Infectious pseudo-aneurysm of the left ventricle: a case report and a review of the literature.

BACKGROUND: In the workup of a pediatric patient with pericarditis we found evidence of a pseudo-aneurysm of the left ventricle, which is a rare complication of purulent pericarditis. CASE PRESENTATION: We present a case of a six-year-old girl who was diagnosed with pericarditis and a fistula between the pericardial and the intra-luminal space of the left ventricle of the heart. She was successfully treated with antibiotics and cardio-thoracic surgery. We found 23 published cases (21 with follow-up) of infectious pseudo-aneurysm of the heart, of which 19 underwent surgery, 5 had fatal outcome, and 2 who refused surgery survived. The majority of cases were associated with Staphylococcus aureus. The exact mechanisms of this rare complication remain unknown. CONCLUSIONS: A pseudo-aneurysm of the left ventricle is a rare and not well understood complication of a purulent pericarditis most commonly caused by Staphylococcus aureus infection. Because of risk of rupture, surgical intervention is advised.

Association between gut microbiota and malignant cardiac tumors: A two-sample Mendelian randomization study.

BACKGROUND: Recent studies provide compelling evidence linking the gut microbiota to most cancers. Nevertheless, further research is required to establish a definitive causal relationship between the gut microbiota and malignant cardiac tumors. METHODS: The genome-wide association studies (GWAS) data on the human gut Microbiota, included in the IEU Open GWAS project, was initially collected by the MiBioGen consortium. It encompasses 14,306 individuals and comprises a total of 5,665,279 SNPs. Similarly, the GWAS data on malignant cardiac tumors, also sourced from the IEU Open GWAS project, was initially stored in the finnGen database, including 16,380,303 SNPs observed within a cohort of 174,108 individuals within the European population. Utilizing a two-sample Mendelian randomization (MR) methodology, we examined whether there exists a causal association between the gut microbiota and cardiac tumors. Additionally, to bolster the credibility and robustness of the identified causal relationships, we conducted an extensive array of sensitivity analyses, encompassing Cochran's Q test, MR-PRESSO tests, MR-Egger interpret test, directionality test and leave-one-out analysis. RESULTS: Our analysis unveiled seven distinct causal associations between genetic susceptibility in the gut microbiota and the incidence of malignant cardiac tumors. Among these, the Family Rikenellaceae, genus Eubacterium brachy group, and genus Ruminococcaceae UCG009 exhibited an elevated risk of cardiac tumors, while the phylum Verrucomicrobia, genus Lactobacillus, genus Ruminiclostridium5, and an unknown genus id.1868 were genetically linked to a reduced risk of cardiac tumors. The causal relationship between these two bacteria, belonging to the phylum Verrucomicrobia (OR = 0.178, 95% CI: 0.052-0.614, p = 0.006) and the genus Ruminococcaceae UCG009 (OR = 3.071, 95% CI: 1.236-7.627, p = 0.016), and cardiac tumors was further validated through sensitivity analyses, reinforcing the robustness and reliability of the observed associations. CONCLUSION: Our MR analysis confirms that the phylum Verrucomicrobia displays significant protection against cardiac tumor, and the genus Ruminococcaceae UCG009 leads to an increasing risk of cardiac tumor.

Infected cardiac myxoma.

A 66-year-old male presenting with low-grade fever and general fatigue was diagnosed as having infected myxoma of the left atrium. Blood cultures grew Streptococcus mitis. He underwent urgent resection and histological examination revealed tumor cells in a mucopolysaccharide matrix and bacterial colonies along with active inflammation. Infected cardiac myxoma is extremely rare; however, it contains a potential risk of arterial embolization and so early diagnosis and urgent surgery should be considered.

Fever of unknown origin: a case of cardiac myxoma infected with Staphylococcus lugdunensis.

Infected cardiac myxoma is a rare entity. It poses a diagnostic challenge as clinical presentation may reflect an underlying infectious, immune, or a neoplastic disease process. To the best of our knowledge, the first case of a cardiac myxoma infected with Staphylococcus lugdunensis is reported in a 54-year-old man with fever of unknown origin for 4 months. Successful excision of the tumor was performed and was followed by an uneventful recovery. Clinical presentation, diagnosis, and management of infected cardiac myxomas are discussed.

Rare pediatric cardiac tumor presentation.

A case of cardiac inflammatory pseudotumor with a unique presentation is reported. This especially rare case belongs to a subset of pseudotumor caused by an infectious etiology. Furthermore, it is unique in that the patient experienced unexplained sinus tachycardia, which resolved with resection of the tumor. This report also emphasizes the importance of multiple imaging methods combined with the usefulness of surgery for treatment and diagnosis.

A Case of Infected Left Atrial Myxoma Presenting as ST-Elevation Myocardial Infarction (STEMI).

BACKGROUND Although left atrial myxoma is the most common benign primary cardiac tumor, infected atrial myxoma is rare. This report presents a case of infected left atrial myxoma with embolization to the left anterior descending (LAD) coronary artery, which was identified following an initial presentation with ST-elevation myocardial infarction (STEMI). CASE REPORT A 34-year-old man with a history of smoking tobacco and intravenous cocaine use presented to the emergency room with symptoms of a feeling of pressure on the chest and symptoms in the left arm. An electrocardiogram (ECG) showed ST elevation in leads II, III, aVF, and V3-V5, consistent with an anterior-inferior STEMI. He underwent percutaneous intervention (PCI) with two drug-eluting stents to the mid-distal LAD coronary artery. The patient also had fever, chills, a history of weight loss, and signs of peripheral emboli. Blood cultures identified Gram-positive Streptococcus parasanguinis, a member of the Streptococcus viridans group. Transesophageal echocardiogram (TEE) identified a large, mobile, pedunculated left atrial mass protruding into the mitral valve in diastole and mitral valve vegetations. Surgical excision and the histology confirmed a diagnosis of benign left atrial myxoma containing Gram-positive cocci. The patient required mitral valve replacement and a postoperative two-week course of gentamicin and a six-week course of ceftriaxone CONCLUSIONS A rare case is reported of infected left atrial myxoma presenting as STEMI secondary to coronary artery embolization, which was treated with PCI, antibiotics, and mitral valve replacement.

Ruptured abdominal aortic aneurysm after resection of an infected cardiac myxoma.

A 12-year-old girl with a high fever underwent echocardiography and was found to have a myxoma that arose from the atrial side of the anterior mitral valve leaflet. The tumor was successfully excised. Histologic examination of the tumor showed myxoma cells and an organized thrombus with bacterial colonization. The patient was discharged from the hospital on antibiotic treatment. After remaining asymptomatic for 3 weeks, she was readmitted with acute abdomen. Ultrasonography and magnetic resonance angiography detected intra-abdominal hemorrhaging and a saccular aneurysm of the abdominal aorta. The patient underwent successful emergency surgery. To our knowledge, no other report has been published concerning an abdominal aortic aneurysm secondary to bacterial infection of a cardiac myxoma. Although complications this severe are rarely observed in patients who have endocarditis, early recognition and treatment can be life-saving.

Adult T-cell leukemia/lymphoma revealed by a surgically cured cardiac valve lymphomatous involvement in an Iranian woman: clinical, immunopathological and viromolecular studies.

A 60-year-old woman from the town of Mashhad in northeastern Iran developed cardiac failure due to aortic and mitral regurgitations which needed cardiac valve replacement. Histopathological study of the valves revealed a T-cell non-Hodgkin's lymphoma. Blood examination showed leukemic features with 32% of abnormal white blood cells. Human T-cell leukemia/lymphoma virus type I (HTLV-I) antibodies were present in the serum and the specific env HTLV-I sequences were detected in the DNA extracted from the valves and peripheral blood mononuclear cells (PBMC) using polymerase chain reaction technique. Clonal integration of two HTLV-I copies was found in both the valves and PBMC DNA, thus the diagnosis of adult T-cell leukemia/lymphoma (ATL) was established. In contrast to the acute life-threatening cardiac localization, our case met the diagnostic criteria of chronic ATL, this was confirmed by favorable evolution without chemotherapy during the 24 months after diagnosis. According to our knowledge, this is the first report of an isolated lymphomatous cardiac valve involvement, without other cardiac abnormalities. It seems important to underline that the patient originated from Iran where endemicity of HTLV-I has only recently been discovered.

Oncogenes and avian development.

In order to detect signs of oncogene activity and elucidate their possible role in avian ontogeny we implemented two different strategies. One was to detect either the protein product or messenger RNA in situ at various stages of development. The other was to try and disturb development with retroviruses carrying one or several oncogenes in their activated forms. Time- and tissue-specific expression of c-myc was apparently not related to particular phases of cell evolution, such as population amplification. Rather the presence of c-myc immunoreactive product at particular stages appeared to depend on cell types. c-myb and c-ets messenger RNAs were found expressed preferentially in the blood system, respectively in hemopoietic and differentiating endothelial cells. The developing embryo heart was found to be uniquely sensitive to the effect of retroviruses provided that two conditions were respected. The first was the injection of the virus or construct prior to E3.5. The second was the presence of the v-myc gene, whether alone or associated with one or several other v-onc. In such cases a large proportion (70%) of chick and all quail embryos developed multiple heart rhabdomyosarcomas within 10 days. In chickens the association of a second v-onc or of two others induced the formation of secondary tumors, whose type was determined by the nature of the other oncogene(s).(ABSTRACT TRUNCATED AT 250 WORDS)

Infected cardiac myxoma.

Infected cardiac myxoma is a rare condition with variable presentation. We report a case of infected cardiac myxoma which presented as fever of unknown origin. Diagnostic considerations and treatment of this condition are discussed.

Infected biatrial myxoma: transesophageal echocardiography-guided surgical resection.

We identified a biatrial myxoma using transesophageal echocardiography whose right atrial component was missed with conventional transthoracic techniques. Identifying the biatrial component directs a safer approach to right heart catheterization. Infected biatrial myxomas are both rare and successfully managed using prolonged intravenous antibiotic therapy followed by resection. Atrial septal defects created during the resection of an infected myxoma may be safely repaired using a prosthetic patch.

Infected left atrial myxoma with concomitant mitral valve endocarditis.

Myxomas are the most common primary cardiac tumors. They may simulate infective endocarditis but are rarely infected. Currently, 17 infected left atrial myxomas have been reported in the literature [1, 7, 8, 10, 11]. We present a patient with infected left atrial myxoma combined with mitral valve endocarditis, treated by excision of the myxoma and mitral valve reconstruction.

Infected cardiac myxoma: an unusual phenomenon.

Infected cardiac myxoma is a rare phenomenon. Cardiac myxomas are primary tumors of the heart, usually benign and account for about 50% of the benign cardiac tumors. Patients usually present with a triad of constitutional, embolic, and obstructive symptoms. There are few reported cases of infected cardiac myxoma and there is no widely used definition. This is a case presentation describing a patient who was admitted to our institution, underwent surgical excision, and was subsequently discharged home.

Two sporadic infected cardiac myxomas in 1 patient.

Infected cardiac myxoma is a rare cause of endocarditis. The finding of coexisting infected cardiac myxomas is highly unusual. Herein, we present the case of a 58-year-old woman with a low-grade fever. Laboratory findings strongly indicated inflammation, and blood cultures detected Staphylococcus species. Echocardiograms revealed mobile masses in the area of the mitral valve. Transesophageal echocardiograms showed 2 formations that arose from opposite sides of the mitral annulus and protruded into the left ventricle during systole. During emergency surgery, 2 abnormal growths with numerous vegetations were completely excised. The diagnosis of myxoma was confirmed upon histologic evaluation. Microbiological and polymerase chain reaction analysis of the myxomas detected the bacterial strain Enterococcus faecalis. Five months postoperatively, the patient showed no signs of recurrent infection and had a normal echocardiographic appearance.This report is the first of an infected cardiac myxoma in the Czech population and one of approximately 60 reports in the medical literature from 1956 to the present. In addition to the case of our patient, we discuss the discrepancy between the bacteriologic findings.