[Atrial fibrillation and anticoagulant therapy].
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Biomedical subjects
Publications and source records attributed to A Mokaddem.
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Cardiac sarcoidosis is a multisystem granulomatous disease of unknown etiology, that is more seen in younger adults. The prognosis of myocardial sarcoidosis is poor and depends on arrhythmia, conduction disorders. We report the case of 35 years old woman with cardiac sarcoidosis and pulmonary involvement who presented acutely with sustained ventricular tachycardia well tolerated. She made a good recovery after steroid therapy and administration of antiarrhythmic agent.
Atrial septum aneurysm (ASA) is an uncommon congenital malformation, which is more frequently diagnosed since the introduction of transoesophageal echocardiography. ASA is often involved in the etiology of cerebral and systemic embolic events. The purpose of our study is to determine from our experience the frequency, the diagnostic aspect and therapeutic modalities of ASA. We report in this study 20 cases of ASA collected from the echocardiographic register. The prevalence of this malformation is 0.08%, with a high male predominance. The mean age was 51 years. ASA was detected after brain embolism in 55% of cases. The diagnosis was established in all cases by transesophageal echocardiography, however only 5 cases were diagnosed by Transthoracic echocardiography. The patients showed favorable evolutions after a of follow up of three years.
The Brugada syndrome is a clinical-electrocardiographic diagnosis characterised by syncopal or sudden death episodes in patients with a structurally normal heart with a characteristic electrocardiographic pattern consisting of ST segment elevation in the precordial leads V1 to V3 and a morphology of the QRS complex resembling a right bundle branch block. In many patients with the Brugada syndrome, the electrocardiographic manifestations transiently normalize; leading to underdiagnosis of the syndrome. The administration of sodium channel blockers such as ajmaline, flecainide or procainamide accentuate the ST segment elevation and can be used to unmask concealed and intermittent forms of the disease. The incidence of sudden death in this syndrome is very high and can only be prevented by implanting a cardioverter-defibrillator. Because of high incidence of familial occurrence, the extension of the testing to family members is important.
We report the case of a 32 years old patient, with a known diagnostic of hypertrophic cardiomyopathy; who has presented at the first trimester of pregnancy a ventricular fibrillation treated by electric shock with a favorable outcome. The risks for the mother and the foetus are discussed; The recommendations for the conduct of the delivery are reviewed.
The left atrial spontaneous contrast is uncommon finding during transthoracic échocardiography. Transesophageal echocardiography provides superior imaging of the left atrium and left spontaneous contrast has been detected more frequently by this technique in rheumatic mitral stenosis. In order to analyze the significance of spontaneous contrast, we have studied 100 patients with mitral stenosis. Trans thoracic and transesophageal echocardiography were performed in all patients. Left atrial spontaneous echo contrast was detected in 60 patients (group A) and was absent in 40 patients (group B) The mean of mitral valvular area was 0.9 10.2 mm in group A and 48 9.5 mm in group B (p < 0.001). Ther was a high incidence of atrial fibrillation in group A; 63% VS 12% in group B (p < 0.001). A systemic embolization was noted in 20% of patients in group A; No one of group B has presented this complication (p < 0.001).
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Congenital coronary aneurysms are an unusual anatomical entity. Their prognosis appears to be particularly dependent on the presence or absence of aneurysm thrombosis. We report two cases of congenital coronary aneurysms, diagnosed in one case after myocardial infarction. The two patients were treated successfully by an exclusion of the aneurysm and coronary bypass. The aim of this study is to discuss the clinical features, prognosis and management of this disease.