Introduction The left main coronary artery (LMCA) originates from the left sinus of Valsalva, passes between the main pulmonary artery and the left atrial appendage before entering the coronary sulcus and bifurcates into the left anterior descending (LAD) and the left circumflex (LCX) coronary arteries. In most individuals, the LMCA supplies ≈75% of the left ventricle (LV). Significant stenosis, which may lead to stable angina and/or acute coronary syndrome, places the patient at risk of life-threatening acute left ventricular failure […]

Introduction Sweet Syndrome is an acute febrile neutrophilic dermatosis characterized by an association of fever, neutrophilia, tender erythematous skin lesions (papules, nodules, and plaques), as well as pathologic findings consisting predominantly of mature neutrophils typically located in the upper dermis. It is a rare condition with a worldwide distribution which can present as one of three main clinical types: idiopathic, malignancy-associated, or drug-induced. – Extracutaneous manifestations may occur but cardiovascular involvement is extremely rare. , […]

Introduction The presence of a left bundle branch block (LBBB) in the apparent absence of any other heart disease raises questions and concerns about the stratification of the risk of subsequent cardiovascular events or symptoms. – The detection of LBBB in asymptomatic adults, including athletes, is estimated to range between 0.1% and 0.8%, which is more likely to represent a structural heart disease rather than a physiological response to exercise. – On the other hand, some studies have shown that […]

Case Report A 29 year-old female patient with double inlet left ventricle, ventricle septal defect, malposition of the great arteries and subpulmonary obstacle, submitted to a modified Fontan procedure, at 9 years of age, presented with severely symptomatic brady-tachy syndrome (palpitations and syncope). Since venous access to the right ventricle was absent (due to the surgical redirection of venous blood flow from the right atrium to the pulmonary artery bypassing the ventricles) and the AV conduction was normal, it was […]

Introduction Cerebrotendinous xanthomatosis (CTX) is an autosomal recessive disease characterized by the formation of xanthomatous lesions in many tissues, particularly the brain and tendons. The disorder is a consequence of the reduced production of bile acids, predominantly chenodeoxycholic acid (CDCA), and an increased formation of cholestanol. Common clinical manifestations include infant-onset diarrhea and juvenile-onset bilateral cataract, usually followed by tendon xanthomas and progressive neurological dysfunction. The final diagnosis is based on biochemical abnormalities, including elevated plasma cholestanol level and increased […]

Introduction Metastases to the heart and pericardium are much more common than primary cardiac tumors and are generally associated with a poor prognosis. , While they are most commonly asymptomatic, cardiac metastases can mimic primary cardiac diseases such as acute coronary syndromes, congestive heart failure and pericarditis. , Lung cancer is the most frequent source of metastatic cardiac disease, either from direct extension or by a combination of lymphatic, hematogenous, and transvenous dissemination. , […]

Introduction The incidence of mechanical complications (MC) after myocardial infarction (MI) was reduced to less than 1% with the routine use of primary reperfusion therapies. MC are classified as early, including acute and subacute forms, and late or chronic. The former mostly present as cardiogenic shock and the latter may vary from asymptomatic to sudden death. As all of these conditions may have potentially lethal consequences, timely diagnosis and treatment is necessary. – […]

Clinical Data The fetal diagnosis of complex cardiac anomaly (Double-outlet right ventricle, severe pulmonary stenosis due to anterior deviation of the infundibular septum, trabecular interventricular septal defect and hypoplasia of the left ventricle and mitral valve) was confirmed shortly after birth with severe hypoxia, relieved by prostaglandin E1 administration and dilation of the ductus arteriosus by percutaneous stent. With the recurrence of more severe hypoxia, the bidirectional Glenn operation was performed at 9 months of age. Good patient evolution was […]

Clinical data The patient evolved without symptoms, doing her usual activities of daily living, such as housekeeping and dressmaking, when total atrioventricular block was identified during a routine evaluation with a heart rate of 66 bpm. At this time, a diagnosis of corrected transposition of the great arteries was made through the echocardiogram, with mild left atrioventricular valve regurgitation. Due to insufficient chronotropism and binodal disease, an atrioventricular pacemaker was placed on the right when she was 59 years old. […]

Clinical Data The newborn, in heart failure with truncus arteriosus type I, underwent repair at 15 days of age, weighing 2800 g. of body weight, by the Barbero-Marcial technique. At that time, the right ventricular outflow tract was approached directly with the pulmonary trunk and a monocusp valve was placed in the pulmonary position. The evolution was adequate, with heart failure control, and he remained asymptomatic and showed normal physical development. The clinical examination ruled out residual lesions, such as […]