Dinca R, Diaconu R, Ungureanu A, Donoiu I

Language: Spanish
References: 0
Page: 62-63
PDF size: 310.20 Kb.

Text Extraction

A 60-year-old woman, with no previous cardiac pathology and without known risk factors for ischemic heart disease, presented to the emergency room complaining of dyspnea and diaphoresis. She recalled an episode of constriction-like chest pain, non-radiating, with prolonged duration, 10 days before. Physical examination revealed a grade 2/6 systolic murmur heard over the mitral area, blood pressure was 100/60 mmHg, heart rate was 101 beats/minute, oxygen saturation of 95% on room air. The electrocardiogram showed sinus rhythm with q waves in DI, aVL, V2-V6 leads, and ST segment elevation in DI, DII, aVL, V2-V6 leads, suggesting distal occlusion of a long left anterior descending artery. Troponin I levels were increased, but creatin kinase MB was negative. Chest X-ray noted increased cardiothoracic ratio with left ventricle (LV) dilatation; pulmonary edema signs were not present. Transthoracic echocardiography showed a giant left ventricle apical aneurysm which occupied approximately 75% of the chamber volume, with dense spontaneous echo contrast in the left ventricle but without thrombi. Left ventricular ejection fraction was estimated at 20%. Moderate mitral regurgitation was present, and a mild circumferential pericardial effusion was noted. The patient was treated conservatively. In the next days she developed cardiogenic shock and died after 4 days.