Cardiac hemangioma is extremely rare. We encountered two patients with cardiac hemangioma detected by thoracic echocardiography during a medical checkup. In the first case, transthoracic echocardiography revealed a pedunculated tumor in the left ventricle. Selective left coronary angiography demonstrated that the main feeding artery of the tumor arose from the third diagonal branch of the left anterior descending coronary artery. In the second case, thoracic and transesophageal echocardiography showed an oval tumor arising from the right atrium. Both tumors were successfully resected. Histopathological examination revealed that one of the tumors was a capillary hemangioma and the other was a mixed capillary and cavernous hemangioma. After operation, both patients had an uneventful recovery without any complications.
Background Bepridil hydrochloride (Bpd) has attracted attention as an effective drug for atrial fibrillation (AF) and atrial flutter (AFL). However, serious adverse effects, including torsade de pointes (Tdp), have been reported. Methods and Results Adverse effects of Bpd requiring discontinuation of treatment were evaluated. Bpd was administered to 459 patients (361 males, 63±12 years old) comprising 378 AF and 81 AFL cases. Mean left ventricular ejection fraction and atrial dimension (LAD) were 66±11% and 40±6 mm, respectively. Adverse effects were observed in 19 patients (4%) during an average follow-up of 20 months. There was marked QT prolongation greater than 0.55 s in 13 patients, bradycardia less than 40 beats/min in 6 patients, dizziness and general fatigue in 1 patient each. In 4 of 13 patients with QT prolongation, Tdp occurred. The major triggering factors of Tdp were hypokalemia and sudden decrease in heart rate. There were no differences in the clinical backgrounds of the patients with and without Tdp other than LAD and age, which were larger and older in the patients with Tdp. Conclusion Careful observation of serum potassium concentration and the ECG should always be done during Bpd administration, particularly in elderly patients. (Circ J 2006; 70: 662 -666)
SUMMARYWe report 2 cases with an isolated single coronary artery who underwent successful primary coronary intervention for acute coronary syndrome. Although coronary angioplasty with stenting may be a feasible therapeutic option for atherosclerotic stenosis in a single coronary artery, the operator should be aware of the potential risk of complications. (Jpn Heart J 2003; 44: 759-765) Key words: Anomalous coronary artery, Percutaneous coronary intervention AN isolated single coronary artery is a rare anomaly, with an incidence of 0.044% to 0.23%. [1][2][3] In this anomaly, only one coronary artery arises from the aortic trunk by means of a single coronary ostium supplying the entire heart. With improvements in equipment and operator experience, primary coronary intervention has become a gold standard treatment for acute coronary syndrome. However, only 5 case reports of coronary intervention for a single anomalous coronary artery have been published in the English literature. [4][5][6][7][8] We report 2 cases with an isolated single coronary artery who underwent successful primary coronary angioplasty and stenting for acute coronary syndrome.
CASE REPORTCase 1: A 75-year-old Japanese male was admitted to our hospital on June 22, 1999 because of new onset of angina. He had several coronary risk factors including diabetes, hypertension, and smoking. He also had suffered a cerebral infarction 3 years previously. Electrocardiogram (ECG) revealed ST depression in
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