Vasoplegic syndrome after off pump coronary artery bypass grafting surgery

We report a case of 48-years-old man who developed nor-epinephrine resistant vasoplegic syndrome after elective off pump coronary artery bypass grafting surgery. The failure of norepinephrine to improve the patients’ hemodynamics promted us to start treatment with vasopressin. Within an hour, the hemodynamics begin to improve. After 4 hours, patient was stable enough to be weaned from vasopressin, extubated at the end of 24 hrs and shifted to ward at the end of 48 hours. Vasoplegic syndrome can occur commonly after cardiopulmonary bypass and incidence can go up to 10%. This case was reported to insist upon the fact that vasoplegic syndrome can occur even after off pump surgeries. Herein we discuss the aetiology, risk factors, pathophysiology and prophylactic measures to be taken, for the prevention of vasoplegic syndrome

Idiopathic multilocular thymic cyst-an incidental anterior mediastinal mass

Acquired thymic cyst are multilocular and they occur de novo or in association with mediastinal neoplasm, systemic autoimmune diseases and trauma. Here, we report a case of acquired multilocular thymic cyst due to non-specific inflammatory etiology in a 42-year old gentleman and our approach to diagnosis and management of anterior mediastinal mass. With no specific clinical symptom, he was diagnosed with anterior mediastinal mass incidentally by imaging studies. Definitive diagnosis of multilocular thymic cyst was obtained by tissue diagnosis of the anterior mediastinal mass resected during the surgery

Posterior mitral leaflet aneurysm – A rare cause of mitral regurgitation

Posterior mitral leaflet aneurysm is a very rare complication of infective endocarditis. A 28-year-old athlete got admitted with fever, congestive heart failure and multi-organ dysfunction syndrome. The echocardiogram showed large aneurysm of the posterior mitral leaflet with severe mitral regurgitation. Patient succumbed to refractory heart failure

Detection of cytomegalovirus, Epstein–Barr virus, and torque teno virus in subgingival and atheromatous plaques of cardiac patients with chronic periodontitis

Background: Periodontitis and atherosclerosis represent a chronic inflammatory process. The incidence of periodontitis in cardiac patients with atherosclerosis is a well-established fact. The role of viruses in the etiopathogenesis of both has been proposed. Aim: The aim of the study was to evaluate the prevalence of Torque Teno virus (TTV), Epstein–Barr virus (EBV), and cytomegalovirus (CMV) in cardiac patients with atherosclerosis and coexisting chronic periodontitis (CP). Materials and Methods: Thirty patients (17 males and 13 females) with atherosclerotic plaques and coexisting periodontitis were recruited for this cross-sectional study. Viral DNA was extracted from the subgingival and atheromatous plaque. The presence of CMV, EBV, and TTV in the plaque samples was identified using polymerase chain reaction. The collected data were statistically analyzed for the prevalence of the viruses and Chi-squared test was performed to find out its association with atheroma and CP. Results: The prevalence of CMV, EBV, and TTV in atheromatous plaque was 63.3%, 56.7%, and 46.7%, respectively, as compared to rates of 80%, 63.3%, and 53.3% in subgingival plaque. Results also indicated no significant association of CMV, EBV, and TTV in both samples (P = 0.08, 0.346, and 0.261, respectively). Conclusions: There was no significant association of CMV, EBV, and TTV between subgingival and atheromatous plaque. The prevalence of CMV, EBV, and TTV was high in atheromatous plaque. TTV was isolated from more than 50% of participants in atheromatous plaque, which is a significant finding