Case report. Рубрика в журнале - Cardiometry
Acute myocardial infarction following COVID-19 vaccination: a cause or a coincidence?
Статья научная
Background. Acute Myocardial Infarction (AMI) is a fatal condition with a subsequent variety of complications. Recently, COVID-19 vaccine has become an essential precaution to avoid infection. However, it is uncommon for AMI to manifest as a result of the COVID-19 vaccination. Methods. Thirty-two years old man, previously healthy, come to the emergency department with a four-hour history of chest discomfort after Covishield (AstraZeneca) vaccination. He was neither hypertensive, diabetic, or smoker and lacked any other typical risk factors for cardiovascular disease. Results. This case describes an adverse response to the COVID-19 vaccination that has the potential to be life-threatening. He had received his first dose of the Covishield vaccination five days prior. Extensive anterior STEMI was diagnosed post-cardiac arrest. He had primary percutaneous coronary intervention (PCI) to recanalize an occluded proximal LAD. Conclusions. Additional screenings for young individuals should be considered before administering the COVID-19 (AstraZeneca) vaccine as a preventive step if reports of significant adverse events in older adults continue.
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Aneurysm left atrial appendage
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Aneurysms of the atrial appendages are rare and extremely rare clinical entities. It can be confused with pericardial cyst, coronary artery aneurysm, left ventricular pseudo-aneurysm and partial or complete congenital absence of the pericardium. Usually clinically asymptomatic, diagnosed as incidental finding by the presence of heart murmur or cardiomegaly on chest radiograph, it can also manifest in the presence of supraventricular arrhythmias or systemic embolism. The treatment of this pathology makes aneurysmectomy. For 3-year preschool heart murmur and echocardiographic finding of insufficiency Mitral and aneurysmal dilation of the left atrial appendage it is presented.
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Arrhythmogenic right ventricular dysplasia is a rare entity and a significant cause of sudden death especially in the Italian population and athletes. The familial form is uncommon especially in the Afro-Caribbean population. This Index family represents an Autosomal Dominant form in a maternal parent who had sudden death at 39 years of age. The Index case was diagnosed at 18 years with increasing palpitations since 8 years of age, becoming symptomatic two decades younger than her mother. This was confirmed using the Treadmill Stress test. This is the 1st Case of Familial Arrhythmogenic right ventricular dysplasia documented in an Afro-Caribbean family. Learning objective Familial Arrhythmogenic right ventricular dysplasia is a rare entity and a significant cause of sudden death especially in the Italian population and athletes. This the first case of Autosomal Dominant type of ARVD with variable penetrance, documented in an Afro-Caribbean family where diagnosis was aided by Ventricular Tachycardia occurring during a Treadmill Stress Test.
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Статья научная
This article discusses the features of the use of regional anesthesia in the surgical correction of traumatic defects of the skull bones and reconstructive plastic surgery. Regional anesthesia is a safe and effective method of anesthesia, which reduces the risk of complications and speeds up the recovery process after surgery. The authors describe in detail various types of regional anesthesia, such as facial nerve blockade, blockage of the frontal branch of the trigeminal nerve, etc. The paper also discusses indications and contraindications to the use of regional anesthesia, as well as possible complications. In conclusion, it is noted that regional anesthesia is an important element in surgical practice during operations for the operative correction of traumatic defects of the skull bones and reconstructive plastic surgery. Keywords Regional anesthesia, Surgical correction, Traumatic defects of the skull bones, Reconstructive plastic surgery.
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Paroxysmal atrial fibrillation in 5 months old Afro-Caribbean
Отчет
Congenital paroxysmal Atrial Fibrillation in infants is a rare occurrence requiring a high index of suspicion. The majority have a Pre-excitation syndrome which may be concealed. It may be associated with specific structural congenital cardiac lesions. This Index case had only paroxysmal atrial tachyarrhythmia with no predisposing condition that subsided spontaneously and is the first case documented in an Afro-Caribbean infant.
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Hemobilia is a rare cause of upper gastrointestinal hemorrhage. Classical presentations of hemobilia are biliary colic, jaundice, hematochezia and melena. Persistent bleeding sometimes requires urgent therapeutic intervention, such as angiographic intervention or surgery. It may be secondary to trauma, inflammatory disorders, gallstones or tumors. Hepatic artery aneurysm rupture is a rare cause of gastrointestinal bleeding. Mycotic hepatic artery aneurysm is not a common vascular lesion, but it is considered to be a late complication of bacterial endocarditis. We present a 43 years old man with history of bacterial endocarditis that led to aortic valve replacement (AVR) and mitral valve replacement (MVR) about 9 months ago, with present complaint of rectal bleeding and dizziness. Angiographic studies suggested ruptured mycotic aneurysm in right hepatic artery, which was successfully treated with coil embolization.
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The course of very severe aortic stenosis due to bicuspid aortic valve calcinosis in a young man
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In the young patients with bicuspid aortic valve, manifestation of aortic stenosis (AS) often remains silent. Asymptomatic very severe AS makes medical decisions challenging. For the better evaluation of AS severity and estimation the indications for the surgical treatment any stress test is preferable. We report a case history of a 46 year old male patient with successfully treated critical AS with severe heart failure (HF) that demonstrates effectiveness of the surgical treatment. Successful aortic valve replacement (AVR) was beneficial and guided to increase functional class, improve LV systolic function, normalization of the heart chambers, decreased pulmonary hypertension (PH), determined reversible left ventricle (LV) hypertrophy. Summarizing our experience, we hypothesize that surgical treatment of this patient with asymptomatic very severe AS would be helpful in increasing quality of life and avoiding manifestation of AS with critical severe HF.
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There are various indications for a mechanical circulatory support (MCS) devices implantation. We report a case of the use of the MCS in a 39 year old male with acute circulatory collapse and at immediate risk of death after endomyocardial biopsy in order to keep the patient alive until intrinsic cardiac function recovers sufficiently to remove the MCS. The patient underwent an implantation of the left ventricular assist device according to progressive decline of the cardiac function due to a heart muscle disease. With successful regression of heart failure symptoms and reverse remodeling of LV, the device was explanted after four month. Evidence of myocardial reverse remodeling and functional improvement during MCS in our patient proved the use of mechanical ventricular unloading as a therapeutic strategy aimed at cardiac recovery, allowing removal of the MCS device instead of extending his use as a bridge to heart transplantation.
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