1/86. Evidence of cell-mediated cardiac myocyte injury involved in the heart failure of a patient with progressive systemic sclerosis.A 54-year-old woman with progressive systemic sclerosis (PSS) was admitted to hospital because of dyspnea and chest pain. Echocardiogram revealed diffuse hypokinesis of the left ventricle (ejection fraction 24%). methylprednisolone, heparin, and diuretics were administered, without benefit. anemia, thrombocytopenia, and renal dysfunction rapidly progressed, and she died of heart failure on the 14th hospital day. Immunohistochemical study of the myocardial tissue showed mild to moderate cell infiltration, mainly consisting of natural killer (NK) cells, macrophages, cytotoxic T lymphocytes (CTLs), and T helper cells. perforin, a cytolytic factor, was expressed in the infiltrating CTLs and NK cells, indicating that these cells were activated killer cells. Furthermore, human leukocyte antigen classes I and II, intercellular adhesion molecule-1, as well as costimulatory molecules B7-1, B7-2, and CD40, all of which are known not to be expressed in cardiac myocytes under normal conditions, were moderately to strongly expressed in cardiac myocytes. There was no detectable level of enterovirus genomes in the polymerase chain reaction products from the myocardial tissue of this patient. These findings strongly suggest that the infiltrating killer cells recognized cardiac myocytes as target cells and directly damaged them by releasing perforin. Enhanced expression of these antigens may have played an important role in the activation and cytotoxicity of the infiltrating killer cells. Absence of enterovirus genomes in the myocardial tissue may suggest that this autoimmune process is primarily induced by PSS.- - - - - - - - - - ranking = 1keywords = chest pain, chest (Clic here for more details about this article) |
2/86. Acute myocardial injury: an entity of acute coronary syndromes.A 46-year-old Indian man was admitted with unstable angina (Braunwald's class IIIB1)--the chest pain at rest was associated with inferolateral ischaemia on the ECG at admission. His serial total creatine kinase levels were elevated but CKMB was not detected. Serial serum troponin t levels were significantly raised suggesting the presence of significant acute myocardial injury.- - - - - - - - - - ranking = 1keywords = chest pain, chest (Clic here for more details about this article) |
3/86. Hydatid disease of the interventricular septum causing pericardial effusion.Echinococcal infestation of the heart is uncommon. We report a case of a 35-year-old man with an hydatid cyst located in distal interventricular septum. Clinical presentation was chest pain and urticaria. diagnosis was made by echocardiography and magnetic resonance imaging. Surgical resection was performed; the cyst was punctured and its content was drained, hypertonic glucose solution was instilled for sterilization, and it was removed. The patient did well and remains asymptomatic. diagnosis and ultimate surgical treatment of this disease prevented potentially lethal complications such as cyst rupture with embolic phenomena and anaphylactic shock.- - - - - - - - - - ranking = 1keywords = chest pain, chest (Clic here for more details about this article) |
4/86. Triscuspid annular dilatation causing severe valvular incompetence and associated with dystrophic calcification of the left ventricular myocardium.We report on a case of severe tricuspid regurgitation (TR) in a young patient with no history of chest trauma and with an anatomically normal tricuspid valve (TV) apparatus and a dilated TV annulus associated with dystrophic calcification of the left ventricular myocardium. The possibility of congenital pathology as well as the possibility of this being a limited inflammatory or restrictive myocardial disease is discussed.- - - - - - - - - - ranking = 0.067225931582231keywords = chest (Clic here for more details about this article) |
5/86. Six-month follow-up of takotsubo cardiomyopathy with I-123-beta-metyl-iodophenyl pentadecanoic acid and I-123-meta-iodobenzyl-guanidine myocardial scintigraphy.A 69-year-old man with a history of transient chest pain was diagnosed takotsubo cardiomyopathy. In I-123-beta-metyl-iodophenyl pentadecanoic acid myocardial scintigraphy, decreased uptake of apex was seen in the acute phase, and it recovered in 3 months. In I-123-meta-iodobenzyl-guanidine myocardial scintigraphy, decreased uptake of apex persisted for 6 months, and there was a discrepancy between apical and total washout rate in the acute phase and after 3 months, which disappeared after 6 months. We speculate that the discrepancy of sympathetic innervation between the apical and basal region is the cause of the characteristic left ventricular apical akinesia of takotsubo cardiomyopathy.- - - - - - - - - - ranking = 1keywords = chest pain, chest (Clic here for more details about this article) |
6/86. MR imaging of myocardial haematoma after blunt chest injury.Myocardial contusion after a chest trauma is a frequently under-diagnosed injury. We report two cases of myocardial contusion in which MR imaging, thanks to its contrast capability, was able to assess the presence of a haematoma and in one case to demonstrate the recovery of the lesion.- - - - - - - - - - ranking = 0.33612965791115keywords = chest (Clic here for more details about this article) |
7/86. fistula from the aortic sinus of valsalva to the right ventricle--case report.The authors report a case of a 42-year-old male, with the incidental finding of a fistula from the aortic root (sinus of valsalva) to the right ventricle in the diagnostic work-up of atypical chest pain. The images and results of the exams are presented and the therapeutic options are discussed after the final diagnosis.- - - - - - - - - - ranking = 1keywords = chest pain, chest (Clic here for more details about this article) |
8/86. Chronic left ventricular pseudoaneurism.We present the case of a 70-year-old white male presenting with an abnormal cardiac silhouette on the chest X-ray and complaining of fatigue in the week before hospital admission. Four months before admission he had a single prolonged ischemic chest pain episode. The ECG revealed an old true posterior myocardial infarction. The transthoracic echocardiogram showed a large left ventricular pseudoaneurysm and surgical resection was performed successfully. The etiology, diagnosis and treatment of left ventricular pseudoaneurysm are reviewed.- - - - - - - - - - ranking = 1.0672259315822keywords = chest pain, chest (Clic here for more details about this article) |
9/86. Infected myocardial hydatid cyst imitating left ventricular aneurysm.We report a case of infected intracardiac hydatid cyst in a patient who had complaints of chest pain, exertional dyspnea, palpitation, evening fever and fatigue. echocardiography demonstrated a left ventricular apical cystic mass in 7 cm diameter. magnetic resonance imaging and hemagglutination test confirmed the diagnosis. Single capsulated cyst full of pus was surgically removed by using cardio-pulmonary bypass. Histopathological examination revealed an infected hydatid cyst. Postoperative recovery was uneventful and the patient remains free of symptoms after one year of follow-up.- - - - - - - - - - ranking = 1keywords = chest pain, chest (Clic here for more details about this article) |
10/86. Right ventricular wall hematoma due to thrombolytic therapy presenting as cardiac tamponade: a case report and review of literature.Intramyocardial hematoma is an uncommon condition, most often occurring after myocardial infarction or chest trauma. A 54-year-old male patient with a large right ventricular wall hematoma who presented with cardiac tamponade three days after acute inferoposterior myocardial infarction and thrombolysis is described. This is the first report of intramyocardial hematoma related to thrombolytic therapy. The patient was managed conservatively with complete resolution of the right ventricular hematoma.- - - - - - - - - - ranking = 0.067225931582231keywords = chest (Clic here for more details about this article) |
| | Next -> |