RESUMEN
Coronary artery fistula (CAF) is a rare disease. In more than 90 percent of cases, a single fistula drains into the right heart chambers or into the pulmonary artery. Fistulae draining into the left ventricle are uncommon; further, multiple CAF involving the three major coronary artery vessels are very rare. This report will describe two rare cases of CAF, one of multiple CAF, and the other of single CAF, all of which drained into the left ventricular chamber.
Asunto(s)
Enfermedad de la Arteria Coronaria/diagnóstico , Fístula Vascular/diagnóstico , Antagonistas Adrenérgicos beta/uso terapéutico , Anciano , Inhibidores de la Enzima Convertidora de Angiotensina/uso terapéutico , Enfermedad de la Arteria Coronaria/tratamiento farmacológico , Vasos Coronarios/diagnóstico por imagen , Electrocardiografía/métodos , Femenino , Ventrículos Cardíacos/diagnóstico por imagen , Humanos , Persona de Mediana Edad , Radiografía , Cintigrafía , Ultrasonografía , Fístula Vascular/tratamiento farmacológicoRESUMEN
The standard initial noninvasive imaging modality for diagnosing May-Thurner syndrome is duplex ultrasound, but this modality provides only indirect measures and is frequently limited, necessitating further imaging to make the diagnosis. Other noninvasive imaging modalities (computed tomographic venography, time of flight, magnetic resonance venography) allow for direct visualization but lack hemodynamic and anatomic information about what is occurring throughout the cardiac cycle. Intravascular ultrasound is the invasive tool of choice in the setting of iliac vein compression syndrome, but quality, noninvasive imaging modalities have yet to be described. Contrast-enhanced, dynamic magnetic resonance venography allows for detailed imaging of the pelvis as well as dynamic vascular imaging, improving preoperative planning.
Asunto(s)
Quiste Mediastínico/complicaciones , Neumonía/etiología , Anciano , Biopsia , Ecocardiografía , Femenino , Humanos , Imagen por Resonancia Magnética , Quiste Mediastínico/diagnóstico , Quiste Mediastínico/cirugía , Neumonía/diagnóstico , Valor Predictivo de las Pruebas , Cirugía Torácica Asistida por Video , Tomografía Computarizada por Rayos XAsunto(s)
Angiografía por Resonancia Magnética , Síndrome de Cimitarra/diagnóstico , Medios de Contraste , Femenino , Humanos , Procesamiento de Imagen Asistido por Computador , Imagenología Tridimensional , Persona de Mediana Edad , Valor Predictivo de las Pruebas , Síndrome de Cimitarra/patología , Síndrome de Cimitarra/fisiopatologíaAsunto(s)
Cardiopatía Carcinoide/complicaciones , Insuficiencia de la Válvula Tricúspide/etiología , Anciano , Cardiopatía Carcinoide/diagnóstico por imagen , Ecocardiografía , Humanos , Masculino , Insuficiencia de la Válvula Mitral/diagnóstico por imagen , Insuficiencia de la Válvula Mitral/etiología , Insuficiencia de la Válvula Pulmonar/diagnóstico por imagen , Insuficiencia de la Válvula Pulmonar/etiología , Insuficiencia de la Válvula Tricúspide/diagnóstico por imagenRESUMEN
Polymorphic ventricular tachycardia (PVT) is a life-threatening arrhythmia that is typically related to long QT syndrome, organic heart disease, electrolyte abnormalities, cardiotoxic drugs, or adrenergic stimulation. A review of the literature reveals that PVT with normal QT interval and without underlying cause is quite rare. We report a case of idiopathic spontaneous PVT with structurally normal heart and without electrolyte abnormalities, drug reactions, or evidence of catecholamine induced arrhythmia. We also review the literature on the electrocardiographic characteristics and management of idiopathic PVT.
Asunto(s)
Taquicardia Ventricular/diagnóstico , Taquicardia Ventricular/fisiopatología , Antiarrítmicos/uso terapéutico , Terapia Combinada , Desfibriladores Implantables , Diagnóstico Diferencial , Ecocardiografía , Electrocardiografía , Femenino , Humanos , Metoprolol/uso terapéutico , Persona de Mediana Edad , Taquicardia Ventricular/terapia , Incontinencia UrinariaRESUMEN
Diaphragmatic weakness in Charcot-Marie-Tooth (CMT) disease may be more common than generally acknowledged. Recognizing diaphragmatic weakness in a patient with CMT is important since recognition of this process may help explain the symptoms of breathlessness and orthopnea, as well as the development of hypercarbia. Although most patients with CMT have a normal lifespan, the subset of patients with diaphragmatic weakness may be at a higher risk of pulmonary morbidity and early mortality. Elevation of one or both hemidiaphragms on chest roentgenogram should raise the suspicion of diaphragmatic dysfunction and prompt further investigation.