Spontaneous coronary hematoma concomitant with myocarditis: the first report of double cardiac complication of dengue.

We reported the case of a 33-year-old male who presented a dengue infection complicated by spontaneous coronary artery intramural hematoma associated with acute myocarditis. The initial presentation was a typical acute coronary syndrome with ST-segment elevation. Coronary angiography and endocoronary optical coherence tomography confirmed the diagnosis of left anterior descending artery intramural hematoma.

Cardiac rehabilitation with intermittent myocardial ischaemia as a new therapeutic option in refractory angina?

A 72-year-old man daily suffered from a refractory angina consecutive to a diffuse coronary artery disease despite optimal medical management. Revascularization could not be performed because of a severe thrombopenia. He was referred to our outpatient cardiac rehabilitation programme where he was candidate for 20 sessions, three times a week, of high-intensity aerobic interval training involving brief episodes of regressive myocardial ischaemia.

[Rationalization of biological tests in cardiology department].

Introduction: Laboratory tests usually complete clinical examinations for diagnostic, prognostic and even therapeutical care. However, French doctors might too easily prescribe such examinations without knowing their cost. As a matter of fact, the prescription is sometimes excessive or unjustified.

Electrical storm in the early phase of HeartMate II device implantation: Incidence, risk factors and prognosis.

Background: Ventricular arrhythmia is common after left ventricular assist device (LVAD) implantation, especially in the early postoperative phase (<30 days).

Aim: To identify the incidence of and risk factors for electrical storm (ES) occurring within 30 days of HeartMate II implantation.

Methods: We reviewed data from all consecutive patients undergoing HeartMate II device implantation at our institution from January 2008 to December 2014.

An unusual cause of myocardial ischemia: Compression of a left internal mammary artery grafting to the left anterior descending artery by a pacemaker lead.

An 83-year-old patient, with prior history of coronary artery disease treated by coronary-artery bypass graft with left internal mammary artery (LIMA) to the left anterior descending artery (2001) and angioplasty of the right coronary artery (2012) and prior pacemaker through left subclavian vein (2014), was referred to coronary angiography for an anterior silent ischemia. It found no evolving lesion on the native coronary artery network (compared with 2012 review) but revealed an external compression of the LIMA bridge by the pacemaker lead. Conservative treatment was chosen rather than explantation and reimplantation of stimulus material or LIMA angioplasty.

An unusual cause of cardiogenic shock: Left atrial compression by a spontaneous rupture of an aneurysm of the descending thoracic aorta.

A 77-year-old woman presented with a feverish hemodynamic collapse, acute respiratory distress, and dorsal pain, initially treated as a septic shock. Transthoracic echocardiogram revealed an impressive compression of the left atrial cavity, by an extrinsic mass preventing the left ventricle from refilling. Thoracic computed tomography revealed a large hemomediastinum emerging from an aneurysm of the descending thoracic aorta compressing the left atrium.

[Lifestyle changes for patients with coronary artery disease].

Shortening the hospitalization period during an acute coronary syndrome can lead to a trivialization of the event, and especially causes many questions among patients about their future lifestyle. A secondary medical care in rehabilitation centers allows to combine the numerous benefits of physical training and to answer to their questioning, through to both a collective and individual therapeutic education.

Characteristics of ventricular tachycardia ablation in patients with continuous flow left ventricular assist devices.

Background: Left ventricular assist devices (LVADs) are increasingly used as a bridge to cardiac transplantation or as destination therapy. Patients with LVADs are at high risk for ventricular arrhythmias. This study describes ventricular arrhythmia characteristics and ablation in patients implanted with a Heart Mate II device.

The use of Impella 2.5 in severe refractory cardiogenic shock complicating an acute myocardial infarction.

Objectives: To investigate the outcome of patients with acute myocardial infarction (AMI) complicated by refractory cardiogenic shock (CS) who underwent mechanical circulatory support with Impella 2.5.

Background: AMI complicated by CS remains a highly fatal condition.

Methadone-induced toxic brain damage.

A 29-year-old man presented with comatose after methadone intoxication. Cerebral tomography only showed cortico-subcortical hypodense signal in the right cerebellar hemisphere. Brain MRI showed a rare imaging of FLAIR and DWI hyperintensities in the two cerebellar hemispheres as well as basal ganglia (globi pallidi), compatible with methadone overdose.

Caseous necrosis of mitral annulus: a rare cause of stroke.

The current report describes a rare case of a caseous necrosis presenting as a pseudotumor in ventricle, revealed by stroke. Cerebral MRI, showing multiples lacunes, evocates a cardioembolic mechanism. Transthoracic and transesophageal echocardiography demonstrate a large hyperechogenic mass fixed to the posterior mitral valve and annulus while thoracic tomography revealed a fully calcified lesion, at the mitral annulus, evocative of caseus necrosis.