IntroductionTuberculosis (TB) can present both in its pulmonary or extra-pulmonary forms. Cardiac tuberculoma previously described only after autopsy is continuously seen with the advent of more advanced imaging modalities.Case reportA 23-year-old male with a four month history of a progressively increasing left anterior thoracic wall mass of 5 cm in diameter was referred from oncology for clinical re-evaluation and for echocardiography. Systemic examination was essentially normal. Transthoracic and trans-oesophageal echocardiography showed the presence of a pericardial mass around the right atrioventricular junction. Thoracic CT scan showed an anterior mass in left chest wall extending to the pericardium and also the presence of mediastinal lymphadenopathy. Mantoux test was positive and histological examination of tissue biopsy confirmed the presence of TB. However, blood tests and culture of aspirated purulent fluid were unyielding. A diagnosis of pericardial tuberculoma with mediastinal and parietal extension was made and patient was successfully treated with standard anti-TB chemotherapy.DiscussionThe possible differential diagnoses for chest wall tumors are varied and a high degree of suspicion is needed to diagnose cardiac tuberculoma especially in endemic regions. Imaging though helpful in morphological description cannot make precise diagnosis. The diagnosis depends on histological and culture studies. There is usually a good evolution with anti-TB treatment.ConclusionIn an era of an increasing number of acquired immune-compromised patients, and with increasing number of diagnoses of tuberculosis, a diagnosis of cardiac tuberculoma should be considered in patients presenting with a thoracic wall mass.
Hemodynamic instability secondary to left atrial (LA) compression by an aortic aneurysm is a rare entity. We report the case of a 43-year old woman with no previous diagnosis of congestive heart failure who was admitted for an initial diagnosis of pulmonary embolism (PE) based on shortness of breath, hypotension and D-Dimers elevation. The electrocardiogram and blood counts were within normal limits. The chest X-ray revealed widening of the mediastinum. Transthoracic echocardiography demonstrated LA compression by a large descending thoracic aortic aneurysm. Left and right ventricle systolic functions were preserved. Chest angiography showed LA and left pulmonary artery (LPA) compression by a descending aortic aneurysm and an intramural hematoma with no evidence of PE evidence. Emergency surgery could not be done because of her financial status. She was treated medically and was discharged 1 week later with significant improvement. However she remained hypotensive.
Background: First described in 1908, TAK has now been recognized as a non-specific inflammatory disease of unknown etiology, predominantly affecting young females. Sometimes, it progresses into relatively rare and potentially fatal scenarios such heart failure. Case Presentation: Here, we present the case of a 50-year sub-saharan female suffering from acute heart failure related to TAK. Despite constitutional symptoms (fever, malaise, weight loss) and more characteristic features such claudication of lower extremities, carotydinia, and pulseless syndrome, diagnosis of TAK was delayed since main presentation was heart failure. Immunosuppressive and anticoagulant therapies have induced improvement in cardiac manifestations. Conclusion: Early diagnosis and proper treatment can protect the patient from dangerous complications such heart failure.
Introduction: Hypertension is a major public health problem in Sub-Saharan Africa. Current recommendations place particular emphasis on ambulatory measures compared to clinical ones for the diagnosis and monitoring of treated hypertensive patients. This is how we conducted this study which aims to assess the contribution of ambulatory blood pressure measurement (ABPM) in our practice. Materials and methods:This was a descriptive cross-sectional study carried out at the cardiology department of the Aristide Le Dantec teaching hospital over a period of twelve ( 12) months (January 1, to December 31, 2018). Results:We collected 122 patients during the study period, with a female predominance (M / F sex ratio = 0.69). The average age of the population was 53.22 ± 13.19 years.The indication for ABPM was a therapeutic evaluation in 81 patients (66.40%), with a diagnostic aim of hypertension for 41 patients (33.60%) including 5 cases of Pregnancy-induced hypertension. ABPMs were normal in 30% of cases. The nycthemeral average was 140 ± 18.66 for systolic blood pressure and 84.02 ± 14.56 for diastolic blood pressure. Among the abnormal measures, we noted 45.90% of dipper subjects, and 41% of non-dippers. In the therapeutic evaluation, hypertension was controlled in 22 patients (27.2%) and uncontrolled in 59 cases (72.80%). In the diagnostic indication, hypertension was confirmed in 23 cases (63.9%) and a white coat hypertension was found in 13 cases (36.1%). Pregnancy-induced hypertension was confirmed in 3 out of 5 patients (60%). Conclusion:This study showed the importance of ABPM as a diagnostic and therapeutic evaluation tool. Its rational use in our context would improve the care of hypertensive patients and thus prevent damage to target organs.
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.
hi@scite.ai
10624 S. Eastern Ave., Ste. A-614
Henderson, NV 89052, USA
Copyright © 2024 scite LLC. All rights reserved.
Made with 💙 for researchers
Part of the Research Solutions Family.