Hellenic journal of cardiology : HJC = Hellēnikē kardiologikē epitheōrēsē
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Case Reports
Multiple cerebral mycotic aneurysms due to left atrial myxoma: are there any pitfalls for the cardiac surgeon?
Acute cerebral embolism or cerebral aneurysm formation as a consequence of left atrial myxomas has been well documented, but the formation of multiple cerebral aneurysms resulting from atrial myxoma is a very rare neurological complication. We present the case of a 72-year-old-woman with a cardiac myxoma who suffered multiple cerebral mycotic aneurysms. After experiencing both vertigo and a sudden collapse accompanied by loss of consciousness, she underwent cerebral computed tomography (CT) and magnetic resonance imaging (MRI) examinations, which revealed multiple cerebral mycotic aneurysms of various dimensions and a large cyst, as a result of a previous haemorrhage. ⋯ Two years after the first diagnosis the patient remains healthy, suggesting that in such cases we should also consider conservative treatment. According to the literature, the risk is high when aneurysms are large, multiple and intractable. We propose that cerebral CT or MRI scan should be performed before operation in all patients with a cardiac myxoma, especially in those with left cardiac chamber localisation.
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The heterotaxy syndrome is a rare and sporadic disorder. This syndrome presents with situs ambiguus, splenic malformations such as asplenia or polysplenia, and congenital heart disease. ⋯ Kommerell's diverticulum is a saccular aneurysmal dilation at the origin of an aberrant subclavian artery, and can be related with other congenital anomalies. However, there is no previous report of Kommerell's diverticulum being found together with patent ductus arteriosus and heterotaxy syndrome.
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Multicenter Study
Quality of life measurement in patients with hypertension in Cyprus.
Cardiovascular diseases and hypertension may have a significant impact on the quality of life of those who suffer from these conditions. The aim of the present study was to measure health-related quality of life among Cypriot patients suffering from hypertension and/or dyslipidaemia, as well as to investigate any temporal changes in their quality of life at 3 and 6 months from the initial visit. ⋯ Hypertension had little association with mobility and physical activities, indicating that performing physical activities was not limited by hypertension. However, hypertension seems to be more strongly related to anxiety and depression.
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Furosemide is a potent loop diuretic that is widely used in the management of heart failure. Several reports have suggested that continuous intravenous administration of loop diuretics may be superior to intermittent administration. In addition the effect of low-dose dopamine to improve renal perfusion might be of benefit to this patient cohort. ⋯ Continuous infusion of furosemide in addition to low-dose dopamine is safe, effective and less nephrotoxic than intermittent boluses in patients admitted with acute decompensated heart failure and portends a shorter hospital stay and lower readmission rates at 30 days.
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Case Reports
Contrast echocardiography: contribution to diagnosis of left ventricular non-compaction cardiomyopathy.
Left ventricular non-compaction (LVNC) is a cardiomyopathy considered to be caused by arrest of normal embryogenesis of the endocardium and myocardium. Echocardiography has been the preferred diagnostic procedure; however, the correct diagnosis is often missed or delayed due to the lack of knowledge about this uncommon disease and its similarities to other diseases of the myocardium and endocardium. Here we present two cases: an asymptomatic 39-year-old man who was considered to be suffering from dilated cardiomyopathy (DCM) for four years; and an asymptomatic 19-year-old man who was considered to be suffering from hypertrophic cardiomyopathy. ⋯ Contrast echocardiography, a low-cost, easy, repeatable, real-time, and non-invasive technique with no ionising radiation, shows a high correlation in the diagnosis of LVNC. In echocardiography, the importance of contrast agents is twofold, as they can be considered essential for a reliable differentiation between the compacted and the non-compacted myocardium, while at the same time they allow accurate measurement of the ratio. Heightened clinical suspicion is necessary for the accurate diagnosis and management of diseases.