RESUMEN
Aortic coarctation is a congenital heart disease that usually presents and is treated in the childhood. The aortic coarctation is often associated with concomitant cardiac pathologies, such as aortic stenosis and bicuspid aortic valve. We report the case of a 56-year-old man, admitted in our cardiologic unit, for sudden onset of chest pain, dyspnea and syncope. Aortic coarctation with aortic valve stenosis was diagnosed. The aortic valve was successfully replaced in the first stage; the coarctation had to be treated in a second time.
Asunto(s)
Coartación Aórtica/diagnóstico , Estenosis de la Válvula Aórtica/diagnóstico , Dolor en el Pecho/etiología , Estenosis de la Válvula Aórtica/cirugía , Disnea/etiología , Humanos , Masculino , Persona de Mediana Edad , Índice de Severidad de la Enfermedad , Síncope/etiologíaRESUMEN
In children, coronavirus disease 2019 infection is rarely symptomatic. Severe forms with respiratory distress are rare, thromboembolic complications are exceptional. We report a rare case of a 14 years old girl with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection who was admitted to the hospital for bilateral pulmonary embolism with intracardiac thrombus. The girl progressed well on anticoagulation.
Asunto(s)
COVID-19/complicaciones , Embolia Pulmonar/virología , Trombosis/virología , Enfermedad Aguda , Adolescente , Anticoagulantes/administración & dosificación , Femenino , Cardiopatías/tratamiento farmacológico , Cardiopatías/etiología , Humanos , Embolia Pulmonar/tratamiento farmacológico , Trombosis/tratamiento farmacológicoRESUMEN
Coronavirus is a source of deep venous thrombosis (DVT) due to complications such as over-coagulation, blood stasis, and endothelial damage. Ovarian vein thrombosis (OVT) is a very serious and rare disease. In this study, we report tow rare case of women with coronavirus who were hospitalized with a right ovarian vein thrombosis mimicking acute abdomen who progressed well on anticoagulation. Our report adds further document in Side effects and rare localisation of obstruction of veins and arteries in patient with corona virus.
Asunto(s)
Abdomen Agudo , COVID-19/complicaciones , Enoxaparina/administración & dosificación , Ovario/irrigación sanguínea , Trastornos Puerperales , Trombosis de la Vena , Abdomen Agudo/diagnóstico , Abdomen Agudo/etiología , Adulto , Anticoagulantes/administración & dosificación , COVID-19/sangre , COVID-19/diagnóstico , COVID-19/fisiopatología , COVID-19/terapia , Diagnóstico Diferencial , Femenino , Productos de Degradación de Fibrina-Fibrinógeno/análisis , Humanos , Masculino , Persona de Mediana Edad , Trastornos Puerperales/sangre , Trastornos Puerperales/etiología , Trastornos Puerperales/fisiopatología , Trastornos Puerperales/terapia , SARS-CoV-2/aislamiento & purificación , Tomografía Computarizada por Rayos X/métodos , Resultado del Tratamiento , Venas/diagnóstico por imagen , Venas/patología , Trombosis de la Vena/sangre , Trombosis de la Vena/etiología , Trombosis de la Vena/fisiopatología , Trombosis de la Vena/terapia , Síndrome Post Agudo de COVID-19RESUMEN
In this paper, we report two cases of induced thrombocytopenia after the infusion of glycoprotein (GP) IIb/IIIa receptors antagonists, following a coronary angioplasty. The first patient is a 65-year-old woman, admitted with acute coronary syndrome requiring percutaneous angioplasty with stenting. The patient was given tirofiban + unfractionated heparin (UFH). Ten hours later, the patient revealed very severe thrombocytopenia and went into hemorrhagic shock (hematemesis and hematoma at the injection site). The patient was transfused with nine units of red blood cells (RBCs), 24 platelets pellets and 4 units of fresh frozen plasma (FFP). The second patient is a 76-year-old woman. She was admitted to hospital for acute coronary syndrome necessitating percutaneous angioplasty with stenting and a glycoprotein IIb/IIIa receptor antagonists, tirofiban + unfractionated (UFH). Four hours later, the patient presented with gingivorrhagia associated thrombocytopenia. She received six platelet pellets transfusion with well clinical and biological improvement. These two observations raise the significance of a close monitoring of platelet count after the initiation of GP IIb/IIIa antagonists infusion, which are sometimes responsible for life-threatening adverse events.
Asunto(s)
Inhibidores de Agregación Plaquetaria/efectos adversos , Complejo GPIIb-IIIa de Glicoproteína Plaquetaria/antagonistas & inhibidores , Trombocitopenia/inducido químicamente , Tirofibán/efectos adversos , Anciano , Angioplastia Coronaria con Balón , Anticoagulantes/administración & dosificación , Anticoagulantes/efectos adversos , Femenino , Heparina/administración & dosificación , Heparina/efectos adversos , Humanos , Plasma , Inhibidores de Agregación Plaquetaria/administración & dosificación , Transfusión de Plaquetas , Trombocitopenia/terapia , Tirofibán/administración & dosificaciónRESUMEN
Hypertrophic cardiomyopathy is a primary muscle disorder characterized by an abnormal thickness of the left ventricular wall. It is often going undiagnosed because many patients have few symptoms and can lead normal lives. This is a case report about an apical cardiomyopathy diagnosed at a very late stage in an old amateur soccer player. He was hospitalized due to acute chest pain; neurologic disorder related to a hypertensive emergency, he underwent successful percutaneous coronary intervention, echocardiography and CMR revealed Apical hypertrophic cardiomyopathy. The development of sports cardiology has major importance in the detection of cardiac disease which may have poor prognosis. Our patient had the chance to achieve his entire career without rhythmic complications.
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Cardiomiopatía Hipertrófica , Fútbol , Cardiomiopatía Hipertrófica/diagnóstico , Dolor en el Pecho/etiología , Ecocardiografía , Electrocardiografía , Ventrículos Cardíacos , Humanos , MasculinoRESUMEN
During the COVID-19 pandemic, the effectiveness of the combination of hydroxychloroquine and azithromycin is widely discussed. This treatment can cause many severe cardiac side effects that makes us discuss its utility. The aim of this study is to describe the cardiovascular effect of hydroxychloroquine and azithromycin by analyzing surface ECG in patients with COVID-19. This observational cohort study included Moroccan patients with COVID-19 diagnosis and were hospitalized in Cheikh Khalifa International University Hospital, Casablanca, Morocco between March 26 and April 20, 2020. Patients were treated with a combination of hydroxychloroquine and azithromycin over a period of at least ten days. We were interested in the effects of this combination on the electrocardiogram. A total of 118 eligible patients were enrolled in the study. QT interval prolongation was observed in 19% of patients under the treatment. Only 5 patients required discontinuation of treatment. The factors associated with QT prolongation are male gender (P value 0,043), age over 68 years (P value 0,09), cardiovascular comorbidity (P value 0,013), tisdale score ≥11 (P value < 0,001), and a severe form of COVID-19 (P value < 0,001). First degree atrioventricular block was observed in 2 patients. No serious rhythm or conduction disorders were observed in this study. QT prolongation is a real risk with the combination of hydroxychloroquine and azithromycin. In the current context, it is necessary to select patients at high risk of severe rhythm disturbances that require closer ECG monitoring. Treatment should be discontinued if there are alarming signs such as QTc prolongation beyond 550 ms and the development of ventricular extrasystole or torsade de pointe.
RESUMEN
INTRODUCTION: coronavirus disease is now a global pandemic due to rapid human-to-human transmission. It can cause mild to fatal respiratory, cardiovascular, and neurological diseases. We aimed to find out whether elevated D-dimer levels are a predictor of the bad progression of COVID-19 to help reducing the mortality. METHODS: the data of COVID-19 patients from March 21, 2020 to April 24, 2020 were retrieved from the Cheick Khalifa Hospital database. We used the receiver operating characteristic (ROC) curve to get the optimum cutoff value of D-dimer levels on admission and after 5 days. We used these cutoffs to divide patients into two groups and compare the in-hospital mortality between them to assess the prognosis value of D-dimer levels. RESULTS: the data of COVID-19 patients from March 21, 2020 to April 24, 2020 were retrieved from the Cheick Khalifa Hospital database. We used the receiver operating characteristic (ROC) curve to get the optimum cutoff value of D-dimer levels on admission and after 5 days. We used these cutoffs to divide patients into two groups and compare the in-hospital mortality between them to assess the prognosis value of D-dimer levels. 89 patients were included in this study, of whom 79 were discharged and 10 died in hospital. The optimum cutoff value to predict mortality in patient using D-dimer levels on admission was 668 ng/ml (sensitivity 90%, specificity 63.3%, Areas under the ROC curve 0,775). As for D-dimer levels on day 5, it was 1360 ng/ml (sensitivity 100%, specificity 88,6%, Areas under the ROC curve 0.946). The group with D-dimer levels on day 5 > 1360 ng/ml (19 patients) had a worst evolution and a higher incidence of mortality compared to the group with D-dimer < 1360 ng/ml (69 patients) (10/19 vs 0/69, P = 0,0002). CONCLUSION: D-dimer greater than 1360 ng/ml on day 5 could help clinicians identify patients with poor prognosis at an early stage of COVID-19.
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COVID-19/diagnóstico , Productos de Degradación de Fibrina-Fibrinógeno/metabolismo , SARS-CoV-2 , Adulto , Anciano , Biomarcadores/sangre , COVID-19/sangre , COVID-19/mortalidad , Bases de Datos Factuales , Femenino , Mortalidad Hospitalaria , Humanos , Masculino , Persona de Mediana Edad , Marruecos , Pronóstico , Sensibilidad y EspecificidadRESUMEN
Hydatid cyst is a parasitic infestation that is usually observed in the liver and lungs. The localization in the brain and the heart is exceptional. Here, we report a 11-year-old boy who was diagnosed to have two large hydatid cysts of the heart and brain. We discuss this unusual presentation of hydatid cyst and its management.
RESUMEN
Coronavirus disease 2019 (COVID-19) has been reported as the possible cause of acute myocarditis. Myocarditis is an inflammatory heart disease mostly caused by viral infections. Cytomegalovirus (CMV) primary infection is often not suspected as a cause of myocarditis in immune-competent adults. We report the case of a 37-year-old male admitted with fever, cough and dyspnea. Chest CT showed typical ground-glass changes indicative of viral pneumonia. He was tested negative for COVID-19 but had biological markers that made us still suspect it. He had elevated troponin I level (up to 111.5 ng/mL) and diffuse myocardial dyskinesia along with a decreased left ventricular ejection fraction (LVEF). He was diagnosed with CMV myocarditis with cardiac insufficiency and totally recovered without antiviral therapy. During the COVID-19 pandemic patients may develop myocarditis, still every myocarditis is not a COVID infection. Myocarditis linked to CMV infection may be rare, but life-threatening.
Asunto(s)
Infecciones por Coronavirus/diagnóstico , Infecciones por Citomegalovirus/diagnóstico , Miocarditis/diagnóstico , Neumonía Viral/diagnóstico , COVID-19 , Prueba de COVID-19 , Técnicas de Laboratorio Clínico , Infecciones por Coronavirus/epidemiología , Tos/etiología , Infecciones por Citomegalovirus/virología , Diagnóstico Diferencial , Disnea/etiología , Fiebre/etiología , Humanos , Masculino , Persona de Mediana Edad , Miocarditis/diagnóstico por imagen , Miocarditis/virología , Pandemias , Neumonía Viral/epidemiología , Tomografía Computarizada por Rayos XRESUMEN
Diffuse alveolar hemorrhage after percutaneous coronary intervention (PCI) is a rare complication. The diagnosis is difficult and can mimic by clinical and radiological features other diagnosis as pneumopathy. We herein report the case of a 63-year-old female admitted to the hospital for ST elevation myocardial infarction. The patient underwent PCI and received dual antiplatelet therapy. Four days later, she developed dyspnea, hemoptysis and fever. Clinical, radiological and biological findings oriented to a pneumopathy and the patient received the treatment for it. Later and because of the non improvement, a thoracic computed tomography was performed and revealed patchy areas of ground-glass opacity consistent with a diffuse pulmonary hemorrhage. The combination therapy with aspirin and clopidogrel was therefore the most likely cause. Although the dual antiplatelet combination reduces systemic ischemic events after PCI, it is associated with increased risk of nonfatal and sometimes fatal bleeding. Hence the necessity of close and careful observation to watch for possible fatal complications.