1/50. Chronic constrictive pericarditis induced by long-term bromocriptine therapy: report of two cases.OBJECTIVE: To report two cases of chronic constrictive pericarditis that appear to be related to the intake of bromocriptine for Parkinson's disease. CASE SUMMARY: Two white men (aged 63 and 69 y) were treated with bromocriptine for four (40 mg/d) and two years (30 mg/d), respectively, with a cumulative dose intake of 58.4 and 21.9 g, respectively. The patients experienced dyspnea with bilateral lower-limb edema and pleural effusion, suggesting right cardiac dysfunction. echocardiography, computed tomography, and cardiac catheterization results were compatible with a diagnosis of constrictive pericarditis, so pericardectomy was performed on both patients. The anatomic pathology examination showed a fibrous pericardium; cultures were sterile. In the first case, pleural effusion recurred seven months after the pericarditis; bromocriptine was suspected and treatment was discontinued. In the second case, just prior to the pericardectomy, an episode of mental confusion occurred and prompted the cessation of bromocriptine therapy. DISCUSSION: To the best of our knowledge, only one case of constrictive pericarditis induced by bromocriptine therapy has previously been described in the literature. CONCLUSIONS: Our cases call attention to a possible association between bromocriptine use in patients who have Parkinson's disease and constrictive pericarditis.- - - - - - - - - - ranking = 1keywords = dysfunction (Clic here for more details about this article) |
2/50. Respiratory bronchiolitis associated with severe dyspnea, exertional hypoxemia, and clubbing.Respiratory bronchiolitis-associated interstitial lung disease (RBILD) is a distinct clinicopathologic disease described almost exclusively in cigarette smokers.(1) (2) The disease usually presents with mild symptoms and is associated with a good prognosis. (2) Severe lung dysfunction has not been reported with RBILD, which is often confused clinically and radiographically with desquamative interstitial lung disease or idiopathic pulmonary fibrosis (IPF). Two patients with RBILD who developed severe dyspnea, hypoxemia, and clubbing are described. Initially, IPF was diagnosed in both patients. The severity of symptoms was such that the first patient's room air saturation was 85% and the second patient had severe impairment of lung function, with FEV(1) of 39% and FVC of 40%. Advanced lung disease required supplemental home oxygen therapy in the first patient and referral for lung transplant evaluation in the second patient. After a detailed review of histology revealed a diagnosis of RBILD, both patients were encouraged to stop smoking; smoking cessation led to considerable improvement in symptoms and lung function tests. We conclude that advanced lung dysfunction occurs in some patients with RBILD and should not dissuade that diagnosis.- - - - - - - - - - ranking = 2keywords = dysfunction (Clic here for more details about this article) |
3/50. Reversible left ventricular dysfunction "takotsubo" cardiomyopathy associated with pneumothorax.An 83 year old woman presented to the emergency department with chest pain and dyspnoea. Chest radiography showed pneumothorax of the left lung. arteries were normal on coronary angiography. Left ventriculography showed asynergy of apical akinesis and basal hyperkinesis. Within 18 days, the asynergy improved without any specific treatment. In the present case the left ventricular dysfunction may have been induced by altered catecholamine dynamics as a result of pneumothorax.- - - - - - - - - - ranking = 195.86140771791keywords = ventricular dysfunction, dysfunction (Clic here for more details about this article) |
4/50. Congenitally corrected transposition of the great arteries in a 65-year-old woman.A 65-year-old Japanese woman was admitted to hospital because of exertional dyspnea. Transthoracic echocardiography showed diffuse hypokinesis of the left-sided ventricular wall, but was not clear enough to provide useful information because of the rotation of the cardiac apex and the presence of lung tissue. Systemic ventriculography showed that the left-sided ventricle with heavy trabeculations was morphologically similar to a normal right ventricle. Magnetic resonance imaging (MRI) clearly revealed corrected transposition of the great arteries. Because this patient had no severe associated cardiac anomalies, systemic ventricular dysfunction is thought to be the major cause of exertional dyspnea. MRI is a useful non-invasive method for the rapid evaluation of cardiac morphology.- - - - - - - - - - ranking = 39.172281543583keywords = ventricular dysfunction, dysfunction (Clic here for more details about this article) |
5/50. Reversible restrictive cardiomyopathy due to light-chain deposition disease.Systemic light-chain deposition due to plasma cell dyscrasias manifests as a form of restrictive cardiomyopathy with diastolic ventricular dysfunction. Although these manifestations are likely to be cardiac amyloidosis, whether these pathological conditions are reversible after treatment of the underlying plasma cell disorders is unknown. To our knowledge, we describe the first patient with cardiac light-chain deposition due to multiple myeloma in whom echocardiographic and biochemical factors of cardiac function were ameliorated dramatically after remission of this disorder. We emphasize that restrictive cardiomyopathy due to light-chain deposition may be reversible and have a relatively better prognosis after remission of plasma cell dyscrasias.- - - - - - - - - - ranking = 39.172281543583keywords = ventricular dysfunction, dysfunction (Clic here for more details about this article) |
6/50. Apical hypertrophic cardiomyopathy: clinical, electrocardiographic, scintigraphic, echocardiographic, and magnetic resonance imaging findings of a case.The apical variant of nonobstructive hypertrophic cardiomyopathy (HCM) constitutes a minority of all cases of HCM and generally carries a favorable clinical outcome. We describe a 68 year-old Caucasian woman who presented with exertional dyspnea. The patient underwent stress testing with electrocardiogram-gated single-photon emission computed tomography imaging and resting transthoracic echocardiography. The patient also underwent cardiac magnetic resonance imaging at rest, including conventional structural and functional imaging and cine complementary spatial modulation of magnetization-tagged imaging (CSPAMM). The noninvasive evaluation of the heart demonstrated apical hypertrophy with regional systolic dysfunction, establishing the diagnosis of apical HCM. This case suggests a potential value of CSPAMM in characterizing apical HCM.- - - - - - - - - - ranking = 1keywords = dysfunction (Clic here for more details about this article) |
7/50. vocal cord dysfunction: more morbid than asthma if misdiagnosed.vocal cord dysfunction may lead to respiratory distress, which in turn may cause the misdiagnosis of asthma. We present two adolescents who were misdiagnosed as asthmatic and aggressively treated for asthma with resulting iatrogenic complications. vocal cord dysfunction simulating or coexisting with asthma should be considered especially in patients with frequent emergency visits for episodic dyspnea despite aggressive treatment.- - - - - - - - - - ranking = 6keywords = dysfunction (Clic here for more details about this article) |
8/50. Left ventricular pseudoaneurysm after myocardial infarction.In this report, a case of a left ventricular (LV) pseudoaneurysm due to a previous myocardial infarction, which was repaired successfully, is described. A 62-year-old man, with a history of acute anterior wall myocardial infarction 6 months previously, was admitted with the complaints of acute dyspnea and palpitation. echocardiography revealed an LV aneurysm, and ventriculography showed ventricular dysfunction and an LV pseudoaneurysm. coronary angiography showed total occlusion of the proximal segment of the left anterior descending artery with a very thin lumen and insufficient retrograde filling. Under cardiopulmonary bypass and beating heart, the pseudoaneurysm was resected and the defect on the ventricular free wall was closed by the remodeling ventriculoplasty method of Dor. Histopathologic examination of the resected material confirmed the diagnosis of pseudoaneurysm. The postoperative course of our patient was uneventful. He was discharged on the ninth postoperative day.- - - - - - - - - - ranking = 39.172281543583keywords = ventricular dysfunction, dysfunction (Clic here for more details about this article) |
9/50. Acute left ventricular failure after large volume pericardiocentesis.This paper reports on two cases of large volume pericardiocentesis followed by transient severe acute left ventricular (LV) systolic failure in the absence of any prior history of LV dysfunction. Acute LV volume overload due to interventricular volume mismatch is believed by most authors to be the cause for this phenomenon. Another plausible physiopathologic explanation is the acute increase in "wall stress" (Laplace's law) due to acute distention of the cardiac chambers secondary to a sudden increase in venous return at high filling pressures, combined with a "vacuum" effect of the evacuated pericardial space.- - - - - - - - - - ranking = 1keywords = dysfunction (Clic here for more details about this article) |
10/50. Tachycardiomyopathy: a diagnosis not to be missed.The prognosis of dilated cardiomyopathy is generally poor. In the vast majority of cases the cause of the ventricular dysfunction is irreversible but occasionally potentially curable causes are identified. Tachycardiomyopathy is a rare and potentially treatable cause of heart failure. A patient with a particularly severe case who had an excellent outcome is presented.- - - - - - - - - - ranking = 39.172281543583keywords = ventricular dysfunction, dysfunction (Clic here for more details about this article) |
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