Case Reports – ABC CARDIOL

IJCS

Case Report

Intermittent Left Bundle Branch Block and Cardiac Memory in a Patient with Dengue Fever: A Case Report and Literature Review

Muchtar Nora Ismail Siregar et al. Jasmine Ibtisamah Alkatiri

Abstract

Background:

Arrhythmias and Electrocardiography changes in Dengue Fever (DF) cases can mimic electrocardiogram (ECG) appearance of threatening clinical conditions such as myocardial ischemia, albeit no significant ischemic injury at the heart muscle.

Case Presentation:

We report a case of subsequent cardiac memory (CM) in a 50-year-old female with DF. A 12-lead ECG on admission revealed sinus rhythm with Left Bundle Branch Block (LBBB), and it resolved on day 4 of hospitalization. However, deep symmetric T wave inversions (TWI), which were later recognized as CM, occurred. The patient received treatment with Ringer’s lactate and paracetamol infusion. A routine 12-lead ECG performed on day 7 of hospitalization revealed the resolution of TWI and normal sinus rhythm.

Conclusion:

This case report highlights one intriguing phenomenon associated with LBBB in DF, which is CM TWI, where the T wave ‘remembers’ the direction of the QRS complex during prior abnormal ventricular activation. Due to its similarity with TWI caused by myocardial ischemia, understanding of this phenomenon may prevent unnecessary interventions.

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IJCS

Case Report

A Rare and Fatal Association With SLE: Lutembacher Syndrome With Huge Atrial Septal Defect

Muhammed Fatih Kaleli et al. Yakup Alsancak Mustafa Celik Mehmet Akif Düzenli

Introduction

Systemic lupus erythematosus (SLE) is an autoimmune disorder characterized by periods of relapse and remission, with the potential to damage multiple organs depending on disease activity and individual susceptibility. Valvular heart disease is one of the cardiac manifestations associated with SLE. Lutembacher syndrome (LS) is an exceedingly rare clinical syndrome defined by the presence of a combination of congenital or acquired ostium secundum atrial septal defect (ASD) and congenital or acquired mitral stenosis (MS). First reported by Lutembacher in 1916, this syndrome is more frequently observed in young adults, with a higher prevalence among females. In this case report, we present the case of a young pregnant woman with SLE who visited the cardiology clinic complaining of palpitations. Eventually, she was diagnosed with LS.

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IJCS

Case Report

Six-Year Follow-Up of an Octogenarian With a Left Atrial Myxoma: Case Report

Miguel Bernardino Antunes Vicente et al. Tânia Amaro Elsa Fernandes

Abstract

Myxoma is the most common primary cardiac tumour, especially in adults. However, reports on this nosological entity in patients over the age of 80 are scarce in the medical literature. Echocardiography is a useful diagnostic tool for detecting cardiac myxomas. These tumours are usually surgically removed soon after diagnosis, limiting knowledge of their natural evolution. In this report, we describe the case of an 86-year-old woman who had been followed irregularly for arterial hypertension since 2016, when an echocardiogram showed a left atrial myxoma adhered to the interatrial septum, initially without impairment of the mitral valve (MV) or obstruction of the pulmonary veins (PV). The patient refused surgical removal at the time. Six years later, she was hospitalized for urinary sepsis. A new echocardiogram revealed an increase in the size of the myxoma, which occupied around 80% of the left atrium (LA), obstructing the PV and MV. New suggestion of surgery was refused by the patient.

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Case Report

A Challenging Case Of Pulmonary Arterial Hypertension: Never Judge By Appearances

Pedro Silvério António et al. Manuel Silvério António Catarina Lopes Resende Tatiana Guimarães … Daniel Cazeiro Yolanda Sá Pereira Fausto José Pinto Rui Plácido

Abstract

We report the case of a patient with symptomatic pulmonary hypertension (PH) associated with diffuse systemic sclerosis (SSc) whose initial assessment suggested a group 3 (clinical classification) PH. The patient had a history of drugs/toxins consumption, which contributed to the development of intrinsic pulmonary vascular disease. This changed the panorama towards the diagnosis of pulmonary arterial hypertension (PAH), with important therapeutic and prognostic implications. In fact, the excellent clinical, laboratory and hemodynamic response to therapy confirmed the hypothesis of a case of drug-associated PAH (DPAH) in a patient with diffuse SSc and lung disease. Considering the presence of DPAH, it was deemed necessary to assess acute vasoreactivity during right heart catheterization (RHC). If criteria were met, the clinical scenario may change towards a favorable and sustained clinical and hemodynamic response with oral calcium channel blockers. However, the response to inhaled nitric oxide was negative in our patient and the therapeutic strategy with dual oral combination therapy with tadalafil and ambrisentan was continued. After six-months of therapy the patient significantly improved, from a high to a low risk of one-year mortality.

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Intermittent Left Bundle Branch Block and Cardiac Memory in a Patient with Dengue Fever: A Case Report and Literature Review

Abstract

Background:

Case Presentation:

Conclusion:

A Rare and Fatal Association With SLE: Lutembacher Syndrome With Huge Atrial Septal Defect

Introduction

Six-Year Follow-Up of an Octogenarian With a Left Atrial Myxoma: Case Report

Abstract

A Challenging Case Of Pulmonary Arterial Hypertension: Never Judge By Appearances

Abstract

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