RESUMO
During a recent volunteer medical mission to the Dominican Republic, we administered anesthesia to a child with severe pulmonary valvular stenosis and suprasystemic right ventricular pressure. This patient underwent a balloon pulmonary valvuloplasty but then developed worsening right ventricular outflow tract obstruction that required immediate therapy to prevent a low cardiac output state. As the development of hyperdynamic right ventricular outflow tract obstruction cannot be predicted, we emphasize the need for preemptive hydration and beta-blockade therapy prior to balloon dilatation.
Assuntos
Anestesia Geral , Estenose da Valva Pulmonar/cirurgia , Obstrução do Fluxo Ventricular Externo/tratamento farmacológico , Adolescente , Antagonistas Adrenérgicos beta/uso terapêutico , Cateterismo , República Dominicana , Ecocardiografia , Feminino , Humanos , Missões Médicas , Propanolaminas/uso terapêuticoRESUMO
Mitral valvuloplasty is efficient for repairing mitral valve disease with few complications. In some cases, obstruction of the left ventricular outflow tract may occur due to systolic anterior motion of the mitral valve. We report the case of a patient with this complication and a pressure gradient between the left ventricle and the aorta of 130 mm Hg after mitral valvuloplasty with implantation of a Gregori's ring. The management was clinical with suspension of the vasoactive drugs and introduction of a beta-blocker. Two years after the surgery, the patient is asymptomatic and has a normal life.
Assuntos
Implante de Prótese de Valva Cardíaca , Valva Mitral/cirurgia , Complicações Pós-Operatórias/etiologia , Obstrução do Fluxo Ventricular Externo/etiologia , Humanos , Masculino , Pessoa de Meia-Idade , Complicações Pós-Operatórias/tratamento farmacológico , Obstrução do Fluxo Ventricular Externo/tratamento farmacológicoRESUMO
We report the case of a 33-year-old male with primary seminoma of the anterior mediastinum with initial clinical manifestations suggestive of heart disease.
Assuntos
Neoplasias Cardíacas/secundário , Seminoma/secundário , Neoplasias Testiculares/patologia , Obstrução do Fluxo Ventricular Externo/complicações , Adulto , Antibióticos Antineoplásicos/uso terapêutico , Neoplasias Cardíacas/tratamento farmacológico , Ventrículos do Coração/ultraestrutura , Humanos , Masculino , Seminoma/tratamento farmacológico , Obstrução do Fluxo Ventricular Externo/tratamento farmacológicoRESUMO
We report the case of a 33-year-old male with primary seminoma of the anterior mediastinum with initial clinical manifestations suggestive of heart disease