve into dyskinesia. Thrombus formation is a common finding, since the apical contractility is impaired. This tutorial illustrates the challenging technical aspects of a large thrombus removal, along with the geometric reconstruction of the left ventricular aneurysm and coronary bypass surgery.


Assuntos
Ponte de Artéria Coronária , Aneurisma Cardíaco/cirurgia , Ventrículos do Coração/cirurgia , Idoso , Humanos , Masculino , Veia Safena/transplante
SELEÇÃO DE REFERÊNCIAS
DETALHE DA PESQUISA
...