RESUMEN

BACKGROUND: Elevated susceptibility to acute myocardial infarction and various cardiovascular diseases has been observed in individuals infected with the human immunodeficiency virus compared with the uninfected population, as demonstrated in numerous studies. The precise mechanism by which human immunodeficiency virus infection heightens the risk of acute myocardial infarction remains elusive. The manifestation of acute coronary syndrome in young patients with human immunodeficiency virus may deviate from the typical, displaying distinct pathophysiological and clinical characteristics. The occurrence of myocardial infarction with non-obstructive coronary arteries in young patients with human immunodeficiency virus poses diagnostic and treatment challenges. CASE PRESENTATION: We present the case of a 46-year-old African woman with no traditional atherosclerotic risk factors. She was diagnosed with human immunodeficiency virus-1 infection 2 years prior to her current admission for chest pain. Her troponin levels were elevated, suggestive of acute coronary syndrome. Although coronary angiography ruled out coronary artery stenosis, it revealed mild myocardial bridging in the left anterior descending artery. Cardiac magnetic resonance imaging confirmed myocardial infarction, indicating a myocardial infarction with non-obstructive coronary arteries with an apical thrombus in the left ventricle. Following medical treatment, the patient experienced resolution of chest pain and improvement in ST-segment elevation. CONCLUSIONS: In young female patients without traditional risk factors, human immunodeficiency virus infection is a possible etiological factor for myocardial infarction with non-obstructive coronary arteries. The likely pathophysiological pathway is superficial endothelial cell denudation as a result of chronic inflammation and immune activation.

Asunto(s)

Angiografía Coronaria , Infecciones por VIH , Infarto del Miocardio , Humanos , Femenino , Persona de Mediana Edad , Infecciones por VIH/complicaciones , Vasos Coronarios/diagnóstico por imagen , Vasos Coronarios/fisiopatología , Dolor en el Pecho/etiología , Electrocardiografía , Imagen por Resonancia Magnética

RESUMEN

Mitral valve aneurysm (MVA) is characterized by a saccular outpouching of the mitral leaflet, and it represents a rare condition typically associated with aortic valve endocarditis. Three-Dimensional Transesophageal Echocardiography (3D-TEE) serves as an effective tool for detecting the presence of MVA and its potential complications. In this report, we present a case involving a young man with striking images of bicuspid aortic valve endocarditis complicated by an aortic root abscess and multiple perforated mitral valve aneurysms, diagnosed using 3D TEE. This case suggests the uncommon coexistence of Marfan like morphotype, bicuspid aortic valve, and infective endocarditis as a triple mechanism in the occurrence of MVA. It underscores the significance of early and accurate imaging diagnosis for facilitating prompt surgical intervention.

Asunto(s)

Enfermedad de la Válvula Aórtica Bicúspide , Ecocardiografía Tridimensional , Endocarditis Bacteriana , Endocarditis , Aneurisma Cardíaco , Síndrome de Marfan , Humanos , Masculino , Absceso/diagnóstico por imagen , Absceso/etiología , Aorta Torácica , Válvula Aórtica/diagnóstico por imagen , Válvula Aórtica/cirugía , Enfermedad de la Válvula Aórtica Bicúspide/complicaciones , Ecocardiografía Transesofágica/métodos , Endocarditis/complicaciones , Endocarditis/diagnóstico por imagen , Endocarditis Bacteriana/complicaciones , Endocarditis Bacteriana/diagnóstico por imagen , Endocarditis Bacteriana/cirugía , Aneurisma Cardíaco/etiología , Aneurisma Cardíaco/complicaciones , Síndrome de Marfan/complicaciones , Síndrome de Marfan/diagnóstico , Válvula Mitral/diagnóstico por imagen , Válvula Mitral/cirugía

RESUMEN

Coronary artery fistulas (CAFs) represent rare congenital anomalies that exhibit a wide range of clinical implications and a heightened risk of complications. It is imperative to accurately identify and delineate these fistulas to avoid missed diagnoses and to recommend suitable therapeutic measures. We present the case of a 46-year-old obese woman who was hospitalized for chest pain associated with palpitations. Clinical examination and ECG results were within normal limits. A 24-hour ECG holter revealed paroxysmal atrial fibrillation. Transthoracic echocardiography revealed a systolodiastolic aliasing originating from the aorta and coursing along the right atrium. Transesophageal echocardiography and coronary angiography confirmed this finding. The diagnosis of a voluminous and tortuous coronary-cameral fistula was established through coronary CT angiography with 3D reconstruction images. A positive stress test indicated the need for surgical closure, given the size and aneurysmal nature of the fistula. However, the patient unfortunately passed away two days after the surgery. This case highlights the critical need for precise identification and management of CAFs. The patient's unfortunate post-surgical outcome underscores the complexity and risks associated with these anomalies, emphasizing the ongoing need for improved treatment strategies and research in this area.

RESUMEN

Paradoxical embolism in coronary artery is a rarely diagnosed clinical entity. In the majority of reported cases; the diagnostic of this pathology is « presumptive ¼ based on certain criteria. It can be considered "proven" when the embolus is found lodged in the abnormal communication between the venous and arterial circulation; which is very rare. We herein report a case of myocardial infarction caused by a proven paradoxical coronary embolism through a patent foramen ovale. The authors highlight through this paper the contribution of echocardiography and particularly trans-esophageal echocardiography, especially if performed soon after presentation, for early diagnosis.

RESUMEN

Left atrial appendage (LAA) aneurysm is an extremely rare anomaly. So far, less than one hundred cases only have been reported worldwide. Revelation modes are dominated by complications such as arrhythmias and thromboembolic events. We herein report a pediatric case of huge congenital LAA aneurysm with an original revelation mode that has never been described before in medical literature.