Ruptured abdominal aortic aneurysm with a horseshoe kidney : an uncommon but potentially troublesome coexistence

We report a case of an elderly patient with a ruptured abdominal aortic aneurysm (AAA) associated with a horseshoe kidney (HSK) treated by an emergency open repair and discuss the anatomical features and surgical challenges attendant to this rare combined pathology.peer-reviewe

A case of atypical Kawasaki disease with giant coronary artery aneurysm containing thrombus

Kawasaki disease (KD) is an acute febrile, systemic vasculitic syndrome of unknown etiology, occurring primarily in children younger than 5 years of age. Administration of IVIG within the first 10 days after onset of fever in combination with high dose aspirin reduces the risk of coronary artery damage in KD. Though rare, giant aneurysms of the coronary arteries may develop in untreated cases and prove extremely challenging to manage. A 9-month-old Caucasian boy presented to our paediatric emergency department with a 4-week history of intermittent pyrexia and irritability. Typical mucocutaneous signs of Kawasaki Disease were absent upon presentation. A trans-thoracic echocardiogram identified a giant aneurysm of the left anterior descending artery with thrombus formation in-situ and the child was managed with intravenous immunoglobulin, steroids, high dose aspirin therapy and later warfarinisation. Cardiovascular sequelae of Kawasaki disease include giant coronary artery aneurysms with thrombosis. Enlargement of a coronary aneurysm after the acute phase of Kawasaki disease is uncommon and the outcome of interventional approaches poorly studied.peer-reviewe

Hypertension in a primary care setting in Buza, Tanzania & Malta

Introduction: Worldwide prevalence of hypertension (HT) in established market economy countries is estimated at 37.4% for males and 37.2% for females. Aim: To identify the frequency of HT in sample populations of Malta and Buza, Tanzania, looking specifically at gender differences, the rate of previous diagnosis and compliance to medication. Methods: A comparative cross-sectional population-based survey to calculate the frequency of hypertension of a sample of the Maltese population reviewed in 2010 and a sample of people reviewed in a primary care medical clinic Buza in that same year. Both samples were statistically matched and compared. Results: Frequency of HT in the Maltese sample was 32.8% (M:F - 32.8:32.8), and compliance rate was 48%. The frequency of HT in the Buza sample was 48.4% (M:F - 47.7:48.9) and the compliance rate was 8%. Frequency of stage II and malignant HT were significantly more prevalent in the Buza population. The frequency of HT increased with age in both populations studied. Conclusions: Prevalence of examined HT in the Maltese sample was higher than the self-reported survey carried out in 2008, but still lower than the Buza sample and within range of the established market economy countries. Education and awareness of HT will increase lifestyle changes and further reduce the frequency of HT and increase the compliance rates in both populations. Hypertension awareness and readily available treatment is a much needed public health service. Furthermore, it is cheap, easy to offer and significantly improves quality of life.peer-reviewe

A Giant Thrombosed Right Coronary Artery Aneurysm Presenting as an Obstructing Left Atrial Mass

Giant coronary artery aneurysms are exceedingly rare. Symptoms are vague and often related to myocardial ischaemia or compression of a cardiac chamber. Surgery is indicated when obstruction to the circulation results in heart failure or syncope, as in our case. A clear elucidation of the pathology may not be possible before exploration and the surgical strategy is tailored to the individual case