ACoronary bifurcation lesions are frequently observed and remain a challenging patient population for successful treatment. Currently, the provisional approach of treatment is considered the first-line method of treatment. Many dedicated bifurcation stents and newer treatment approaches such as drug-coated balloons and bioresorbable scaffolds are also particularly attractive concepts. The aim of this article is to review the current treatment approaches for coronary bifurcation lesions, mainly the dedicated bifurcation stent systems while briefly covering the related topics of provisional and two-stent procedures of treatment and the current status of drug-coated balloons and bioresorbable scaffolds. This article highlights the critical trials involving these strategies. We searched PubMed, Google Scholar, Medline and ClinicalTrials.gov to identify all the relevant trials assessing the safety and efficacy of dedicated bifurcation stent systems, drug-coated balloons vs. other traditionally used coronary stents. A debate still prevails to treat coronary bifurcation lesions optimally. Provisional stenting strategy remains the gold standard for treating a majority of coronary bifurcation lesions, but the two-stent approach can be indicated for some lesions. More long-term follow-up trials are required to concretely define the role of newer treatment approaches such as dedicated bifurcation stents, drug-coated balloons, and bioresorbable scaffolds.
Fabry disease is an X-linked disorder due to deficiency of the lysosomal hydrolasea-galactosidase A and the resultant accumulation of glycosphingolipids throughout the body, such as in the heart. Cardiac manifestations in Fabry disease are due to glycosphingolipid deposition in the myocardium, valves, and conduction system. Fabry cardiomyopathy, characterized by progressive severe concentric left ventricular hypertrophy. We, as a result of this, have reported a case of Fabry disease with left ventricular hypertrophy. He was admitted with dyspnea and also dizziness, general weakness, and acroparesthesias. Physical examination showed Angiokeratoma on the skin. The electrocardiography revealed ST-segment depression in leads V3–V6, and changes related to left ventricular hypertrophy. Echocardiography showed concentric left ventricular hypertrophy.
Acute rheumatic fever is a well-known disease that is still widely observed in developing countries, including our country Morocco. It is known that the majority of patients diagnosed with acute rheumatic fever display abnormalities of the conduction system; However, there are only a few case reports that describe severe impairment in the electrical conduction system. We describe a 21-year-old man who was diagnosed with acute rheumatic fever with complete atrioventricular block. In our patient, the diagnosis of acute rheumatic fever was established. 24-hour electrocardiography showed a paroxistic complete atrioventricular block. Penicillin prophylaxis was made, and salicylate treatment in an anti-inflammatory dose was initiated. The electrocardiographic abnormalities of the patient disappeared. Although rare, this diagnosis should be considered in patients with complete heart block, particularly when it is associated with other features of acute rheumatic fever. Conduction disorders associated with acute rheumatic fever often resolve following appropriate treatment without the need for permanent pacemaker placement.
We present here a rare case of Scimitar syndrome on a full-term newborn female issued from consanguineous marriage and diagnosed at the age of two months who was suffering from polypnea since the age of two weeks. She was admitted at the age of two months for polypnea, non-dysmorphic facies, healthy systemic arterial tension, regular pulse, but the family history raises that before her birth, two newborns respectively boy and girl died both at an early age with dilated cardiomyopathy. After hospitalization, we realized chest radiography, which has shown opaque right lung and suspicion of scimitar syndrome. After that, an echocardiogram was performed, showing severe hypoplasia of the right pulmonary artery with pulmonary hypertension. The Thoracic computed tomography confirmed the diagnosis by revealing hypoplasia of the right pulmonary artery with pulmonary arterial hypertension, right pulmonary hypoplasia (bilobar), and abnormal partial right pulmonary venous return toward the vena cava under the diaphragm.
Bacterial pericarditis is a rapidly progressive infection sown with heavy mortality. It usually occurs as a secondary infection to either a contiguous or hematogenous spread from a distant focus of infection. The primary involvement of the pericardium without evidence of underlying infection disease elsewhere, is sporadic. We present a unique case of a 69 -year-old patient who was diagnosed as having purulent acute bacterial pericarditis caused by Streptococcus pneumonia, revealing an underlying squamous cell lung carcinoma in the cardiology department of IBN ROCHD University hospital of Casablanca.
One of the rare abnormalities of coronary artery anatomy is the common origin of all three coronary arteries from the right sinus of Valsalva, which, may associated with myocardial ischemia. Percutaneous coronary intervention of such patients with anomalous coronary arteries is particularly challenging. In such patients femoral route is usually chosen for coronary angioplasty, various studies have proved that the radial access provides better engagement and robust support to the guide catheter. We report a rare case diagnosed with ST-segment elevated myocardial infarction. The patient underwent successful trans-radial primary angioplasty with a buddy wire, parked in the non-culprit artery.