International journal of cardiology
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After Mustard or Senning repair for transposition of the great arteries (d-TGA), qualitative assessment of the systemic right ventricle remains difficult. We wanted to evaluate the relationship between demographic and echocardiographic variables, and exercise performance. ⋯ Maximal exercise capacity is reduced in adult patients after Mustard or Senning repair. Standard echocardiographic 2D-measurements are insufficient to determine the reduction in their functional capacity. The inverse relationship between age and the cardiac indices suggests an age dependent and progressive diminution of systemic ventricular function.
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Clonidine-induced delirium has rarely been reported. To the best of our knowledge, there are six related case reports in the literature. We describe one such case here and review the six previously published cases. ⋯ However, there are no clearly identifiable risk factors for the development of severe psychological side effects, including dose of medication, duration of treatment, and predisposing mental illness. Treatment for clonidine-induced delirium involves cessation of the medication and patient observation. Given the large clinical burden of hypertension and the not uncommon requirement for polypharmacy to achieve blood pressure goals, heightened clinical awareness of this potential side effect appears justified.
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Letter Case Reports
Ventricular septal defect and Swyer-James (Macleod's) syndrome together: a case report.
Swyer-James (MacLeod's) syndrome is a rare entity that is characterized by the hyperlucent appearance of one or more lobes of one lung, diminished ipsilateral hilar shadow and hardly visible arterial structure on chest radiography. Ventricular septal defect is the most common childhood congenital heart defect and, if left untreated, this will result to irreversible pulmonary hypertension, reversing of the shunt and Eisenmenger's syndrome. In this case report, we describe a 19-year-old female patient who had diagnosis of VSD and Swyer-James syndrome at the same time.
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Letter Case Reports
Intracoronary air embolism in open heart surgery--an uncommon source of myocardial ischaemia.
We report a case of air embolism detected by transesophageal echocardiography in a patient undergoing open heart surgery for acute mitral regurgitation. Intraoperative transesophageal echocardiography revealed an increased brightness of the apical wall and a severely compromised left ventricular myocardium with severe diffuse hypokinesis after removal of the aortic cross clamps and spontaneous resolution in the control echocardiography.
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Letter Case Reports
Free-floating thrombus in the right heart and pulmonary embolism.
We describe the case of a woman with acute pulmonary embolism and free-floating thrombus in the right heart. The diagnosis was performed using transthoracic echocardiography. The patient received urgent intravenous thrombolytic therapy with tissue plasminogen activator and vasoactive agent. This observation emphasizes the echocardiographic monitoring during thrombolysis in acute pulmonary embolism, allowing to strictly assess cardiac chamber sizes.