Publications by authors named "Rienzi Diaz"

Background: Coronary anomalies are rare heart diseases that can cause sudden cardiac death, especially in young individuals. Coronary computed tomography angiography delivers a three-dimensional view of excellent quality with information of the origin, course and anatomic relationships of the anomalous vessel, allowing differentiation between benign and malignant variants, entities that require different management and treatment.

Aim: To show that coronary computed tomography angiography is the non-invasive technique of choice for the evaluation of a coronary anomaly due to its high diagnostic accuracy.

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Coronary artery anomalies arising from the opposite sinus of Valsalva and having an interarterial course between the aorta (AO) and pulmonary artery (PA) are the second most common cause of sudden cardiac death among young athletes, after hypertrophic cardiomyopathy. The right coronary artery (RCA) originating from the AO above the left sinus of Valsalva (LSV) is an extremely rare anomaly. We report the first case of a RCA arising from the AO above the LSV that subsequently runs between the AO and the PA, discovered by a 64-slice multidetector coronary CT, in a patient who was successfully resuscitated from ventricular fibrillation (VF) cardiac arrest while running in a marathon race.

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We report a 74-year-old man with diabetes mellitus type 2 and hypertension, who recently underwent coronary bypass surgery due to severe triple vessel disease receiving cardiological and combined antidiabetic therapy, including metformin 4 g/day. He was admitted with abdominal pain, nausea, vomiting, diarrhea and loss of consciousness. At admission, he was disoriented and agitated with signs of poor perfusion.

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Bilateral renal vein thrombosis is an unusual etiology of acute renal failure and usually is associated with nephrotic syndrome. We report a 77-year-old man, consulting in the emergency room for anuria that appeared 24 hours after a syncope. The patient was carrier of an inferior vena cava filter prophylactically installed 17 months earlier and was not receiving anticoagulation.

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Arrhythmogenic right ventricular dysplasia is an inherited condition characterized by replacement of normal myocardium by fatty or fibro-fatty tissue, which mainly affects the right ventricle. The most frequent form of presentation is ventricular tachycardia or sudden death, whose origin is considered to be a product of fibrous or fatty infiltration of the myocardium. This structural damage can be detected by cardiac magnetic resonance imaging (MR).

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In the last 2 decades, there have been significant advances in medical treatment of heart failure. However, there is a group of patients who are refractory to the available medical therapy and progress inevitably to a state of end-stage heart failure, whose only therapeutic alternative is cardiac transplantation. But this is an option limited by the scarce availability of donors.

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We report a 50 year-old hypertensive and asymptomatic woman in whom a left ventricular tumor was found on a routine two-dimensional transthoracic echocardiogram. Complementary 3D echocardiography, cardiac magnetic resonance and cardiac computed tomography allowed the diagnosis of a calcified left ventricular myxoma. Surgical treatment was performed through a transaortic transvalvular approach with tumor resection and implantation of a pericardial bovine patch.

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Celiac disease may be associated with other autoimmune diseases and exceptionally with glomerulopathies and nephrotic syndrome. Associations have been reported with IgA nephropathy, membranoproliferative glomerulonephritis, membranous glomerulopathy and minimal change disease. We report a 63-year-old woman who simultaneously presented with massive nephrotic syndrome (proteinuria 46 g/day) and cachexia due to a malabsorption syndrome secondary to celiac disease.

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Endomyocardial fibrosis (EMF) is a rare progressive restrictive cardiomyopathy of unknown etiology that mainly presents with heart failure. The presence of a small ventricle with obliteration of the apex and a large atrium are two-dimensional echocardiographic findings that are highly suggestive of EMF. Cardiac magnetic resonance with delayed enhancement allows detection of subendocardial fibrosis with good histopathological correlation, providing a noninvasive modality for diagnosing EMF.

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Phaeochromocytomas are rare catecholamine secreting tumours that usually present as paroxysms of hypertension associated with headache, palpitations and sweating. We report the case of a 50-year-old man with a phaeochromocytoma who presented with sudden onset of hypertension, syncope, and fever who later developed a multiple-organ failure secondary to a multiple organism bacteraemias due to transient episodes of intestinal ischaemia. After receiving full intensive care support, antibiotics and tumour removal, the patient made a complete recovery and he is at present doing well.

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We report a 16 year old male with a history of angina on exertion. A treadmill exercise test was positive for ischemia in concordance with a Thallium-201 scintigraphy showing a septal and infero-posterior reversible myocardial perfusión defect. Coronary angiography disclosed severe aneurysmal coronary artery disease.

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