In Regard to Otelea et al.

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Arrow Cause of Angina Pectoris: Single Coronary Artery Anomaly in Elderly Patient

DergiPark: 700196tmsjAims: Coronary artery anomalies are rare diseases among the population. These anomalies, which are usually noticed by chance, can remain silent for many years without symptoms. We aimed to present a patient with a coronary artery anomaly withouthaving any symptoms for many years. Case Report: A 73-year-old female patient presented to the Department of Cardiologyof the Trakya University School of Medicine. The patient stated that she had chest pain that decreased with rest and increasedwith exercise for the last 2 months. After the cardiac examination of the patient, imaging procedures were deemed necessary.After imaging, the patient was diagnosed with a single coronary artery anomaly. The patient was recommended to have surgery,but she refused. Upon this, the patient was discharged on condition that she was kept under frequent follow-up. Conclusion:Coronary artery anomalies have reached higher rates of diagnosis thanks to increased imaging technologies in recent years. Ifthese congenital diseases that can even cause death are noticed early, there are various treatment options. First of all, medicaltreatment is preferred, and surgery is recommended in patients with no response to the medical treatment. This disease, whichis closely related to the patient's life, should be carefully evaluated by the doctors. Keywords: Coronary arteries, cardiac anomaly,angiograph

Hydatid Cyst in a Heart Failure Patient Mimicking Phantom Tumor

DergiPark: 1020978tmsjAims: We aimed to present a heart failure patient with a hydatid cyst of the lung, mimicking a phantom tumor. Case Report: A 71-year-old male patient pre- sented to the cardiology department of Trakya University School of Medicine with increasing shortness of breath and cough. His hospital admission complaints, heart failure history, and chest radiology results were consistent with a phantom tumor of the lung secondary to congestive heart failure. The patient was given diuretics; however, there was no evidence of resolution or change in the size of the observed cystic lesion. A hydatid cyst as a differential diagnosis was consid- ered, and subsequent questioning of the patient revealed animal contacts. The patient was offered the option of surgical removal of the cyst, which he declined due to the high mortality risk. The patient was prescribed 400 mg of albendazole and was advised to have regular check-ups. In the long term, he showed no further signs and symptoms of hydatid cyst. The hydatid cyst was neither removed nor disappeared, and it continued to be visible on radiological follow-up examinations. Conclusion: Due to the similarities present in admission complaints and chest examinations, it is challenging to differentiate hydatid cyst of the lung in heart failure patients. Physicians should be aware of the hydatid cyst in the differential diagnosis of pleural cysts and consider patients’ occupation and residency in order to not overlook zoonotic diseases

Constrictive Pericarditis: An Overlooked Cause of Ascites

DergiPark: 963058tmsjAims: Constrictive pericarditis is a well-known but unusual and rare cause of ascites. The diagnosis of constrictive pericarditis in most patients who have chronic ascites is challenging. We aimed to present a patient with constrictive pericarditis with chronic ascites and pericardial calcifications seen in chest radiography. Case Report: A 66-year-old male patient presented to the emergency room of Trakya University School of Medicine. The patient had abdominal swelling and ascites for the last 5 years and underwent large-volume paracentesis in his previous emergency admissions. After the electrocardiography of the patient, he was directed to the cardiology department for further examinations. The chest radiography revealed significant pericardial calcifications. Following imaging procedures confirmed radiological findings, and the patient was diagnosed with constrictive pericarditis. Furthermore, his cardiac catheterization findings were consistent with constrictive pericarditis. The patient was recommended to have a pericardiectomy operation and there was a significant reduction in the patient's symptoms after surgery. Conclusion: The absence of specific symptoms and resemblances of existing symptoms to liver disease make the early diagnosis of con- strictive pericarditis difficult. Physicians should consider constrictive pericarditis as a differential diagnosis when dealing with a patient who has chronic ascites

A Spider in the Spider’s View: Behçet’s Disease-related Giant Coronary Aneurysm

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Successful Management of Peripartum Cardiomyopathy in a Young Female Patient

DergiPark: 1020979tmsjAims: Peripartum cardiomyopathy is a rarely seen pregnancy-related myocardial disorder. The diagnosis is usually challenging and is made by exclusion. We aimed to present the recovery of a patient with peripartum cardiomyopathy as a result of a successful treatment plan. Case Report: A 26-year-old female patient with type-2 diabetes mellitus presented to the cardiology department of Trakya University School of Medicine. The patient experienced dyspnea and edema after delivery at 37 weeks of gestation. After the results of the blood tests, further cardiac examinations were deemed necessary. The echocardiogram revealed a low ejection fraction, indicating heart failure. The patient was recommended to halt breastfeeding and bromocriptine treatment was started. The patient was discharged one week later and kept under follow-up. Conclusion: Peripartum cardiomyopathy is a rare disease and therefore not easy to diagnose, but with appropriate treatment plans and frequent follow-ups, patients have high chances of full recovery

Evaluation of Demographic, Clinic and Genetic Characteristics of Patients Admitted to Trakya University Hospital With Hypertrophic Cardiomyopathy

DergiPark: 1020973tmsjAims: This study aims to evaluate the genetics, clinical characteristics, and functional abnormalities of patients diagnosed with hypertrophic cardiomyopathy in Trakya University Hospital. Methods: This retrospective study was conducted with patients who were diagnosed with hypertrophic cardiomyopathy between November 2009 - November 2019 in Trakya University Hospital. The data were obtained from the hospital’s database. Patients’ data (regarding age, gender, ge- netics, transthoracic echocardiogram findings, medications, types of hypertrophic cardiomyopathy, and first diagnoses) were examined. Numbers, percentages, means, and standard deviations were used as descriptive statistics. Results: Eleven patients with hypertrophic cardiomyopathy were evaluated. Five (45.45%) were female and 6 (54.54%) were male. The mean age of the female patients was 58.20 ± 8.57 years. The most common type of hypertrophic cardiomyopathy was found to be asymmetrical septal cardiomyopathy [7 (63.63%)]. Three (27.27%) patients presented with hypertension. There were gene mutations in three patients. Among these three patients, two (18.18%) patients have MYBPC3, and one (9.09%) patient has TTN gene mutations. Conclusion: Hypertrophic car- diomyopathy is usually accompanied by comorbidities such as arrhythmias, myocardial infarction, coronary artery disease. Therefore, these patients must be paid attention to in these matters

Hypereosinophilic Cardiac Involvement Presenting With Left Ventricular Massive Thrombus and Cardioembolic Stroke: A Case Report

Introduction: It is well known that the tendency toward thrombosis is increased in cancer patients. The increase in cancer procoagulant and tissue factor levels, endothelial damage, and stasis due to compression are among the most accused causes of thrombosis in cancer patients. Hypereosinophilia is a rare condition that causes endothelial damage leading to thrombosis. Case Presentation: We present a 64-year-old male patient with cardiac involvement of hypereosinophilia which developed in the T-cell lymphoma ground resulting in a fatal cardioembolic stroke. Despite normal left ventricular (LV) contractions, almost half of the ventricular volume was full of thrombus in this case. Conclusion: Hypereosinophilia is a rare cause of thrombus formation in the left ventricle in patients with preserved ejection fraction. However, hypereosinophilic cardiac involvement can lead to rapid, progressive, life-threatening complications

The ratio of contrast volume to glomerular filtration rate predicts in-hospital and six-month mortality in patients undergoing primary angioplasty for ST-elevation myocardial infarction

Background: The aim of this study is to determine the impact of ratio of contrast volume to glomerular filtration rate (V/GFR) on development of contrast-induced nephropathy (CIN) and long-term mortality in patients with ST-segment elevation acute myocardial infarction (STEMI) undergoing primary percutaneous coronary intervention (PCI). Methods: A total of 645 patients with STEMI undergoing primary PCI was prospectively enrolled. CIN was defined as an absolute increase in serum creatinine > 0.5 mg/dL or a relative increase > 25% within 48 h after PCI. The study population was divided into tertiles based on V/GFR. A high V/GFR was defined as a value in the third tertile (> 3.7). Results: Patients in tertile 3 were older, had higher rate of smoking, diabetes mellitus and CIN, lower left ventricular ejection fraction, hemoglobin, and systolic and diastolic blood pressure compared to tertiles 1 and 2 (p < 0.05). V/GFR was found an independent predictor of in-hospital and 6-month mortality. We found 2 separate values of V/GFR for 2 different end points. While the ratio of 3.6 predicted in-hospital mortality with 78% sensitivity and 82% specificity, the ratio of 3.3 predicted 6-month mortality with 71% sensitivity and 76% specificity. Survival rate decreases as V/GFR increases both for in-hospital and during 6-month follow-up. Diabetes mellitus and multivessel disease were other predictors of in-hospital mortality. Conclusions: High V/GFR level is associated with increased in-hospital and long-term mortality in patients with STEMI undergoing primary PCI.

Congenital absence of the pericardium: A rare cause of right ventricular dilatation and levoposition of the heart

Congenital absence of the pericardium is a rare cardiac defect with variable clinical presentations and is usually discovered incidentally. The pathology may lead to serious complications such as incarceration of cardiac tissue, myocardial ischemia, aortic dissection or valvular insufficiency. Diagnosis is not difficult so long as some tips are remembered. We present the cases of two patients with congenital absence of left pericardium