[Atrial fibrillation and anticoagulant therapy].
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Biomedical subjects
Publications and source records attributed to K Selmi.
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Mobile thrombus of the ascending thoracic aorta is an uncommon source of embolism. We report the case of a 40-year-old woman, without coronary risk factors, who was admitted for an acute myocardial infarction associated with stroke. Transesophageal echocardiography showed the presence of a pedunculated highly mobile thrombus attached to the aortic wall near the right coronary ostium. With appropriate anticoagulation, the thrombus resolved after 2 weeks and no recurrence occurred over the next 18 months. Coronary angiography was normal.
In women with prosthetic heart valves, pregnancy carry a risk for both mother and fetus, requiring an obstetrical and cardiological management at an optimal level. We performed a systematic review of the literature to estimate the maternal and fetal complications and in order to offer pregnant women carrying a prosthetic heart valve the most practical approach enabling reduction of these risks. As there are no available controlled clinical trials, larger prospective studies are needed to provide guidelines for effective antithrombotic therapy.
Hydatid pulmonary embolism is an uncommon condition resulting from the rupture of hydatid heart cyst or the opening of a visceral hydatid cyst often in the liver into the venous circulation. We report a case of 60 years old woman, admitted to hospital for acute heart pulmonale due to fistulization of an hepatic hydatid cyst into the inferior vena cava.
Mitral valve prolapse (MVP) is a common disorder that, in general, has a good prognosis. Rare occasions of sudden death have been reported in patients with MVP and it is presumed that the basis of sudden death is arrhythmias. We report a case of a 47 years old men affected by MVP complicated by ventricular arrhythmias and sinoatrial block; who died suddenly from ventricular tachycardia. The pathophysiology and risk factors of sudden cardiac death in MVP are discussed.
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.
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.
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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.