Cannabis is the most widely used illicit drug in the world. It is generally considered to be a drug with low toxicity. Nevertheless, there are several case reports of myocardial infarction following cannabis use in otherwise low-risk individuals. We report the first case of a cannabis user presenting with acute coronary syndrome related to multivessel coronary artery dissection.
Caseous calcification of the mitral annulus (CCMA) is a rare echocardiographic finding. It is commonly misdiagnosed as an abscess, tumor or infective vegetation on the mitral valve. Since it is a benign process, differentiating it from malignant intra-cardiac mass is primordial to avoid unnecessary surgery. Various imaging modalities can be complimentary for definitive diagnosis. We present a case of CCMA in a 71-year-old female patient. Her medical history revealed hypertension, diabetes mellitus, hyperlipidaemia and coronary artery disease. She was referred to our department for coronary catheterization because of angina symptoms upon minimal exertion. The lesion was detected during echocardiography and was defined as a mass of heterogeneous content with calcification points, located at the posterior side of the mitral valve annulus. Restricted motion of the posterior leaflet and the mass effect caused only minimal mitral regurgitation. To establish the correct diagnosis, we performed the full spectrum of noninvasive cardiac imaging modalities. Transesophageal echocardiography identified well-organized, composite lesion with regular edges, markedly calcified margins and more echolucent central portion. A computed tomography (CT) was performed, showing a hyperdense mass with hypodense center and a calcified peripheral rim located at the posterior mitral ring. Cardiac magnetic resonance imaging (MRI) showed that the mass was hypointense with respect to the myocardium in the T1 and T2-weighted sequences and only presented late-phase enhancement in the surrounding capsule. Based on the CT and MRI findings, the diagnosis of CCMA was established. The patient was managed conservatively.
Although pericarditis is the most prevalent cardiac involvement in systemic lupus erythematosus (SLE), cardiac tamponade is extremely infrequent notably as the first manifestation of the disease. Here we report the case of a 22-year-old woman presenting with cardiac tamponade as the initial presentation of SLE.
Aims: To evaluate the relationship between inflammatory biomarkers and lipid parameters in a Tunisian coronary artery disease group. Material and Methods: In the study, we have included 122 subjects with acute coronary syndrome (ACS) confirmed by coronary angiography, selected among patients admitted to the cardiology department and 162 subjects free of any cardiovascular disease, recruited from medical and paramedical volunteers. Lipid parameters, high sensitivity CRP (hsCRP) and proinflammatory cytokines (IL6, IL8 and TNFα) were determined for all patients and controls. Results: A highly significant difference (P < 10 −3 ) was noted between the mean of the hsCRP in coronary patients (14.65 ± 9.81 mg/L) compared to controls (1.63 ± 1.75 mg/L). We note also a significant difference between the means of IL6 in the diseased population (11.56 ± 8.23 pg/mL) compared to controls (2.5 ± 0.84 pg/mL) with a value of P < 10
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