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Case Report
TEE-Guided Cardiac Surgery in a Child with Mitral Valve Prolapse, Hyperthyroidism and Myasthenia Gravis: A Case Report
Guowei Wu
,
Hongwei Xu*
Issue:
Volume 8, Issue 2, June 2024
Pages:
51-55
Received:
13 March 2024
Accepted:
25 March 2024
Published:
11 April 2024
Abstract: Intraoperative transesophageal echocardiography is used to more accurately assess a patient's cardiac condition and is important for the guidance of cardiac surgery. This case reports a pediatric cardiac surgery performed under TEE guidance in a patient with multiple complications. A 5-year-old child presented with diarrhea as the first symptom. At the age of 2 years, she was admitted to the hospital with ptosis of the right upper eyelid, morning lightness and evening heaviness, hand tremor, and the presence of a murmur in the mid to late stages of cardiac systole on auscultation. She was diagnosed with mitral valve prolapse and myasthenia gravis, which resolved with treatment. Subsequently, she was diagnosed with hyperthyroidism due to obvious protrusion of the eyeballs, and was admitted to the hospital for heart valve surgery after her thyroid function was controlled. Intraoperative TEE suggested mitral valve prolapse combined with embolization of the P2 region. In the complex case of this child, the suture points during mitral valvuloplasty and the scar tissue caused by the mitral valvuloplasty annulus may limit the growth of the annulus as well as the leaflet motion. Therefore, it was recommended that the surgeon perform mitral valve extension to maximize the prognosis. TEE herein guided the cardiac surgical decision making to maximize the prognosis of the child.
Abstract: Intraoperative transesophageal echocardiography is used to more accurately assess a patient's cardiac condition and is important for the guidance of cardiac surgery. This case reports a pediatric cardiac surgery performed under TEE guidance in a patient with multiple complications. A 5-year-old child presented with diarrhea as the first symptom. At...
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Research Article
Evolutionary Etiopathogenic Particularities of Peripartum Cardiomyopathy in a Disadvantaged Environment in Brazzaville
Solange Flore Mongo Ngamani,
Kivie Mou-moue Ngolo Letomo*,
Christian Michel Kouala Landa,
Eric Gibrel Kimbally Kaky,
Rog Paterne Bakekolo,
Synthiche Okoko,
Gankama Thibault Naibe,
Jospin Karel Makani Bassoukouahou,
Fikahem Ellenga Mbolla
Issue:
Volume 8, Issue 2, June 2024
Pages:
56-64
Received:
1 March 2024
Accepted:
21 March 2024
Published:
11 April 2024
Abstract: It was carried out a study on peripartum cardiomyopathy (PPCM) in the cardiology and internal medicine department of the University Hospital Center of Brazzaville. This work takes place from May 1, 2019 to April 31, 2023. It had aimed at identifying the profile of peripartum cardiomyopathy in women disadvantaged in cardiovascular diseases. Fifty-two files were selected on the basis of predefined inclusion criteria. The frequency of myocardiopathy peripartum was estimated at 1.4% of admissions and 9.7% of women of childbearing age, or 13 cases per year. The average age of the patients was 30.78.02 (range: 16 to 44 years), the most frequently found risk factors were respectively high low level socio-economic (77%), multiparity (36%); pregnancy-induced hypertension (32%) and anemia (31%). clinical picture was stereotypical and included signs of heart failure. This one was global in thirty-nine (39) cases (75%), left in thirteen (13) cases (25%), cardiomegaly was noted in all cases with mean cardiothoracic ratio at 0.614 (range 0.52 to 0.83). Sinus tachycardia was observed in fifty-one 51 cases (98%). Left atrial dilatation was noted in twenty-three 23 cases (44.2%), left atrial dilatation was noted in thirteen (13) cases (25%). Diffuse disorders of the repolarization were noted in forty-three cases (83%). Echocardiography revealed: left cavitary dilatation in 100% of cases; thrombosis left ventricular intravenous was noted in two cases (4%).
Abstract: It was carried out a study on peripartum cardiomyopathy (PPCM) in the cardiology and internal medicine department of the University Hospital Center of Brazzaville. This work takes place from May 1, 2019 to April 31, 2023. It had aimed at identifying the profile of peripartum cardiomyopathy in women disadvantaged in cardiovascular diseases. Fifty-tw...
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Research Article
Understanding the Influence of Psychosocial Factors and Multimorbidity on Patient Outcomes in Severe Hypertensive Patients Attending Health Institutions in Southeastern Nigeria
Sylvia Oluchi Nwaike*,
Ebenezer Obi Daniel,
Sheriff Lamidi,
Michael Olabode Tomori,
Michael Avwerhota,
Israel Olukayode Popoola,
Adebanke Adetutu Ogun,
Aisha Oluwakemi Salami,
Olukayode Oladeji Alewi
Issue:
Volume 8, Issue 2, June 2024
Pages:
65-72
Received:
5 April 2024
Accepted:
18 April 2024
Published:
10 May 2024
Abstract: Hypertension is a prevalent problem worldwide and it is an important risk factor for a variety of health conditions. Severe hypertension (180+ systolic or 110+ diastolic) is associated with a two-fold increase in relative risk of death. Interventions to date fail to achieve sustained improvement in blood pressure, particularly in regional areas of high social disparity. Growing evidence points to multiple psychological, social and morbidity factors as contributors to the onset of and trajectory of hypertension. The main objective of this study is to examine the association of psychosocial factors and multimorbidity with response to treatment and treatment outcomes in the management of severe hypertensive patients providing additional knowledge and recommendations to improve their quality of care. We conducted cross-sectional research, using interview self-administered semi-structured questionnaires. Data collected was transcribed, coded, and analyzed thematically. Findings were presented in tables, charts, and in narrations as appropriate. Results: There was a significant association between age of the patients and response to treatment in severe hypertension. Overweight/obesity was noted to be significantly associated with response to treatment. In this study, the burden of psychosocial factors and multimorbidity’s in the management of severe hypertension is highlighted. There is a need for effective monitoring and surveillance to monitor progress in reducing the prevalence of severe hypertension and in increasing the awareness for the treatment and management of hypertension.
Abstract: Hypertension is a prevalent problem worldwide and it is an important risk factor for a variety of health conditions. Severe hypertension (180+ systolic or 110+ diastolic) is associated with a two-fold increase in relative risk of death. Interventions to date fail to achieve sustained improvement in blood pressure, particularly in regional areas of ...
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Research Article
Epidemio-Clinical and Paraclinical Aspects of Venous Thromboembolic Diseases in a Cardiology Department in Mali
Toure Mamadou*,
Thiam Coumba Adiaratou,
Fofana Daouda,
Sankare Hamma,
Dagnogo Mariam,
Traore Ousmane,
Yalcoue Djamila,
Guire Sadik Mahamat,
Sidibe Samba,
Diall Mahan Ameri,
Sow Mady,
Cisse Almadane,
Keita Asmaou,
Daffe Sanoussy,
Konate Massama,
Coulibaly Souleymane,
Menta Ichaka
Issue:
Volume 8, Issue 2, June 2024
Pages:
73-77
Received:
6 May 2024
Accepted:
21 May 2024
Published:
30 May 2024
Abstract: Introduction: Venous thromboembolic diseases (VTED) include deep vein thrombosis of the lower limbs and pulmonary embolism (PE), which is its severe form due to its high mortality. The objective of our study was to determine the epidemio-clinical and paraclinical aspects of patients hospitalized for venous thromboembolic diseases. Patients and method: Cross-sectional study with prospective recruitment from patient records hospitalized for (VTED) from January to December 2023 in the cardiology department of the Mother-Child University Hospital in Bamako, Luxembourg. Results: We collected 55 out of 580 patient records hospitalized for (VTED), a hospital frequency of 9.48%. PE accounted for 58.20% of cases, 10.90% for deep vein thrombosis (DVT), and 30.90% for their association. The mean age of patients was 55.56 years ± 15.52 years. The majority of patients, 90%, were under 66 years of age. The predominance was female, 56%. In lower extremity DVT, calf pain and Homans' sign were present in 56% and 24% of patients. In pulmonary embolism, dyspnea and chest pain were present in 85.50% and 65.50% of patients. Etiological factors were dominated by neoplasia in 10.90%, contraception 5.45% and orthopedic surgery in 5.45% of cases. Cardiovascular risk factors were a sedentary lifestyle (50.90%), obesity (34.45%), high blood pressure (36.36%) and diabetes (21.81%). Laboratory abnormalities were elevation of troponin (46.87%), BNP (40.62%), D-Dimer (62.50%) and anemia (9.09%). Electrocardiographic abnormalities were tachycardia in 65.4% and S1Q3 in 21.81% of patients. Echocardiography showed dilation of the right cavities (47.27%), systolic pulmonary arterial hypertension (38.18%) and thrombus in the right cavitary (5.45%). On thoracic CT angiography, PE was proximal (36.40%), bilateral (61.80%) and massive (29.10%). On venous Doppler ultrasound, TVP was proximal in 65.21%. Conclusion: VETD was more common in women and younger subjects.
Abstract: Introduction: Venous thromboembolic diseases (VTED) include deep vein thrombosis of the lower limbs and pulmonary embolism (PE), which is its severe form due to its high mortality. The objective of our study was to determine the epidemio-clinical and paraclinical aspects of patients hospitalized for venous thromboembolic diseases. Patients and meth...
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Case Report
A Case of Transmural Lipoma of the Right Atrium
Lin Song,
Xuejie Li*
Issue:
Volume 8, Issue 2, June 2024
Pages:
78-82
Received:
13 May 2024
Accepted:
28 May 2024
Published:
14 June 2024
Abstract: Primary cardiac tumors are a relatively rare disease. About 75% of primary cardiac tumors are benign. The most common histological type is myxoma, followed by cardiac fibroma, lipoma, etc. We report a case of a 53-year-old female patient admitted to the hospital due to "repeated palpitations and tightness of breath for 5 years, worsened for 2 days." Preoperative transthoracic echocardiography revealed a hypoechoic mass approximately 3.1 cm x 3.0 cm in size within the right atrium, suggesting an intracardiac mass: nature? Chest computed tomography (CT) indicated a fat-density nodule within the right atrium, with a larger cross-sectional size of about 3.0 cm x 2.5 cm, suggesting a lipoma. The patient underwent excision of the right atrial mass under cardiopulmonary bypass. Intraoperative transesophageal echocardiography (TEE) revealed a mass within the right atrium, closely connected to the atrial wall, with no signs of tricuspid valve obstruction. Exploration during surgery revealed a yellow, smooth-surfaced mass approximately 3.0 cm x 3.0 cm in size, penetrating the right atrial wall, from which the mass and an additional 2mm margin of the right atrial wall were completely excised. A suitable-sized bovine pericardial patch was used to repair the defect in the right atrial wall. Postoperative TEE showed the disappearance of the right atrial mass. The postoperative pathological result indicated a lipoma. Cardiac lipoma is a rare benign primary cardiac tumor. The common sites of occurrence of this tumor are the right atrium, left ventricle, and pericardium. Based on their location, cardiac lipomas can be divided into three types: subepicardial, intramyocardial, and subendocardial lipomas, with subendocardial lipomas being the most common, accounting for over 50% of primary cardiac lipomas. Clinical symptoms largely depend on the size and growth location of the tumor, and it is generally believed that most cardiac lipomas are asymptomatic. Symptomatic lipomas can be treated with curative surgical excision. Transmural lipomas of the right atrium are relatively rare, and such lipomas may affect adjacent structures both inside and outside the atrial wall. Although the lipoma in this case did not significantly affect valve function or blood flow, the patient experienced repeated symptoms of palpitations and tightness of breath. Despite being a benign tumor, the lipoma in this case exhibited transmural growth within the right atrium, showing a certain degree of invasiveness, making surgical excision an effective treatment method.
Abstract: Primary cardiac tumors are a relatively rare disease. About 75% of primary cardiac tumors are benign. The most common histological type is myxoma, followed by cardiac fibroma, lipoma, etc. We report a case of a 53-year-old female patient admitted to the hospital due to "repeated palpitations and tightness of breath for 5 years, worsened for 2 days....
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