Left bundle branch block and myocardial infarction, a diagnosis not always easy: Our experience and review of literature

The occurrence of left bundle branch block (LBBB) is quite common in clinical practice. The changes in cardiac repolarization, caused by this disorder of electric conduction, may mask the presence of an acute myocardial infarction (AMI), delaying the diagnostic-therapeutic iter, with an important impact on prognosis. We describe the case of a woman of 59 years with LBBB, came to our observation for a constrictive chest pain associated with dyspnea. The diagnostic workup for suspected acute coronary syndrome (ACS), initially conducted only on the analysis of the electrocardiogram (negative TnI at entry), showed the presence of coronary arteries free of stenosis. However, the diagnostic confi…

Coronary artery fistulas as a cause of angina: How to manage these patients?

Abstract Coronary artery fistulas represent the most common hemodynamically significant congenital defect of the coronary arteries and the clinical presentation is mainly dependent on the severity of the left-to-right shunt. We describe a case of a 55-year-old man with history of chest pain and without history of previous significant chest wall trauma or any invasive cardiac procedures. A coronary multislice computed tomography showed two large coronary fistulas arising from the left anterior descending coronary artery and ending in an angiomatous plexus draining into the common pulmonary trunk. Coronary angiography confirmed the CT finding and showed a third fistulous communication arising…

MULTIFOCAL ATHEROSCLEROSIS INFLUENCING THE OUTCOME OF PATIENTS WITH ACUTE AND CHRONIC CORONARY HEART DISEASE

MULTIFOCAL ATHEROSCLEROSIS INFLUENCING THE OUTCOME OF PATIENTS WITH ACUTE AND CHRONIC CORONARY HEART DISEASE

The Role of Cardiac Pacing in Heart Block Complicating Acute Myocardial Infarction

The organization of the Coronary Care Unit and the use of electrocardiographic monitoring have allowed a re-evaluation of the incidence of the atrioventricular conduction disturbances in acute myocardial infarction.

Troponin I/ejection fraction ratio: A new index to differentiate Takotsubo cardiomyopathy from myocardial infarction

– Transient hypokinesis, akinesis, or dyskinesis of the left ventricular mid-segments with or without apical involvement; the regional wall motion abnormalities extend beyond a single epicardial vascular distribution; a stressful trigger is often, but not always, present; – Absence of obstructive coronary disease or angiographic evidence of acute plaque rupture; – New ECG abnormalities (either ST-segment elevation and/or T wave inversion) or modest elevation in cardiac troponin; and – Absence of pheochromocytoma or myocarditis.

[Metabolic syndrome in children and in adults: is it an autonomous nosological entity?].

The term metabolic syndrome defines a cluster of risk factors for cardiovascular diseases and diabetes. This syndrome is very frequent in general population. However, despite the efforts to define the diagnostic criteria, nowadays its clinical utility is object of a lively debate.

INFLUENCE OF CAROTID AND PERIPHERAL ATHEROSCLEROSIS ON THE OUTCOME OF PATIENTS WITH ACUTE CORONARY SYNDROME

RITMO SINUSALE VERSUS FIBRILLAZIONE ATRIALE: UNO STUDIO OSSERVAZIONE SU 150 PAZIENTI

Evaluation of the Haemorheological Determinants in Coronary Heart Disease

Increased blood viscosity has been described in patients with coronary artery disease (1, 2, 3, 4, 5, 6, 7, 8).

A rare case of Prinzmetal angina 3 days after coronary artery stenting with a second-generation drug-eluting stent

Non previsto.

Inefficiency of renin-angiotensin inhibitors to prevent the Atrial Fibrillation in patient with normal heart

Chronic stress and early recurrence of takotsubo cardiomyopathy: A clinical case

Takotsubo cardiomyopathy (TC) is characterized by transient systolic dysfunction of the apical and middle segments of the left ventricle, accompanied by electrocardiographic abnormalities and mild elevation of cardiac biomarker levels in the absence of obstructive coronary artery disease. The following case is of a woman suffering from chronic emotional stress with a very early recurrence. An acute trigger event was not detectable in both cases. It is possible to suppose that, in predisposed subjects, chronic stress by increasing sympathetic activity may be considered not only a trigger for TC, but also a negative prognostic factor for early recurrence.

CAROTID INTMAL-MEDIAL THICKNESS ANS ENDOTHELIAL FUNCTION IN YOUNG ADULTS PATIENTS WITH MYOCARDIAL INFARCTION

Un caso di endoplastite in portatore di ICD: ruolo Dell'ecografia cardiaca nell'iter diagnostico

Non-responders to cardiac resynchronization therapy: Insights from multimodality imaging and electrocardiography. A brief review

Background Cardiac resynchronization therapy (CRT) is a successful strategy for heart failure (HF) patients. The pre-requisite for the response is the evidence of electrical dyssynchrony on the surface electrocardiogram usually as left bundle branch block (LBBB). Non-response to CRT is a significant problem in clinical practice. Patient selection, inadequate delivery and sub-optimal left ventricle lead position may be important causes. Objectives In an effort to improve CRT response multimodality imaging (especially echocardiography, computed tomography and cardiac magnetic resonance) could play a decisive role and extensive literature has been published on the matter. However, we are so fa…

Carotid and periferal atherosclerosis in patients underwent to primary PCI and outcome associated with multifocal atherosclerosis

Acidi grassi ematici e infarto miocardico

SIGNIFICATO PROGNOSTICO DELL’MMP-9 IN PAZIENTI CON SINDROME CORONARICA ACUTA

MULTIFOCAL ATHEROSCLEROSIS INFLUENCE THE OUTCOME OF PATIENTS UNDERWENT TO PRIMARY PTCA

Psicosomatica e ischemia cardiaca:correlazio ne tra eventi stressanti,meccanismi di dife sa,personalità e stili di vita.

MULTIFOCAL ATHEROSCLEROSIS INFLUENCE THE UTCOME OF PATIENTS UNDERWENT TO PRIMARY PTCA

INFLUENCE OF CAROTID AND PERIPHERAL ATHERLSCLEROSIS IN THE OUTCOME OF PATIENTS WITH ACUTE CORONARY SYNDROME

INFLUENCE OF CAROTID AND PERIPHERAL ATHERLSCLEROSIS IN THE OUTCOME OF PATIENTS WITH ACUTE CORONARY SYNDROME

CAROTID AND PERIPHERAL ATHEROSCLEROSIS IN PATIENTS UNDERWENT TO PRIMARY PCI AND OUTCOME ASSOCIATED WITH MULTIFOCAL ATHEROSCLEROSIS

INFLUENZA DELL’ATEROSCLEROSI MULTIFOCALE NELL’OUTCOME DI PAZIENTI CHE HANNO EFFETTUATO PTCA PRIMARIA

Non-Invasive Assessment of LV Systolic Function and Diastolic Filling at Rest and During Exercise in Coronary Heart Disease

In the assessment of the main determinants of cardiac function the study of the systolic phase and diastolic filling appear to be of paramount importance[1–3].

Growth hormone deficiency and increased coronary risk.

Ischemia Cardiaca e Psicosomatica: ruolo di eventi stressanti e stili di vita

Objective: the aim of our study was to evaluate the role of stressful events, lifestyles and various socio-environmental factors in the beginning of ischemic cardiac diseases, together with cardiovascular factors. Materials and methods: 64 patients with recent cardiac ischemia and 64 controls matched 1:1, according to their sex and age, have been evaluated. The study required the filling in of clinico-anamnestic reports and the evaluation of stressful events, using the Holmes Rahe scale. Results: in the 44% of the patients who had a heart ischemia, an emotional striking event occurred few day before, with a 28% incidence of work and family problems. The mean score of the Holmes Social Readj…

A late diagnosis of aortic coarctation began as an acute coronary syndrome

Abstract Aortic coarctation accounts the 5%–10% of congenital heart disease. It is usually diagnosed during childhood but the postductal form is most common in adults and may be diagnosed incidentally in the context of investigation for hypertension. The age of correction is the most important factor for the relief of hypertension and long-term survival. We describe a case of a 63-year-old man, came to our emergency room for acute coronary syndrome. Cardiac catheterization with right femoral artery access was performed but for many difficulties during the introduction of catheters was therefore performed aortography that showed an interruption "a cul de sac" at the level of the descending t…

Rupture of the atherosclerosis plaque: is chlamydia pneumonie a possible agent

MIOCARDIO NON COMPATTATO

Climatic variables in Takotsubo cardiomyopathy: role of temperature

Background Recent studies documented a seasonal (summer) and circadian (morning) temporal distribution of takotsubo cardiomyopathy (TTC). Aim The aim of our study was to investigate whether there is a relationship among season, temperature and the occurrence of TTC. A second aim of our study was the comparison of climatic variables in Takotsubo cardiomyopathy versus acute myocardial infarction (AMI). Methods We enrolled consecutive patients with TTC in three Italian centres and, for comparison consecutive patients with AMI. The frequency of TTC and AMI patients according to month, season and quartiles of temperature (I quartile: 9.8–15-, II quartile: 15–19-, III quartile: 19–25- and IV quar…

RUPTURE OF THE ATHEROSCLEROTIC PLAQUE: IS CHLAMYDIA PNEUMONIAE A POSSIBLE AGENT?

BACKGROUND: The natural history of atherosclerosis has not clearly been elucidated yet. Some works reported that flogosis plays a role in plaque instability. Why does this inflammatory process start? We investigated the correlation between Chlamydia pneumoniae acute infection and plaque rupture. METHODS: We compared blood concentrations of IgM anti-Chlamydia pneumoniae in patients affected by acute myocardial infarction (AMI) and in patients affected by stable angina. RESULTS: Our results showed a minimal statistical difference, with a more positive value in patients with AMI. Subsequently, the group affected by AMI was divided into two subgroups with and without plaque rupture: the subgrou…

Diagnosis and treatment of asymptomatic left ventricular systolic dysfunction after myocardial infarction.

The increased survival after acute myocardial infarction induced an increase in heart failure with left ventricular systolic dysfunction. Early detection and treatment of asymptomatic left ventricular systolic dysfunction give the chance to improve outcomes and to reduce costs due to the management of patients with overt heart failure.

RISK FACTORS AND MULTIFOCAL ATHEROSCLEROSIS INFLUENCE THE RATE OF RESTENOSIS POST-PTCA

Cytokine Polymorphism in Takotsubo Cardiomyopathy

IMIN11. Cytokine Polymorphism in Takotsubo Cardiomyopathy P. Di Gangi1, L. Scola1, S. Giambanco1, M. Bova1, G. Santini1, L. Vaccarino1, C. R. Balistreri1, D. Lio1, P. Assennato1, S. Novo1, G. Novo1 1University of Palermo, Palermo, Italy Background: Takotsubo (TT) cardiomyopathy is characterised by an acute left ventricular dysfunction triggered by emotional or physical stresses. Clinically, the syndrome is characterised by acute symptoms mimicking acute infarction without relevant electrocardiographic and biochemical markers of myocardial damage changes. Stressful events inducing an excess catecholamine release and myocardial β-adrenergic receptors (β-AR) seem to play a major role in TT. Ac…

The percutaneous treatment of Patent Foramen Ovale, an effective and safe therapeutic choice

Introduction: The aim of our study is to evaluate the feasibility, safety and efficacy of the percutaneous closure of PFO (abnormal communication between the right and left atrium). Methods: Between July 2009 and October 2012 percutaneous closure was performed in 37 patients. The presence of PFO was diagnosed through the use of ultrasound techniques: transcranial doppler with contrast (cTCD), transthoracic echocardiography(TTE) and transesophageal echocardiography (TEE). Follow-up was composed consisted of a Holter ECG 7 days after the closure with a 24 hour heart rhythm monitoring, to evaluate eventual arrhythmia cases and programmed controls which included a TTE at 1-3 months, TTE+ cTCD a…

Two cases of tako-tsubo cardiomyophaty in Caucasians

Tako-tsubo cardiomyopathy is a recently described disease characterized by chest pain, transient left ventricular dysfunction and specific electrocardiographic changes. The disease takes its name from the typical left apical ballooning observed at left ventriculogram. Tako-tsubo cardiomyopathy was first described by Sato in 1990. Since then sporadic cases were reported by Japanese authors, and only a few European publications are available. We describe 2 cases of patients affected by this syndrome.

LIVELLI PLASMATICI DI MCSF IN PAZIENTI CON SINDROMI CORONARICHE ACUTE.

Rupture of the atherosclerotic plaque: is Chlamydia pneumoniae a possible agent?

PREVALENCE OF METABOLIC SYNDROME IN PATIENTS WITH ACUTE CORONARY SYNDROME

PREVALENCE OF METABOLIC SYNDROME IN PATIENTS WITH ACUTE CORONARY SYNDROME

Selective pacing sites

The right ventricular apex (RVA) has always been the most used pacing site, because it is easily accessible and provides a stable lead position with a low dislodgment rate. However, it is well-known that long-term right ventricular apical pacing may have deleterious effects on left ventricular function by inducing a iatrogenic left bundle branch block, which can have strong influences on the left ventricle hemodynamic performances. More specifically, RVA pacing causes abnormal contraction patterns and the consequent dyssynchrony may cause myocardial perfusion defects, histopathological alterations, left ventricular dilation and both systolic and diastolic left ventricular dysfunction. All t…

Angiographic Evaluation of Coronary Microvascular Dysfunction in Patients with Heart Failure and Preserved Ejection Fraction

Background The aim of this study was to evaluate myocardial perfusion and coronary blood flow through validated angiography indices to assess whether there is greater MVD in patients with microvascular angina and HFPEF compared to those who do not have. Methods Our study was performed on a population of 286 patients with stable angina that underwent coronary angiography and echocardiography. They showed epicardial coronary arteries free from stenosis. We divided the sample into two categories: patients with HFPEF and those without. We calculated indices for each patient based on angiographic images, including TFC, MBG, and TMBS. Results Our sample compared two groups: HFPEF (n = 155) and no…

Pacing ventricolare destro: una risorsa o una minaccia?

Early after the beginning of the pacemaker era, endocardial right ventricular apex has been the most extensively used site for cardiac pacing because it was easily accessible and reliable in a long-term perspective. However many data have demonstrated that this kind of pacing is suboptimal from a physiologic point of view because it causes several adverse effects such as altered ventricular contraction geometry, mitral regurgitation, perfusion alterations and interference with myocardial ion channels which determine a worsening of left ventricular function. Several strategies have been proposed to solve these problems (alternative pacing sites, specific algorithms able to reduce the percent…

Morbillo e fenomeno di Brugada: un caso clinico

DUE CASI DI DISFUNZIONE VENTRICOLARE SINISTRA REVERSIBILI: ERA CARDIOMIOPATIA DI TAKOTSUBO?

Prevalence of metabolic syndrome in patients with acute coronary syndrome

The spectrum of risk factors for contrast induced nephropathy in patients undergoing coronary angiography or intervention

Abstract Introduction Contrast induced nephropathy is an unfavorable acute event which can complicate the clinical course of patients undergoing coronary angiography. Clinical characteristics predisposing to its occurrence are still rather obscure. Methods We enrolled 591 patients (mean age 64.2 ± 10.98; 449 male and 142 female) who underwent emergency or elective Coronary angiography/Angioplastic in our Cardiologic Division between 10/2006 and 06/2008, paying attention to their Cardiovascular risk factors, dose and type of contrast medium, type and number of affected coronary arteries, pharmacological therapies, baseline renal function and extracoronary atherosclerosis. We performed a univ…

Hemodynamic Effects of Ventricular Pacing

Fixed rate ventricular pacing is used in most cases of implanted pacemakers. It does not usually create considerable hemodynamic problems, as the heart, by its adaptation mechanism, is capable of varying its pump performance to meet the metabolic needs[1,3].

CLINICAL APPROPRIATENESS OF CORONARY ANGIOGRAPHY EXAMINATION IN PATIENTS OBSERVED IN A DIVISION OF CARDIOLOGY

Measles and Brugada pattern: A case report

No abstract available

Large Mediastinal mass in pregnancy: utility of echocardiography and cardiac MRI. A case report

PREVALENCE OF CAROTID LESIONS IN A MEDITERRANEAN POPULTION OF HYPERTENSIVES

A case of Takotsubo syndrome

Quantitative criteria for the diagnosis of the congenital absence of pericardium by cardiac magnetic resonance

Congenital absence of the left ventricular pericardium (LCAP) is a rare and poorly known cardiac malformation. Cardiac Magnetic Resonance (CMR) is generally used for the diagnosis of LCAP because of its high soft tissue contrast, multiplanarity and cine capability, but the diagnosis is usually made by only qualitative criteria. The aim of the present study was to establish quantitative criteria for the accurate diagnosis of LCAP on CMR.We enrolled nine consecutive patients affected by LCAP (mean age 26±8years, 7 males), 13 healthy controls, 13 patients with dilated cardiomyopathy (DCM), 12 patients with hypertrophic cardiomyopathy (HCM) and 13 patients with right ventricular overload (RVO).…

LA CHLAMYDIA PNEUMONIAE E’ CORRELABILE CON LA ROTTURA DELLA PLACCA ATEROSCLEROTICA?

INCREASED MACROPHAGE COLONY STIMULATING FACTOR CONCENTRATIONS ARE ASSOCIATED WITH LEFT VENTRICLE SYSTOLIC DYSFUNCTION IN PATIENTS WITH ACUTE CORONARY SYNDROMES

INCREASED MACROPHAGE COLONY STIMULATING FACTOR CONCENTRATIONS ARE ASSOCIATED WITH LEFT VENTRICLE SYSTOLIC DYSFUNCTION IN PATIENTS WITH ACUTE CORONARY SYNDROMES

CHLAMIDYA PNEUMONIAE AND VULNERABLE PLAQUE: DOES EXIST A CORRELATION?

ICD implantation in noncompaction of the left ventricular myocardium: a case report

Isolated noncompaction of the ventricular myocardium (INVM) is an uncommon cardiomyopathy characterized by the persistence of fetal myocardium with prominent trabecular meshwork and deep intertrabecular recesses, often associated with systolic dysfunction and ventricular dilatation. A 23-year-old man from Burkina Faso was referred to our operative unit with a diagnosis of INVM, made with echocardiogram and magnetic resonance imaging and nonsustained ventricular tachycardia. The literature reports the incidence of malignant ventricular arrhythmias in as many as 47% of the patients and sudden cardiac death in almost 50% of them and this supported our decision to perform implantable cardiovert…

PREVALENCE OF METABOLIC SYNDROME IN PATIENTS WITH ACUTE CORONARY SYNDROMES

Thrombus-like small apical fibroma in patient with left ventricular dysfunction and thrombophilia: an unusual presentation.

[Coronary artery ectasia: etiopathogenesis, diagnosis and treatment].

Coronary ectasia is a dilation of coronary arteries, angiographically defined if the diameter of the artery is ≥ 1.5 times greater than that of the intact adjacent vascular segment. An association has been found between coronary artery ectasia and a broad spectrum of different diseases, first of all atherosclerotic coronary artery disease. The mechanisms that determine the abnormal dilatation of the vascular lumen and the etiology of coronary artery ectasia are still poorly understood. Various hypotheses have been formulated over the time, the most accredited between these recognizes as main responsible an uncontrolled activity of a particular family of enzymes that degrade the extracellula…

Immediate decision making in a case of iatrogenic dissection of left main coronary artery: A successful synergetic treatment

Cardiac changes in subclinical and overt hyperthyroid women: retrospective study

This retrospective and descriptive 4-year study was undertaken to describe cardiac changes in subclinical and overt hyperthyroidism.We revised the charts of 386 consecutive cardiopathic women whose blood samples were referred to the Radioimmunoassay Laboratory to evaluate thyroid function from 1 January 1997 through 31 December 2000.After excluding women because euthyroid or hypothyroid, or taking amiodarone and women with hypertension, rheumatic disease, myocardial infarction, a total of 31 hyperthyroid women were thus selected for the study: 19 with subclinical hyperthyroidism and 12 with overt hyperthyroidism. The prevalence of atrial fibrillation did not differ between subclinical (48%)…

EFFICACIA DELL’ATP IN PAZIENTI CON ICD E TV RAPIDE: UN CASO CLINICO

IN HOSPITAL STAY OF PATIENTS WITH ACUTE CORONARY SYNDROME WITHOUT OR WITH DIABETES MELLITUS

In Hospital stay of patients with acute coronary syndrome without or with diatetes mellitus

LA TERAPIA DI RESINCRONIZZAZIONE CARDIACA (TRC) COME PONTE AL TRAPIANTO CARDIACO. UN CASO CLINICO

La terapia di resincronizzazione cardiaca (TRC) come ponte al trapianto cardiaco. Un caso clinico

The Prognostic Role of Hypertrabeculation By Cardiac Magnetic Resonance in Thalassemia Intermedia Patients

Abstract Background. Differentiation of left ventricle non-compaction (LVNC) from hypertrabeculated LV due to a negative heart remodeling in thalassemia intermedia (TI) can depends on the selected CMR criterion. The recently proposed Piga's criterion (NC/C ratio threshold of >2.5, Am J Haem 2012) seems to have a low specificity to identify the true LVNC in TI. Anyway, the Piga's criterion could well detect easy a negative heart remodeling in TI patients. Purpose: To assess prospectively whether the Piga's criterion has a prognostic role for adverse cardiovascular outcomes in TI patients. Methods. We studied prospectively by CMR 168 TI patients (81 males, mean age 38.32 ±11.61 years) cons…

INFLUENZA PROGNOSTICA DELL’ATEROSCLEROSI CAROTIDEA O PERIFERICA IN PAZIENTI CON SINDROMI CORONARICHE ACUTE.

A case of neurogenic heart disease: is there a elationship between heart and brain?

Ectasia coronarica: ruolo delle gelatinasi e dei loro inibitori tissutali.

The QRS narrowing index for easy and early identification of responder to cardiac resynchronization therapy.

The rationale for cardiac resynchronization therapy (CRT) in patients with heart failure (HF) is based on the possibility of inducing substantial left ventricular reverse remodeling. It is well known that some of these patients don't benefit from this therapy (the so-called non-responders) [1,2]. No better predictors of a positive answer to CRT than pre-CRT QRS duration (QRSd) were found [3,4]. The aim of our study was to identify a parameter for an easy and early identification of responders to CRT. In this regard, according to Rickard et al., we identified and observed QRS index (QI), as an expression of electrical remodeling after CRT, and its relation with anatomic reverse remodeling, e…

CLINICAL FEATURES OF PATIENTS WITH ACUTE CORONARY SYNDROME WITHOUT OR WITH DIABETES MELLITUS

The association between coronary microvascular dysfunction and carotid intima media thickness in patients with cardiac syndrome X

Abstract Objective The aim of this study was to evaluate in patients with cardiac syndrome X (CSX), using validated angiography indices, coronary blood flow and myocardial perfusion of the microcirculation to assess whether there is greater microvascular dysfunction in patients with increase of carotid intima media thickness (C-IMT), compared to those who do not have. Methods Our study was performed on a population 124 patients with CSX that underwent coronary angiography and carotid ultrasound. We divided the sample into two categories: patients with increase of C-IMT and those without increase. We calculated Gibson and Yusuf indices for each patient based on angiographic images, including…

Influence of carotid peripheral atherosclerosis on the outcome of patients with acute coronary syndrome

Resting and Exercise Systolic Time Intervals

The measurement of Systolic Time Intervals (STI), for the indirect assessment of ventricular function, has become one of the established “non-invasive” techniques of clinical cardiology. (1,2).

CAROTID INTIMAL-MEDIAL THICKNESS AND ENDOTHELIAL FUNCTION IN YOUNG ADULT PATIENTS WITH MYOCARDIAL INFARCTION.

Bifocal stimulation in patient with congenitally corrected transposition of great vessels

Congenitally corrected transposition of the great vessels (CCTGV) is a rare congenital heart defect associated with multiple cardiac morphological abnormalities and conduction defects. Complete atrioventricular (AV) block occurs in 30% of patients and it may be present at birth or develop later with a rate of 2% per year; moreover, a systemic right ventricle is frequently characterized by heart failure in adult life. We used a bifocal cardiac stimulation for a young woman affected by CCTGV and atrioventricular Mobitz 2 and 2:1 block, considering structural, anatomic condition, and the high rate of pacing she underwent

Heart ischemia and psychosomatics: the role of stressful events and lifestyles

Objective: the aim of our study was to evaluate the role of stressful events, lifestyles and various socio-environmental factors in the beginning of ischemic cardiac diseases, together with cardiovascular factors. Materials and methods: 64 patients with recent cardiac ischemia and 64 controls matched 1:1, according to their sex and age, have been evaluated. The study required the filling in of clinico-anamnestic reports and the evaluation of stressful events, using the Holmes Rahe scale. Results: in the 44% of the patients who had a heart ischemia, an emotional striking event occurred few days before, with a 28% incidence of work and family problems. The mean score of the Holmes Rahe Social…

Bicuspid aortic valve and unruptured sinus of Valsalva aneurysm, a rare association

Bicuspid aortic valve (BAV) is one of the most common forms of congenital heart defect and is associated with other congenital vascular and cardiac defects. The most common comorbidity is dilation of thoracic aorta and clinical manifestations are usually related to function of the aortic valve and to other cardiovascular acquired complications. Sinus of Valsalva aneurysm (SVA) is an uncommon congenital cardiovascular anomaly and the combination of these two anomalies is very rare. Common complications are rupture and obstruction of the termination chamber due to space-occupying effect of large unruptured aneurysms. Early cardiac imaging can help limiting morbidity and mortality in these pat…

The importance of being “responder” in cardiac resynchronization therapy