[Cardiac metastasis from malignant melanoma].

The authors describe a case of cardiac metastasis associated with a malignant melanoma, which was removed in its totality. Malignant melanoma is a tumour which metastases frequently at the cardiac level. The mechanism of implantation and the symptomatology of this metastatic localisation are discussed.

[Isolated tricuspid valve endocarditis as a cause of fever of unknown origin].

Isolated tricuspid valve endocarditis is the least common endocarditis with an incidence of 5 to 10% in the literature. It is usually described in drug abusers and as a complication of nosocomial infections (catheter, post-surgery..

[Clinical case of the month. Subvalvular aortic stenosis].

A case of fixed subvalvular aortic stenosis is reported. This clinical observation is the occasion to review the pathophysiology of this lesion and the last developments in the surgical treatment.

[Clinical case of the month. Carcinoid syndrome due to a small intestine secreting tumor with a cardiopathy].

Uncommon but classically described, intestinal carcinoid tumors represent a variety of neuroendocrine tumors. Able to secrete amines and hormones, they can produce characteristic symptoms called "carcinoïd syndrome". A cardiopathy is sometimes associated with the disease and carries a high risk of mortality and morbidity.

[Pre-competition health screening of young high-level athletes].

The unexpected death of an athlete during the practice of his sport is generally an event largely covered by the newspapers. It raises the problem of screening the athletic population in the aim to disclose anomalies (generally cardiac in origin) that predisposes to sudden death during exercise. In young people, most of these episodes are due to cardiac disorders that can be detected before initiation of the training program.

Usefulness of dobutamine stress tests for detection of cardiac abnormalities in dogs with experimentally induced early left ventricular dysfunction.

Objective: To determine whether dobutamine stress tests (DST) can be used to detect cardiac dysfunction in dogs with early left ventricular dysfunction (ELVD) induced by rapid right ventricular pacing (RRVP).

Animals: 7 adult male Beagles.

Procedure: A pacemaker was surgically implanted in each dog at the level of the right ventricular apex.

[How I treat...persistent atrial fibrillation, by internal cardioversion, in a patient with exreme obesity].

An ethylic hypertensive patient with a BMI of 51.4 developed persistent atrial fibrillation with high ventricular rates. External electrical cardioversion was attempted, but failed in spite of high energy shocks (350 joules).

[How I treat...congenital cardiopathies in adults].

Nowadays, the diagnosis of congenital heart disease is generally made in the infant, or even at times, in utero. Neonatal surgery has in this field made remarkable progresses. In this article, we describe the situation of patients who reach the adult age without having their congenital abnormality corrected.

[Atherosclerotic pathology of the aortic arch and cerebrovascular accidents].

Over the last 10 years, transoesophageal echocardiography has allowed the visualisation of the particularly frequent atheromatous involvement of the initial part of the aorta in patients suffering from cerebral as well as peripheral embolism. Recent studies have shown that atherosclerosis of the initial, precarotid, part of the aorta is both a marker of general as well as coronary atherosclerosis and an important, accident independent risk factor of recurrence of stroke. The therapy of these aortic lesions is still currently under debate and there are no published guidelines about this issue in the literature.

Atrial flutter in the perinatal age group: diagnosis, management and outcome.

Objectives: The aim of this retrospective study was to evaluate perinatal atrial flutter (AF) and the efficacy of maternally administered antiarrhythmic agents, postpartum management and outcome.

Background: Perinatal AF is a potentially lethal arrhythmia, and management of this disorder is difficult and controversial.

Methods: Forty-five patients with documented AF were studied retrospectively.

Reversible hypertrophic cardiomyopathy in congenital hyperinsulinism.

A neonate with congenital focal hyperinsulinism developed hypertrophic cardiomyopathy that progressed until partial pancreatectomy was performed. Surgery was followed by complete resolution of the condition. Hyperinsulinism may be a cause of treatable cardiomyopathy.

[Sub-valvular aortic stenosis by a discrete membrane].

We report the case of a 55 year old patient presenting a discrete obstructive sub-aortic membrane. After clinical examination, complete echocardiographic evaluation and cardiac catheterisation, an operative procedure was decided and the sub-aortic membrane was resected. The results were satisfactory but the literature reports risks of re-obstruction of the left ventricular outflow tract.

Doppler echocardiographic study of left and right ventricular function during dobutamine stress testing in conscious healthy dogs.

Objective: To evaluate left and right ventricular filling and ejection performances by use of Doppler echocardiography in healthy, conscious dogs submitted to dobutamine stress testing.

Animals: 10 unsedated, healthy adult Beagles.

Procedure: Doppler echocardiography was performed during cardiac stress testing on each dog twice at 24-hour intervals.

[Clinical case of the month. Inaugural myocardial infarction from a congenital coronary-cardiac fistula].

We report a case of a 47-year-old woman with a typical clinical pain, a ST elevation in lateral EKG leads and an increase of the CPK-MB enzymes serum level suggesting the diagnosis of an acute lateral myocardial infarction. The emergency coronary arteriography did not showed any coronary artery lesions but a coronary artery fistula from the left main coronary artery to a terminal thrombosed aneurysmal dilatation located between the left atrium and the right pulmonary artery. Through this case report, authors will discuss aetiology, physiopathology, clinical presentation and treatment of coronary artery fistulae.

Physiologic response to dobutamine infusion during cardiac stress testing of dogs.

Objective: To evaluate response of various cardiovascular variables after administration of incremental doses of dobutamine in healthy conscious dogs, using standardized dobutamine stress echocardiography (DSE).

Animals: 8 healthy dogs.

Procedure: A DSE was performed twice on each dog within 24 hours.

Relative value of clinical and transesophageal echocardiographic variables for risk stratification in patients with infective endocarditis.

Background: Infective endocarditis remains a life-threatening disease, and its optimal management is of paramount importance. Transesophageal echocardiography (TEE) is useful for the diagnosis of endocarditis-induced lesions, but the prognostic significance of the method remains controversial.

Hypothesis: The purpose of this study was to relate clinical and TEE characteristics to the occurrence of mortality and/or systemic embolization in a consecutive series of 45 patients with a diagnosis of infective endocarditis.

Nosology of lysosomal glycogen storage diseases without in vitro acid maltase deficiency. Delineation of a neonatal form.

We describe a boy with an early lethal hypertrophic vacuolar cardiomyopathy of neonatal onset. Abnormal intra- and extralysosomal glycogen storage disease was demonstrated in heart and skeletal muscles. Glycogen content was twice the normal in muscles and over 3-fold the normal in the heart.

Atrial flutter in the human fetus: diagnosis, hemodynamic consequences, and therapy.

In the context of a large program of prenatal echocardiographic detection of fetal heart disease, special attention was paid to the in utero detection and identification of fetal heart rate disorders. This article focuses on 18 cases of tachycardiac fetuses. It provides information on how to identify the nature of the detected tachycardia, the hemodynamic consequences of tachycardia, the particular characteristics of fetal atrial flutter, and the efficacy of the transmaternal treatment of fetal tachycardia.

Successful tricuspid valve replacement and pulmonary valvulotomy for carcinoid heart disease.

A case of successful tricuspid valve replacement with a mechanical prosthesis and pulmonary valvulotomy for carcinoid heart disease is reported. The patient was a 61 years old women. The primary tumor was in the terminal ileum.