Clinical aspects A 55-year-old patient with arterial hypertension and heart failure for one year and with chest pain, had a cardiorespiratory arrest five months before, developed heart failure and mitral regurgitation due to mitral valve prolapse and rupture of chordae tendineae. The diagnostic impression is that heart failure due to mitral valve disease preceded the episode of precordial pain and severe dyspnea. […]

Clinical Case A 64-year-old woman with a history of Diabetes and Hypertension was admitted to the emergency department with acute dyspnea and chest pain. Physical examination revealed hypertension, sinus tachycardia (150 bpm), acute pulmonary edema and poor extremity perfusion. In the context of respiratory failure and hemodynamic instability, she required invasive mechanical ventilation. Blood works showed increased levels of hs-TroponinT (rising from 800 to 1600 ng/L) and the ECG showed poor R wave progression and incomplete right bundle branch block. […]

Clinical Aspects This is a 55-year-old male patient known to have insulin dependent DM and CKD who in February 2017 had a nocturnal episode of dyspnea. Due to the episode, he sought medical care in the emergency room, where changes in markers of myocardial necrosis were identified – increased CKMB and troponin, as well as ST-segment depression from V2 to V6 on the ECG. A coronary angiography was performed at the time showing only a 30% lesion in the right […]

Clinical aspects Chagas’ disease was first described by Brazilian physician and scientist Carlos Chagas in 1909. This multifaceted disease is caused by the protozoan Trypanosoma cruzi, which can be transmitted in different ways. Vector transmission through hematophagous insects is the most classic one, although it has declined in importance in recent years with measures to control the vector population. Transfusion transmission, as well as vector transmission, have shown a drastic reduction in the last decades, and no cases have been […]

Clinical aspects This is the case of a young, male patient, smoker, who had hypothyroidism post-treatment with radioactive iodine, who sought medical care due to symptoms of dyspnea and cough for a week; these complaints had been preceded by chest pain at exertion two weeks before. The medical evaluation at the first consultation was notable for the presence of tachycardia and mild leukocytosis in the whole blood count. The chest X-ray was normal despite the presence of dyspnea at rest. […]

Clinical aspects The patient developed arrhythmia at 26 years of age. At age 33, in 2013, he developed heart failure, which rapidly progressed to functional class IV, with consecutive hospitalizations due to acute decompensation. In 2015, after the last hospitalization, he was placed on the priority list for heart transplantation due to clinical treatment refractoriness. In March 2016 he underwent the procedure and remained asymptomatic, being followed through outpatient clinic consultations since April 2017. This is a heart failure case […]

Clinical aspects This was a male patient, who presented with ascending aortic dissection, and who, even after surgery for dissection repair, developed a picture of severe heart failure and died. The International Registry of Acute Aortic Dissection (IRAD) showed that patients with aortic dissection were older than our patient, 61 years; and a majority of males (63%). Regarding the diseases related to the dissection, they were: Marfan syndrome (6.7%), hypertension (69.3%), atherosclerosis (24.4%), previously known aortic aneurysm (12.4%), previous aortic […]

Clinical aspects This patient is a 67-year-old woman with cardiovascular risk factors and ischemic cardiomyopathy, with severe left ventricular systolic dysfunction. Cardiac catheterization disclosed multivessel coronary disease and apical akinesis with an intracavitary thrombus. During outpatient follow-up, clinical treatment was chosen, possibly influenced by the patient’s clinical status, as well as the characteristics of the coronary anatomy. The indication of surgical treatment with myocardial revascularization in patients with coronary heart disease with heart failure and severe left ventricular systolic dysfunction […]

Clinical aspects The case reported is of a 36-year-old pregnant woman with repaired complex congenital heart disease, with a mechanical mitral valve prosthesis implanted 28 years before, paroxysmal atrial fibrillation, and a history of thromboembolism, a triad that characterizes a high thromboembolic risk. Notwithstanding, the patient maintained the adequate anticoagulation goal (INR = 3) until the pregnancy diagnosis, when the anticoagulation regimen of warfarin was replaced by enoxaparin due to the risk of fetal warfarin syndrome, which occurs between the […]