1/3. Uncommon presentation and surgical correction of unroofed coronary sinus syndrome.A 59-year-old man with signs and symptoms of congestive heart failure, occurring a few months after an infective episode, underwent cardiac investigations revealing severe biventricular dysfunction, persistent left superior vena cava with almost completely unroofed coronary sinus, and critical stenosis of the proximal right coronary artery. Surgical correction of the congenital malformation associated with revascularization of the right coronary allowed a prompt recovery of clinical conditions and ventricular function.- - - - - - - - - - ranking = 1keywords = dysfunction (Clic here for more details about this article) |
2/3. Successful management of CAPD in infants with cardiac failure.Continuous ambulatory peritoneal dialysis (CAPD) was selected and introduced as a primary dialysis method in two infants with cardiac failure. CAPD was started at 14 days after birth with body weight of 2125 gm and at 7 months of age with body weight of 2325 gm. In both cases, cardiac failure was due to large ventricular septal defect (VSD) and renal failure was due to dysplastic kidneys. In the first case (case 1), direct closure of atrial septal defect and patch closure of VSD were successfully completed at 9.5 months of age with body weight of 4844 gm. CAPD has been managed well for 1 year and 8 months and the child reached a body weight of 8440 gm. In the second case (case 2), CAPD was managed well for 11 months with body weight increasing to 4920 gm at the age of 1 year and 7 months. This marked deterioration of this boy's physical growth was mainly caused by the delay in introducing CAPD and partly due to his cardiac dysfunction which has not been corrected surgically. Both cases show almost normal mental development and are managed well at home. Although CAPD introduction yielded water balance and physical growth in these infants, earlier introduction of CAPD may result in better clinical outcomes including management following open heart surgery. Selection of CAPD as a primary dialysis maneuver is strongly recommended for uremic infants with cardiac failure.- - - - - - - - - - ranking = 1keywords = dysfunction (Clic here for more details about this article) |
3/3. "Functional myocardial bridging" and "hyperkinetic state": a rare association as a cause of acute myocardial infarction.An 82-year-old female was admitted to the catheterization laboratory for investigation of acute antero-lateral myocardial infarction with evidence of severe left ventricular dysfunction. Angiographically, she was found to have normal coronary arteries, with the exception of the presence of myocardial bridging in the left anterior descending coronary artery. This was recognized as a "functional" variation of anatomical bridging, in which a systolic coronary compression is caused by abnormal muscular septal hypertrophy. We describe this condition as an unusual cause of myocardial infarction and outline its treatment with beta-blockade therapy, using only esmolol, an ultra-short-acting drug. The patient recovered successfully, with complete recovery of ventricular function and the disappearance of this "functional condition", as shown in an angiographic check-up done prior to hospital discharge. A subsequent long-term follow-up was favorable.- - - - - - - - - - ranking = 1keywords = dysfunction (Clic here for more details about this article) |