1/11. Ballooning posterior leaflet syndrome: syncope and sudden death.Two of four patients with ballooning posterior leaflet syndrome died suddenly and the remaining two developed a near-fatal arrhythmia. These four patients demonstrate the potentially fatal nature of the ballooning posterior leaflet syndrome.- - - - - - - - - - ranking = 1keywords = nature (Clic here for more details about this article) |
2/11. A cardiac papillary fibroelastoma with chordal location.Papillary fibroelastomas, which were initially incidental findings at autopsy and surgery, are now being recognized with increasing frequency with the widespread use of echocardiography. Because of their embolic potential, an aggressive treatment approach is generally accepted. We report a papillary fibroelastoma located at the chorda of the anterior mitral leaflet that underwent conservative follow-up for 8 years without any complications. Because most of the cardiac papillary fibroelastoma cases reported are incidental findings, the question of whether symptomless fibroelastomas must be removed or other factors contribute to the embolic nature of the selected cases remains a challenge for the future.- - - - - - - - - - ranking = 1keywords = nature (Clic here for more details about this article) |
3/11. minocycline pigmentation of heart valves.minocycline, a derivative of tetracycline, is a broad spectrum antibiotic used in the treatment of gram-positive and gram-negative infections. Benitz et al. (1) were the first to report black discoloration of the thyroid gland in rats, dogs, and monkeys given minocycline. Since that time, there have been numerous reports in the literature describing minocycline related black pigmentation of the skin, thyroid gland, and other sites. We report an unusual case of minocycline induced pigmentation of the cardiac valves and coronary vessels. The pigment stained with Fontana-Masson and was reduced with bleaching. The exact nature of the pigment is unclear; however, various theories have been advocated. ochronosis is another cause of black pigmentation of the heart valves; the clinical history should allow distinction between the two.- - - - - - - - - - ranking = 1keywords = nature (Clic here for more details about this article) |
4/11. Possible relationship between degenerative cardiac valvular pathology and lyme disease.We report an unusual clinical presentation of Lyme carditis in a previously healthy 20-year-old black woman without any epidemiologic history of lyme disease, fulminant in nature, involving a heart valve necessitating emergent mitral valve replacement, and requiring further surgical intervention because of the development of pericardial effusion and tamponade. A dilated right ventricle with normal contractility and severe tricuspid regurgitation with increase in the right atrial size diagnosed later remains under close surveillance.- - - - - - - - - - ranking = 1keywords = nature (Clic here for more details about this article) |
5/11. Isolated tricuspid valve vegetations and steno-insufficiency in primary antiphospholipid syndrome.Although cardiac valve disease is frequent in the antiphospholipid syndrome, isolated tricuspid valve pathology is uncommon and tricuspid valve steno-insufficiency with concomitant vegetations in association with primary antiphospholipid syndrome has very rarely been mentioned in the literature. We describe a 54-year-old Indian woman with newly-diagnosed antiphospholipid syndrome and isolated tricuspid valve disease, the nature of which was only discernible by transoesophageal echocardiography. This case report highlights the importance of being aware of antiphospholipid syndrome as the possible underlying diagnosis in isolated organic tricuspid valve disease and the need for transoesophageal echocardiography in such cases.- - - - - - - - - - ranking = 1keywords = nature (Clic here for more details about this article) |
6/11. A cluster of cases of aspergillus endocarditis after cardiac surgery.aspergillus endocarditis is an ominous condition whose prevalence is increasing in the hospital population. Despite the life-threatening nature of the disease, detection of the source, establishment of the diagnosis, and treatment remain highly challenging. A cluster of three cases of aspergillus endocarditis recently encountered at the Montreal Heart Institute are presented.- - - - - - - - - - ranking = 1keywords = nature (Clic here for more details about this article) |
7/11. Three cases of destructive native valve endocarditis caused by staphylococcus lugdunensis.Described here are three cases of acute native valve endocarditis due to the coagulase-negative pathogen staphylococcus lugdunensis with serious complications. Two of the three patients died despite optimal antibiotic therapy and cardiovascular surgery. These cases demonstrate the aggressive nature of S. lugdunensis and emphasize the importance of identifying coagulase-negative staphylococci to the species level and not considering the isolation of S. lugdunensis from normally sterile body fluids as contamination. On the contrary, when this organism is found in patients with endocarditis, early surgery should be considered. The possibility that this organism could be misidentified as S. aureus because of "autocoagulation" and that commercial identification systems may misidentify it as S. haemolyticus, S. hominis or S. warneri should also be remembered.- - - - - - - - - - ranking = 1keywords = nature (Clic here for more details about this article) |
8/11. Iatrogenic thrombosis on the tendinous cords of the tricuspid valve.Iatrogenic thrombosis within the heart is rare following intracardiac operations. We undertook surgery to correct a 30-month-old girl with Fallot's tetralogy. After a period of 6 months following the operation, echocardiography revealed a thrombus measuring 16 by 12 millimetres attached to the tendinous cords supporting the antero-superior leaflet of the tricuspid valve. Medical treatment having failed, we proceeded to surgical excision so as to avoid pulmonary embolisation. Histological examination confirmed the thrombotic nature of the mass.- - - - - - - - - - ranking = 1keywords = nature (Clic here for more details about this article) |
9/11. Laparoscopic cholecystectomy in anticoagulated patients.Although minimally surgically invasive, laparoscopic surgery has yet to be proven safe in patients receiving anticoagulants. Retrospectively, the laparoscopic management of four patients requiring anticoagulation for cardiac valvular prostheses or chronic atrial fibrillation was reviewed with regard to potential hemorrhagic complications. warfarin was discontinued preoperatively in all cases. heparin anticoagulation was individualized according to each patient's risk for thrombosis. Laparoscopic cholecystectomy and intraoperative cholangiography were completed in each patient without resulting hemorrhagic complications. The operative management of patients exhibiting cholecystitis may be complicated by anticoagulation therapy required for preexisting conditions/diseases such as cardiac valve prostheses, chronic atrial fibrillation, deep venous thrombosis, and pulmonary embolism. The minimally invasive nature of laparoscopic surgery lends itself well to cholecystectomy required in the face of anticoagulation treatment. This limited initial series of selected patients demonstrates the feasibility and efficacy of laparoscopic cholecystectomy in patients receiving anticoagulants.- - - - - - - - - - ranking = 1keywords = nature (Clic here for more details about this article) |
10/11. Group C beta-hemolytic streptococcal endocarditis: report of a pediatric case.A 9-year-old boy with a ventricular septal defect and a bicuspid aortic valve developed bacterial endocarditis due to group C streptococci. He responded to an initial antibiotic regimen of nafcillin plus gentamicin and was cured by the use of penicillin g following the isolation of the organism. The unusual nature of this case is discussed and physicians are cautioned to recognize this organism as a potential cause of infectious endocarditis in the pediatric population.- - - - - - - - - - ranking = 1keywords = nature (Clic here for more details about this article) |
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