Large ventricular myxoma causing inflow and outflow obstruction of the right ventricle; A Case Report.

BACKGROUND: Myxomas are the most common primary benign heart tumors, typically found in the left atrium, with only 2-4% occurring in the right ventricle. Clinical presentations vary widely, including congestive heart failure and systemic embolic phenomena. This case report describes a rare right ventricular myxoma causing both inflow and outflow obstruction, presenting as progressive exertional dyspnea. CASE PRESENTATION: A 23-year-old male presented with two weeks of worsening exertional dyspnea. He was stable but tachypneic with a systolic murmur over the tricuspid area. Elevated erythrocyte sedimentation rate (ESR) and C-Reactive protein (CRP) were noted, while other lab tests were normal. Imaging, including echocardiography and chest tomography scan (CT) revealed a 4 × 3.8 × 4.6 cm mass in the right ventricle extending to the pulmonary trunk. Surgical resection via right ventriculotomy was performed, and histopathology confirmed myxoma. The patient recovered uneventfully. CONCLUSION: Right ventricular myxomas, though rare, can cause significant obstruction and present with diverse symptoms. Timely diagnosis using imaging techniques like echocardiography is crucial. Surgical resection remains the definitive treatment, offering excellent outcomes and low recurrence rates. Early intervention is vital to prevent serious complications and ensure favorable patient prognosis.

Metabolic syndrome and related risk factors among adults in the northern West Bank, a cross-sectional study.

BACKGROUND: Metabolic syndrome (MetS) is a cluster of cardiometabolic risk factors that includes central obesity, insulin resistance, dyslipidaemia and hypertension. The aim of this study was to establish the prevalence of MetS and its associated risk factors among adult Palestinians using the International Diabetes Federation definition. METHODS: A total of 1348 subjects ages 18-65 y were recruited in a cross-sectional study that was conducted in 2018-2019 in the northern West Bank. RESULTS: A total of 1082 subjects participated; 51.7% were men. The prevalence of MetS was high (44.9%), and higher among women (46.1%) than men (44.2%) (p<0.001). The prevalence increased significantly with increasing age and body mass index (BMI) in both genders (p<0.001). However, metabolically obese but normal weight individuals (MONW) (8.4%) were also identified, with a slight increase among women (9.4%) compared with men (7.5%) (p=0.56). MetS was more likely to be prevalent among participants with increased fasting blood sugar (5.8 times), increased triglyceride (7.4 times), increased blood pressure (4.5 times) and BMI ≥25 (19.9 times) (p<0.001). The prevalence of MetS was higher among rural (50.3%) vs urban (39.3%) residents and refugees (33.8%). CONCLUSIONS: With increasing age and obesity, clustering of MetS components increased remarkably in both genders. Effective prevention and treatment strategies for MetS and its risk factors should be developed targeting different ages and genders.