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CPC 2018
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Curso de Atualização em Medicina Cardiovascular 2019
Reunião Anual Conjunta dos Grupos de Estudo de Cirurgia Cardíaca, Doenças Valvulares e Ecocardiografia da SPC
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0 Topics
A. Basics
B. Imaging
C. Arrhythmias and Device Therapy
D. Heart Failure
E. Coronary Artery Disease, Acute Coronary Syndromes, Acute Cardiac Care
F. Valvular, Myocardial, Pericardial, Pulmonary, Congenital Heart Disease
G. Aortic Disease, Peripheral Vascular Disease, Stroke
H. Interventional Cardiology and Cardiovascular Surgery
I. Hypertension
J. Preventive Cardiology
K. Cardiovascular Disease In Special Populations
L. Cardiovascular Pharmacology
M. Cardiovascular Nursing
N. E-Cardiology / Digital Health, Public Health, Health Economics, Research Methodology
O. Basic Science
P. Other
0 Themes
01. History of Cardiology
02. Clinical Skills
03. Imaging
04. Arrhythmias, General
05. Atrial Fibrillation
06. Supraventricular Tachycardia (non-AF)
07. Syncope and Bradycardia
08. Ventricular Arrhythmias and Sudden Cardiac Death (SCD)
09. Device Therapy
10. Chronic Heart Failure
11. Acute Heart Failure
12. Coronary Artery Disease (Chronic)
13. Acute Coronary Syndromes
14. Acute Cardiac Care
15. Valvular Heart Disease
16. Infective Endocarditis
17. Myocardial Disease
18. Pericardial Disease
19. Tumors of the Heart
20. Congenital Heart Disease and Pediatric Cardiology
21. Pulmonary Circulation, Pulmonary Embolism, Right Heart Failure
22. Aortic Disease
23. Peripheral Vascular and Cerebrovascular Disease
24. Stroke
25. Interventional Cardiology
26. Cardiovascular Surgery
27. Hypertension
28. Risk Factors and Prevention
29. Rehabilitation and Sports Cardiology
30. Cardiovascular Disease in Special Populations
31. Pharmacology and Pharmacotherapy
32. Cardiovascular Nursing
33. e-Cardiology / Digital Health
34. Public Health and Health Economics
35. Research Methodology
36. Basic Science
37. Miscellanea
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Abstract
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Report
CLEAR FILTERS
Aortitis with left main coronary artery stenosis – an etiology not to be missed
Session:
Sessão de Casos Clínicos I
Speaker:
Sofia Torres
Congress:
CPC 2018
Topic:
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Theme:
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Session Type:
Sessão de Casos Clínicos
FP Number:
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Authors:
Sofia Torres; Mariana Vasconcelos; Paula Dias; Pedro Bernardo Almeida; Rui Rodrigues; Paulo Pinho; Filipe Macedo; Maria Júlia Maciel Barbosa
Abstract
<p>We report a case of a 55-year-old woman with a medical background of hypertension and diabetes and a history of breathlessness and chest pain with moderate exertion. She was admitted to our hospital due to an acute coronary syndrome without persistent ST segment elevation and acute heart failure.</p> <p>Transthoracic echocardiography revealed a moderately dilated ascending aorta after the sinotubular junction (46mm), a dilated left ventricle with moderate systolic dysfunction and severe aortic regurgitation (ERO 0,43cm<sup>2</sup>, RV 56ml, holodiastolic reverse flow in descending aorta with an end diastolic flow velocity of 0,28 m/s). Akinesia of the left ventricular apex and of the mid-segments of the lateral, posterior e anterior walls was also evident. The right ventricular systolic function was preserved.</p> <p>Coronary angiography showed a severe lesion of the left main coronary artery ostium, with no evidence of stenosis in the remaining coronary arteries.</p> <p>Based on the findings of ascending aorta dilation and isolated ostial coronary artery lesion, syphilis serologic tests were undertaken and revealed positive. The patient had no recollection of any primary lesions or symptoms related to secondary syphilis.</p> <p>She was successfully submitted to cardiac surgery, with aortic valve and ascending aorta replacement plus coronary artery bypass grafting, and was given a three-week course of benzathine penicillin. The anatomopathological and microbiologic examination of the resected tissue revealed an inflammatory infiltration of plasma cells and lymphocytes and confirmed the presence of Treponema Pallidum DNA through the polymerase chain reaction (PCR) technique.</p> <p>Conclusion: Cardiovascular manifestations of tertiary syphilis infections, though uncommon in developed countries, still represent a relevant source of mortality and morbidity, and may indeed grow in prevalence in decades to come based on recent epidemiologic studies. Syphilitic aortitis is characterized by aortic regurgitation, dilatation of ascending aorta and ostial coronary artery lesions, and clinicians should suspect this diagnosis so that the correct antibiotic treatment and follow-up can be undertaken.</p>
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