Re: Spontaneous coronary artery dissection.
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Aortic Dissection↗
Biomedical subjects
J Fernando Val-Bernal
Publications and source records attributed to J Fernando Val-Bernal.
Incidental detection of an asymptomatic papillary fibroelastoma on a control biopsy of a heart transplant recipient.
BACKGROUND: Papillary fibroelastoma (PFE) of the right ventricle is a rare lesion. This tumor has not been described in the heart of a cardiac transplant recipient. METHODS AND RESULTS: We report a 42-year-old woman suffering from chronic ischemic cardiopathy who underwent an orthotopic cardiac transplantation. Five years after surgery, the control two-dimensional echocardiography showed no abnormalities. At this time, the programmed endomyocardial biopsies of the right ventricle included a 2-mm lesion that was diagnosed as PFE. To our knowledge, only a previous case of this tumor has been detected at random in a control cardiac biopsy. Differential diagnosis includes chordae tendinae removed at the time of cardiac sampling, Lambl excrescence, and myxoma. CONCLUSION: PFE can arise in a cardiac transplant recipient and may be detected on a random programmed biopsy.
Adult↗
Incidental localized (solitary) epithelial mesothelioma of the pericardium: case report and literature review.
Primary mesotheliomas of the pericardium are rare tumors. They may occur in diffuse, multiple, and localized forms. Most of the pericardial mesotheliomas are multiple or diffuse growths encasing the heart, localized forms being distinctly uncommon. We report a localized mesothelioma of the pericardium found incidentally at the autopsy of a 76-year-old woman. The neoplasm measured 3.6 x 2.4 x 2.5 cm., was well circumscribed, and affected the entire thickness of the myocardium extending from the epicardium to the endocardium of the anterior wall of the right ventricle. The tumor was epithelial in type, showed an immunohistochemical profile compatible with mesothelioma, and was DNA aneuploid. A review of the literature yielded four cases of localized pericardial mesothelioma, including the present. Most cases are seen in women and are of the epithelial variant. There is a wide age range at presentation. Localized mesotheliomas are capable of aggressive behavior. Nevertheless, in contrast to diffuse tumors, complete surgical excision may be curative. Differential diagnosis includes solitary fibrous tumor, synovial sarcoma, epithelioid angiosarcoma, and adenomatoid tumor of the pericardium.
Adenoma↗
Churg-Strauss syndrome and sudden cardiac death.
Churg-Strauss syndrome is a rare disorder characterized by necrotizing vasculitis, granulomas with eosinophilic necrosis, and tissue infiltration by eosinophils. Sudden cardiac death is rarely described in Churg-Strauss syndrome. In this article, we describe a case of Churg-Strauss syndrome with multiorgan involvement manifested as sudden cardiac death. To the best of our knowledge, this form of presentation has not been reported. A 49-year-old woman was found dead in her room. No premonitory complaints had been noted during the days preceding her death. Past medical history did not reveal any relevant illness. At autopsy, multiorganic Churg-Strauss syndrome with prominent cardiac involvement was found. Therefore, this syndrome in the active vasculitic phase may be asymptomatic and may involve predominantly the heart. This variant of the syndrome may be fulminant and present as sudden cardiac death. This form can only be elucidated by autopsy study.
Churg-Strauss Syndrome↗