Background Systemic sclerosis is a multisystemic character autoimmune disease. It is characterized by vascular dysfunction and progressive fibrosis affecting mainly the skin but also different internal organs. All heart structures are commonly affected, including the pericardium, myocardium, and conduction system. However, tachycardia–bradycardia syndrome is not common in the literature as a cardiac complication of systemic sclerosis. Case presentation We report a case of tachycardia–bradycardia syndrome in a 46-year-old Moroccan woman followed for systemic sclerosis with cutaneous, vascular, and articular manifestations. The diagnosis was based mainly on patient-reported symptoms and electrocardiogram data. A permanent pacemaker was implanted, allowing the introduction of beta-blockers with good outcomes. Conclusions This case aims to show that even minor electrocardiogram abnormalities should be monitored in this group of patients, preferably by 24-hour ambulatory electrocardiogram because they could be a good indicator of the activity and progression of cardiac fibrosis.
Background Wolff-Parkinson-White (WPW) syndrome is a condition characterized by the persistence of an accessory pathway responsible for ventricular pre-excitation that can lead to symptomatic and potentially severe arrhythmias. Coexistence with atrial fibrillation is well known and not uncommon, exposing to potential degenerescence into ventricular fibrillation when atrial impulses are transmitted along the accessory pathway. WPW syndrome is most prevalent in younger patients and cases revealed after an advanced age have rarely been described in the literature. Case presentation Here, we report a case of atrial pre-excitation first diagnosed at the age of 72 years that required external electrical cardioversion with a favorable outcome. The diagnosis was based on clinical and electrographic findings. Conclusions WPW syndrome is a relatively rare cardiac disorder that can be a cause of sudden death, especially when combined with atrial fibrillation. Therefore, cardiologists have to consider this diagnosis in patients presenting clinical signs of arrhythmia with an electrical pattern of WPW.
Acute stent malapposition poses a significant risk for adverse cardiac events following percutaneous coronary intervention. Detection of acute stent malapposition traditionally relies on intracoronary imaging techniques, such as intravascular ultrasound and optical coherence tomography, which may be limited in developing countries due to accessibility issues. A new angiographic sign called the POT-PUFF sign has been introduced as a potential alternative for detecting malapposition during coronary bifurcation procedures. Here, we present two clinical cases from a developing country where the POT-PUFF sign was employed to assess the result of proximal optimization therapy after stent implantation. The POT-PUFF sign exhibits potential as an affordable and feasible approach for assessing stent malapposition in settings with limited resources.
Background: Acromegalic cardiomyopathy is a significant cardiovascular complication associated with acromegaly, a rare condition caused by excessive growth hormone production from a pituitary adenoma. While acromegaly often presents with distinct physical changes, early diagnosis can be challenging due to its insidious nature, leading to delayed recognition and the presence of multiple comorbidities at the time of diagnosis. Cardiovascular disease is the most common comorbidity in acromegaly, contributing to significant morbidity and mortality. Case presentation: This case report describes a non-hypertensive patient who presented with biventricular hypertrophy, revealing the presence of acromegalic cardiomyopathy at the age of 54. The diagnosis relied on information from clinical examination, imaging tests, and biological data. The patient successfully underwent transsphenoidal surgery to remove the pituitary adenoma, resulting in a positive outcome. Conclusions: Acromegaly patients have higher mortality rates compared to healthy individuals due to the wide array of associated comorbidities, consequently leading to a reduced life expectancy. Hence, early diagnosis and management, particularly before the age of 40, play a crucial role in mitigating the cardiovascular risks associated with acromegaly.
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