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  • ISSN: 2333-6676
    Volume 6, Issue 1
    Case Series
    Vishwanath Hesarur*, and Suresh V Patted
    Introduction: Double chambered right ventricle (DCRV) is a rare congenital anomaly in which right ventricle (RV) is divided into two chambers by anomalous muscle band (AMB), a proximal high-pressure and distal low pressure chamber. Most of DCRV cases present during childhood, however, less commonly manifest in adulthood because of the nonspecific nature of symp¬toms leading to a delayed diagnosis. However, there are very few studies of DCRV in adults with regard to clinical features, hemodynamic data, treatment and prognosis, hence these are assessed in this current study.
    Methods: A total of 10 adult patients (age = 18 years) diagnosed as DCRV by echocardiograpy and cardiac catheterization in our hospital from January 2008 to December 2015 was included. Nine patients had a history of a known heart disease since childhood (PM-VSD) with one patient being operated at the age 9 years and one patient had isolated DCRV. Nine patients underwent surgery. Their follow-up echocardiogram showed the pressure gradient in their right ventricle was significantly decreased from 63.5 ± 14.1 mmHg preoperatively to 10.0 ± 5.0 mmHg postoperatively (p < 0.05).
    Conclusion: DCRV has been reported as a rare disease in adults. Consequently, number of cases are missed and not diagnosed. Careful evaluation of DCRV by echocardiography including TEE is necessary, especially in patients with VSD. These patients should be treated surgically, because the obstruction is progressive and ends in heart failure.
    Clinical Image
    Ashar Pirzada, Bradley Hayley and Corey Adams*
    We present the unique case of a 51 year old female with three month history of dyspnea (New York heart association class III symptoms), new onset rapid atrial fibrillation, and an intracardiac mass on surface echocardiography. Past medical history is significant for primary biliary cholangitis. Despite maintaining a high level of function, the patient had increasing lower leg edema, new onset of 20 kg weight gain, and recurrent assessments in the emergency department for shortness of breath.
    Commentary
    Burton M. Altura*, Asefa Gebrewold, Anthony Carella, Nilank C. Shah, Joseph C. Marcus, Robert Evans, and Bella T. Altura
    Pulmonary arterial hypertension (PAH) is a disease of the small blood vessels in the lung. Due to this disease, the right side of the heart has to work much harder to pump blood to the periphery. Thus, PAH not only causes major problems for the lungs, but the heart as well. In newborns, this often produces a syndrome of persistent hypertension (PPHN) with mortalities approaching 80%. In order to better understand and treat PAH and PPHN, animal models have been employed for more than 50 years, yielding very important data and some new therapeutic approaches. Our laboratory, for more than 30 years, has been studying these diseases using monocrotaline MCT)-induced PAH. During these decades, we have discovered a brand- new host-defense factor, HDFx, which displays remarkable anti-inflammatory properties along with the ability to accelerate wound healing. Numerous investigators have utilized magnesium (Mg) salts in the treatment of experimental and PAH and PPHN. In this paper-review, we present new findings on the successful use of combined therapy of HDFx and Mg in the treatment and prevention of MCT-induced PAH. We also review a number of studies which demonstrate some of the underlying mechanisms whereby this combined therapy is protective in MCT -induced PAH. We conclude that this new combined therapy might be successfully employed to treat clinical PAH and PPHN in newborns.
    Case Report
    Michal Kidawa*, Bartosz Orlowski, and Grzegorz Krauza
    Percutaneous coronary angioplasty (PCI) with stent implantation is widely used method of treatment of coronary artery lesions. Before the era of bioresorbable stents once stent was implanted it stayed for ever in the coronary artery. The most common complications of PCI are coronary artery dissection, stent restenosis or stent thrombosis. Malaposition of stent struts is one of the most important factors of stent thrombosis. Maloposed stent struts may also lead to severe technical difficulties when performing further PCI procedures in the artery.
    Sergio Fasullo* and Giorgio Maringhini
    We present the case of a patient with platypnea-orthodeoxia syndrome (POS) and we discuss its clinical features and its physiopathology. The manifestations of the syndrome are dyspnea and oxygen desaturation that occur in an upright position and that improve in the supine position.In February 2018 a 26-year-old girl presented herself at our department of cardiology, reporting on palpitations and fainting. She also complained about unusual fatigue. Why not think about minor syndromes associated with PFO? After a series of examinations, the diagnostic conclusion of a patent oval foramen (PFO) associated with an interatrial aneurysm was reached.
    It is believed that the syndrome remains very underdiagnosed, although cases in the literature have been described from the original description of Burtchell and Wood in 1949.
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