Atrial myxoma is a rare and benign clinical entity. It remains common in women and mainly affects the left atrium. Its clinical picture is polymorphic. We report the case of a 53-year-old woman who consulted for dyspnea with cardiac failure‘s picture. The diagnosis of myxoma of the left atrium was made on echocardiography which also objectified the existence of mitral stenosis. The patient underwent surgical excision and mitral valve replacement with good postoperative outcomes.
Post-infarction ventricular septal defect (PIVSD) is one of the most serious mechanical complications of acute myocardial infarction (AMI). Over the last decade, percutaneous closure is increasingly undertaken, with results similar to cardiac surgery. We present a case of ST-elevated anterior AMI, complicated by apical PIVSD successfully treated with transcatheter closure.
An 83-year-old man was hospitalized for chest pain occurred 18 hours before, during the night time. He was an active smoker. Clinical examination revealed normal heart sounds and pulmonary bibasilar crackles. ST-segment elevation with deep T waves inversion in anterior leads were detected on the electrocardiogram. A mildly-reduced ejection fraction (40%) was found by transthoracic echocardiogram. The patient underwent emergency coronary angiography, which revealed a subocclusive stenosis of the mid left anterior descending artery with a TIMI 2 flow, treated by balloon angioplasty and drug-eluting stent. Four days after revascularization, the patient developed an acute deterioration with signs of decompensated heart failure and a new holosystolic murmur with large irradiation. Inotropic agents’ administration was required to maintain a precarious hemodynamic condition. A bedside Echo revealed an apical VSD, measuring 15 × 10 mm, with left-to-right shunting, and pulmonary hypertension. The patient was scheduled for transcatheter PIVSD closure. The procedure was performed under fluoroscopic guide. Two vascular access sites were placed, femoral arterial and right internal jugular vein. Through the right internal jugular vein, a 24-mm Amplatzer atrial septal occluder on a 9 French Amplatzer TREVISIO™ intravascular delivery system was advanced via right ventricle into the PIVSD. Contrast fluoroscopy was used to assess apposition and the degree of shunt reduction before release. Echocardiographic evaluation performed 48 hours later confirmed a correct apposition of the device with insignificant residual shunt. At 6 months follow-up, he was asymptomatic, with unchanged prosthetic findings.
Percutaneous closure has been emerged as a valid cost-effective alternative to surgery and should be advised. However, debate remains on the optimal preprocedural optimization, timing of repair and modality of treatment.
Coronary artery embolism is an uncommon cause of myocardial infarction (MI). Among several etiologies of coronary embolism, we mention a very rare cause which is the paradoxical embolism via patent foramen ovale (PFO). It interests generally youngest people without cardiac risk factors. We report three cases who presented ST-elevation MI (STEMI) due to paradoxical embolism with high risk PFO that can justify embolic infarction. The aim of this article is to define the high risk PFO, to establish causal link between PFO and embolic events and to guide therapeutic management.
Behçet's disease is a chronic inflammatory vascular disorder that can affect arteries and veins of various sizes. Arterial involvement, which plays a significant prognostic role, requires a treatment approach involving corticosteroids, immunosuppressants, and potentially surgical or endovascular procedures. This article presents the case of a young man diagnosed with Behçet's disease, manifested by a spontaneous pseudoaneurysm in the superficial femoral artery. The patient underwent surgical intervention to remove the pseudoaneurysm and restore circulation using a venous graft. This case underscores the importance of considering Behçet's disease in vascular manifestations.
To calculate the vascular age of hypertensive patients and assess the risk at 10 years of occurrence of an absolute cardiovascular event in outpatient consultation of the Abidjan Heart Institute. Patients and methodology: Cross-sectional study with descriptive and analytical purposes from June 2021 to September 2021, i.e. 4 months in patients at least 30 years of age followed in the outpatient department for arterial hypertension without cardiovascular complications. Data were collected using a questionnaire. We considered the parameters established in the D'Agostino chart for the calculation of vascular age. Each parameter was weighted and the total points obtained corresponded to the vascular age. The cardiovascular risk at 10 years was also obtained from another abacus established by D'Agostino by cross-referencing the total points of each patient with pre-established data.
Three hundred hypertensive people were included in this study. The calendar average age was 62.0 ± 10 years with extremes of 30 and 95 years. The gender distribution showed female predominance and there was no significant difference in vascular age by sex. The mean vascular age of all patients was 73.4 ± 9.9 years. The mean difference between actual and vascular age was 11.4 years. Dyslipidemia (p = 0.0002), diabetes (p = 0.0004) and unstandardized BP (p = 0.0000) significantly influenced vascular age. There was no significant difference between smokers and non-smokers (p = 0.1349). All men had a greater than 30% risk of having a cardiovascular accident while women before the age of 35 had no risk. Over the age of 60, almost all patients (both men and women) had a greater than 30% risk of having a cardiovascular accident at 10 years.
The calculation of vascular age made it possible to assess arterial aging and calculate the probability at 10 years of occurrence of a cardiovascular event. This study also highlights the importance of cardiovascular risk and vascular age assessment for management adaptation and therapeutic education.
The endovascular approach is widely used in the management of aortic isthmic rupture. Even if it remains less invasive than conventional surgery, a life-threatening complications are possible.
We report the case of a young female patient presenting a stent-graft migration during the deployment with total obstruction of the supra-aortic vessels. We describe the therapeutic management with a cerebral rescue procedure followed by a delayed surgical repair.
To describe self-reported sitting time (ST), and determine the factors associated with health status (HS) among patients with heart failure (HF).
A cross-sectional study design was used in this study. Outcome measures included an international physical activity questionnaire and a self-report health status questionnaire. The data assessments were examined using the Pearson correlation coefficient, t-test, one-way ANOVA, and Hierarchical multiple regression.
180 respondents joined this study. The mean age was mean 59.92 (SD= 11.90) years old, and 60% were male. The mean score of HS was mean 9.43 (SD= 2.16). The HS had a significant correlation with age (r= .17, p< .05), Hemoglobin (r= −.46, p< .01), HF medications (r= .31, p< .01), length of diagnostic HF (r= .35, p< .01), and comorbidity (r= .25, p< .01), and the HS was associated with the NYHA Classification (F= 203.43, p< .001), and the ST (F= 73.97, p< .001). Four variables were significant predictors of HS such as comorbidity (β = .14), NYHA Class I (β= –2.22), ST 6 to 8 hours/day (β= 1.27), and ST > 8 hours/day (β= 3.03), and they were predicted 75.1% of the variance in HS.
High amounts of ST and high NYHA classifications were associated with decreased HS in patients with HF, Moreover, HS is independently associated with comorbidities status and length of diagnostic HF.
Acute rheumatic fever (ARF) is a multi-systemic disease, in which cardiac involvement is the most serious major manifestation of disease. The aim of this study was to analyse cardiac involvement in children with ARF and his risk factors.
It were a retrospective study including all children under the age of 14 years who were hospitalized for ARF in the pediatric department of the CHU Hédi Chaker of Sfax, during a period of twelve years (2010–2022).
We collected 50 cases (31 boys and 19 girls). Twenty-two patients (44%) developed cardiac lesions. The mean age at diagnosis was 9.6 years [5–14 years]. A pathological heart murmur was detected in 14 cases (n = 14/22) was classified as mild carditis in 15 cases, moderate carditis in 5 cases and severe in 2 cases.
The median follow-up time was 3,3 years. Nineteen patients developed valvular sequelae Risk factors of cardiac lesions was: age more than 8 years, heart murmur, allonged PR, CRP > 100 mg/l and VS > 100 mm.
CR is still a public health problem in Tunisia. It is a serious pathology that can cause serious increases in morbidity rates. Thus, we must strengthen preventive strategies.
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