Alveolar hemorrhage (AH) is a heterogeneous clinical syndrome with a high mortality rate, characterized by extensive bleeding into the alveolar spaces. AH secondary to systemic thrombolysis treatment in the setting of acute myocardial infarction is an uncommon complication, but potentially fatal and can lead to acute respiratory failure. This entity is rarely reported in the literature. We report two cases of acute AH after intravenous thrombolysis for acute myocardial infarction, which could contribute to the literature on the subject, and discuss the risk factors as well as the clinical and radiological findings supporting the diagnosis. We overview also the rare previous published case reports in this context, and we contrast our findings with those reported in the literature.
Atrial myxoma is the most common primary cardiac tumor. We report the case of left atrium myxoma accompanied by severe thrombocytopenia in a 72-years-old woman. The thrombocytopenia has been discovered 5 years ago, it was explored, no obvious cause was found, the diagnosis of idiopathic thrombocytopenia was retained based on clinical and paraclinical arguments, corticosteroid treatment was ineffective and platelet count remains low. Complete surgical excision of the mass was performed. Platelet count was gradually increased to reach 95 103/µl after 6 months postoperatively. In this report, we highlight that thrombocytopenia might be one rare hematological manifestation of myxoma but need more cases for support. By illustrating this association, we hope to facilitate an earlier diagnosis of cardiac myxoma to treat and avoid complications of both thrombocytopenia and myxoma.
Highlights
Mediastinal and pericardial hydatid cysts are very rare even in endemic areas.
Clinical features depend on the size and location of the cysts and involvement of neighboring structures.
The diagnosis is based on ultra-sound examination, CT scan and serology.
Cardiac MRI can provide interesting information in case of discrepancy between echocardiography and CT scan.
The curative treatment of cardiac hydatidosis is above all surgical.
Transient left ventricular (LV) dysfunction syndrome, or Tako-tsubo syndrome, occurs following intense emotional or physical stress and simulates the clinical presentation of an acute myocardial infarction. The prognosis is favorable with normalization of wall motion abnormalities within weeks. In this case we report a young female patient who developed sudden chest pain and consciousness disorder after a profound stress (mother’s death).The patient had characteristic feature of progressive pulmonary edema. Her symptom worsened gradually leading to herintubation. An immediately performed echocardiography showed akinetic mid-to-distal portion of the left ventricular chamber and hyperkinetic activity in basal segment with an ejection fraction (EF) of 25%. Coronary angiography showed normal coronary arteries. After 6 days of monitoring she was extubated and had a cardiac MRI that confirmed the diagnosis of tako-tsubo.
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