RESUMEN
INTRODUCTION: Neoplasms of the heart are extremely rare and difficult to diagnose. In this study, we intend to describe the experience at the Cardiovascular Center of Puerto Rico and the Caribbean (CCPRC) dealing with benign cardiac neoplasms. METHODS: A retrospective review of the archival material at our institution was conducted using the 2007 ICD-9-CM code 212.7. A total of 77 cases with a diagnosis of Benign Heart Neoplasm were found from 1992 to 2008 but only those with an official pathologic report (n = 43) were considered. The clinical charts provided data related to age, sex, presenting symptoms, non-invasive and invasive characteristics, surgical procedures, and pathological findings. Data was compared using paired and unpaired Student's t-test, x2, and Fisher's Exact Test when appropriate. For interpretation of results, a p-value < 0.05 was considered significant. RESULTS: The mean age for diagnosis was 51.49 years. The most common presenting symptom by which these patients sought medical attention was congestive heart failure (35%), followed by chest pain (18%) and neurologic symptoms (14%). The most common location of the mass was the left atrium (81%) and overall, the most common heart neoplasm in this study was myxoma (83.7%). The rate of surgical complications was 30% (n = 13), with the cross clamp time and bypass time found to be the only factors influencing length of stay. Mortality rate was 7% (n = 3). CONCLUSIONS: This study of a total of 43 pathologically confirmed benign cardiac neoplasms admitted to the Cardiovascular Center of Puerto Rico and the Caribbean from 1992 to 2008 validates the fact that heart neoplasms represent a fairly rare diagnosis. It is also consistent with previously published series that establish myxoma as the most common of these benign neoplasms. The main clinical findings as well as the results of surgery were presented.
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Neoplasias Cardíacas/diagnóstico , Femenino , Humanos , Masculino , Persona de Mediana Edad , Estudios RetrospectivosRESUMEN
Non-compaction of the left ventricle is an extremely rare cardiomyopathy resulting from a defective morphogenesis of the endomyocardium. It results in an architecturally aberrant ventricular wall consisting of two layers: a compacted layer and a loose interwoven meshwork with prominent trabeculae and deep intertrabecular recesses that communicate with the left ventricular cavity. This report describes the case of a 25-year-old man with dilated cardiomyopathy, due to non-compaction of the left ventricle, presenting with a transient ischemic attack.
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Cardiomiopatías/patología , Ventrículos Cardíacos/patología , Adulto , Resultado Fatal , Humanos , MasculinoRESUMEN
Over the past two decades, the use of percutaneous coronary intervention (PCI) to treat ischemic coronary artery disease (CAD) has expanded dramatically. With new technological improvements (e.g., drug eluting stents, distal protection devices), refinements in periprocedural adjunctive pharmacology (e.g., glycoprotein IIb/IIIa [GP IIb/IIIa] inhibitors, alternative thrombin inhibitors), and better understanding of early and late outcomes, the procedural success, safety, and durability of results have improved dramatically. Increase in mortality associated with drug eluting stents has been a concern lately. Until newer randomized studies are available to fully evaluate this increase in mortality, physicians should abide by the Food and Drug Administration's guidelines for use of these stents.
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Angioplastia Coronaria con Balón , Angioplastia Coronaria con Balón/instrumentación , Angioplastia Coronaria con Balón/métodos , Diseño de Equipo , Humanos , StentsRESUMEN
The management of an ST elevation myocardial infarction has undergone significant changes in the past few years. Fibrinolytic agents have become more and more clot specific increasing their efficacy. However, percutaneous coronary intervention, along with its adjuvant therapy (glycoprotein IIB/IIIA receptor inhibitors and clopidrogel), have come to challenge fibrinolytic use. Many studies have demonstrated the benefits of percutaneous coronary intervention as compared to fibrinolysis in the management of acute myocardial infarction by decreasing infarct size, myocardial function loss, and mortality.