Clinical aspects This is about a 59-year-old woman with double mitral lesions with pulmonary hypertension who, while awaiting surgery, had arterial hypotension, respiratory failure with hypotransparency in the right lung field. It evolved without improvement with vasoactive drugs, orotracheal intubation and antibiotic therapy, and she passed away in electrical activity without pulse. The etiology of this patient’s valve disease should be attributed to rheumatic fever, although there is no description of an acute outbreak of that disease in the patient’s […]

Clinical aspects This 60-year-old patient had the following problems: dyspnea, dry cough, weight loss, slightly elevated body temperature, anemia, enlarged pulmonary hila, hilar calcifications (lymph nodes) and pulmonary nodule (granuloma with necrosis). In addition, she had the following antecedents: Chagas disease (not confirmed, because no serology for Chagas disease was performed), systemic arterial hypertension, heart failure with reduced ejection fraction, and previous akinetic areas, apical aneurysm and sustained ventricular tachycardia. Of the granulomatous diseases, sarcoidosis has unspecific symptoms, such as […]

Clinical aspects The patient here reported is a male elderly with ischemic cardiomyopathy, and significant weight loss in the previous 4 months, in addition to worsening of his general state of health and clinical instability in the 24 hours prior to admission. Some diagnostic possibilities could explain his significant weight loss. Cardiac cachexia is a frequent complication in the advanced stages of congestive heart failure (CHF) and associates with shorter survival. The physiopathology of that disorder has been first described […]