[Double mitral orifice. Apropos of a case].

The authors report a case of Double Mitral Orifice (DMO), existing in isolation and type 3 by the Floch Prigent classification. This rare anomaly is often associated with another congenital malformation, dominated by intra-atrio-ventricular defect. Two-dimensional echocardiography is the essential diagnostic factor.

False positive diagnosis of arterial hypertension: the diagnostic errors and their avoidance.

Arterial hypertension is a risk factor both for morbidity and mortality. The diagnosis usually depends on the auscultation method using the cuff and the mercury manometer, which remains the international reference method. However, this indirect method is the source of numerous errors, sometimes important, which are related variously to the equipment used, the observer, the conditions under which the measurement is taken and sometimes to the patient.

[Recent advances in the investigation of the renin-angiotensin and cardiac natriuretic systems in patients with chronic heart insufficiency].

The renin-angiotensin and cardiac natriuretic systems were studied by measuring plasma renin activity, plasma concentrations of active renin, angiotensinogen, atrial natriuretic hormone and urinary cyclic GMP in 37 patients with moderate to severe cardiac failure. The plasma sodium and osmolality were chosen as markers of hydroelectrolytic imbalance and plasma concentrations of préalbumin and retinol-binding protein as indicators of the degree of hepatocellular dysfunction. Plasma renin activity (PRA) plasma concentration of active renin, atrial natriuretic hormone and urinary cyclic GMP were higher in patients in NYHA Class IV than in those in Classes II-III, whilst plasma sodium, angiotensinogen, prealbumin and retinol-binding protein concentrations were lower in Class IV patients than in patients in Classes II-III.

[Neurologic complications of cocaine abuse].

Cocaine is increasingly used by drug addicts. It is considered harmless, but numerous, varied and often serious complications due to its abuse have been published. Among these, neurological complications are in the forefront.

[Magnetic resonance imaging in the diagnosis of pheochromocytoma].

The diagnosis of pheochromocytoma is biological. If ultrasound enables the visualization of certain adrenal tumours or hepatic metastasis, in fact two tests enable the topographic diagnosis, the screening of ectopic localizations and metastasis. They are IMBG scintigraphy and tomographic scanning.

[False and true hypertension in the aged subject. Diagnostic errors and potential solutions].

Arterial hypertension has the same definition in elderly people as in young adults. Epidemiologically, it has clearly been demonstrated that in the elderly it is a risk factor of morbidity and cardiovascular mortality. The international reference method for measuring blood pressure is by auscultation and mercury manometer.

[Mycotic aneurysms].

Mycotic aneurysms are aneurysms infected by bacteria or fungi. These may be secondary to an endocarditis, or they may be primary, and then are developed from a septicemia or bacteremia. The diagnosis, often difficult, is sometime only made during complications, the most severe of which is rupture.

[Experience at an Internal Medicine service in the postoperative follow-up of 403 patients operated on at a cardiovascular surgery service].

Over the last 3 years, 403 patients operated in the Department of Cardiovascular Surgery of Broussais Hospital have been transferred to a Department of Internal Medicine for secondary postoperative care. A total of 245 non-cardiac complications (64%) and 134 cardiac or vascular complications (36%) were observed in 321 of these 403 patients (80%). Infections accounted for 26% of non-cardiac complications (63/245).

[Spontaneous dissection of the renal artery].

In this paper we describe a case involving spontaneous dissection of the renal artery (DRA) successfully treated with an aorto-renal venous graft. DRA is a rare disorder which strikes men especially. Hypertension is the most frequent sign of its presence, which is usually of sudden onset, and with major adverse impact on the eye and brain.

[Bronchial cancer with extension into the heart. Apropos of a case with magnetic resonance imaging].

The authors report a case of a 64-year-old patient with an adenocarcinoma of the bronchus with mediastinal involvement. The echocardiography and CT scan showed the existence of involvement of the left auricle. Confirmation and the extent of the intra-cardiac involvement were provided by nuclear magnetic resonance imaging which confirmed the diagnosis here and was particularly helpful.

[Infectious complications, delayed wound healing and inflammatory syndromes as late complications of cardiovascular surgery].

Four-hundred and three patients were admitted to an internal medicine unit for late complications of cardiac or vascular surgery; 321 of these patients (80 per cent) had a total of 379 complications or intercurrent disease, 147 (40 per cent) of which were infections (71 cases), delayed healing of the operative wound (39 cases) or inflammatory syndromes (37 cases). Such complications are notable for their immediate or secondary severity, the diagnostic problems sometimes raised by their latency, their repercussions on the length of hospitalization and cost of surgery, and the thoughts they inspire concerning the minimal stay in hospital required after this type of surgery.

Surgical treatment of constrictive fibrous endocarditis.

Between 1971 and 1980, 20 patients with fibrous endocarditis were treated by resection of ventricular endocardium and replacement of the atrioventricular valve. There were 13 male and seven female patients whose ages ranged between 12 and 58 years. Thirteen were white and the remaining seven were black Africans.