Texas Heart Institute journal
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Psychiatric consultation to the critically ill cardiac patient focuses on several common problems: anxiety, delirium, depression, personality reactions, and behavioral disturbances. A review of the causes and treatment of anxiety in the coronary care unit is followed by a discussion of delirium in the critically ill cardiac patient. ⋯ After the initial crisis has been stabilized in the critical care unit, the premorbid personality traits of the patient may emerge as behavioral disturbances--particularly as the duration of stay increases. The use of psychiatric consultation completes the discussion.
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We report a case of stab wound to the heart resulting in an atrial septal defect and perforation of the anterior leaflet of the mitral valve, which we repaired successfully 7 years after the injury. To our knowledge, repair of an atrial septal defect due to penetrating trauma has never before been reported. Investigation of possible valvular heart disease in a patient with a history of chest trauma should be aimed at identifying both intracardiac shunts and valvular abnormalities, so that a complete repair can be performed.
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Papillary fibroelastoma is a rare cardiac tumor arising most frequently from valvular endocardium. These tumors are clinically important because of their tendency to embolize. ⋯ To our knowledge, only 2 such cases have been reported in the English literature. Our case illustrates the discovery of a rare, but potentially fatal cardiac tumor, successfully removed by surgery.
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Complete atrioventricular canal defect is a serious and complex cardiac anomaly that is frequently associated with other congenital cardiac defects. Its natural course is ultimately fatal; 80% of children born with this defect will die within 2 years. ⋯ The risk of corrective surgery for this defect in infancy has steadily decreased because of improvements in surgical techniques, anesthesia, and postoperative management. This report describes our current surgical technique for primary corrective repair of complete atrioventricular canal defect, with a review of recent results of this procedure in 34 patients.