was read the article
array:24 [ "pii" => "S2174204915000616" "issn" => "21742049" "doi" => "10.1016/j.repce.2015.03.006" "estado" => "S300" "fechaPublicacion" => "2015-03-01" "aid" => "603" "copyright" => "Sociedade Portuguesa de Cardiologia" "copyrightAnyo" => "2014" "documento" => "simple-article" "licencia" => "http://creativecommons.org/licenses/by-nc-nd/4.0/" "subdocumento" => "crp" "cita" => "Rev Port Cardiol. 2015;34:209.e1-3" "abierto" => array:3 [ "ES" => true "ES2" => true "LATM" => true ] "gratuito" => true "lecturas" => array:2 [ "total" => 3956 "formatos" => array:3 [ "EPUB" => 172 "HTML" => 3255 "PDF" => 529 ] ] "Traduccion" => array:1 [ "en" => array:19 [ "pii" => "S0870255115000384" "issn" => "08702551" "doi" => "10.1016/j.repc.2014.08.027" "estado" => "S300" "fechaPublicacion" => "2015-03-01" "aid" => "603" "copyright" => "Sociedade Portuguesa de Cardiologia" "documento" => "simple-article" "licencia" => "http://creativecommons.org/licenses/by-nc-nd/4.0/" "subdocumento" => "crp" "cita" => "Rev Port Cardiol. 2015;34:209.e1-3" "abierto" => array:3 [ "ES" => true "ES2" => true "LATM" => true ] "gratuito" => true "lecturas" => array:2 [ "total" => 4622 "formatos" => array:3 [ "EPUB" => 205 "HTML" => 3696 "PDF" => 721 ] ] "en" => array:13 [ "idiomaDefecto" => true "cabecera" => "<span class="elsevierStyleTextfn">Case report</span>" "titulo" => "Multiple mechanical complications in ST-segment elevation myocardial infarction with angiographically normal coronary arteries" "tienePdf" => "en" "tieneTextoCompleto" => "en" "tieneResumen" => array:2 [ 0 => "en" 1 => "pt" ] "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "209.e1" "paginaFinal" => "209.e3" ] ] "titulosAlternativos" => array:1 [ "pt" => array:1 [ "titulo" => "Enfarte agudo do miocárdio com supradesnivelamento de ST com múltiplas complicações mecânicas e artérias coronárias angiograficamente normais" ] ] "contieneResumen" => array:2 [ "en" => true "pt" => true ] "contieneTextoCompleto" => array:1 [ "en" => true ] "contienePdf" => array:1 [ "en" => true ] "resumenGrafico" => array:2 [ "original" => 0 "multimedia" => array:7 [ "identificador" => "fig0015" "etiqueta" => "Figure 3" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr3.jpeg" "Alto" => 684 "Ancho" => 975 "Tamanyo" => 73422 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0035" class="elsevierStyleSimplePara elsevierViewall">4-chamber triple inversion recovery fast spin echo and delayed enhancement images showing communication between a left ventricular aneurysm and a right ventricular pseudoaneurysm.</p>" ] ] ] "autores" => array:1 [ 0 => array:2 [ "autoresLista" => "André Viveiros Monteiro, Ana Galrinho, Luísa Moura Branco, José Fragata, Rui Cruz Ferreira" "autores" => array:5 [ 0 => array:2 [ "nombre" => "André" "apellidos" => "Viveiros Monteiro" ] 1 => array:2 [ "nombre" => "Ana" "apellidos" => "Galrinho" ] 2 => array:2 [ "nombre" => "Luísa" "apellidos" => "Moura Branco" ] 3 => array:2 [ "nombre" => "José" "apellidos" => "Fragata" ] 4 => array:2 [ "nombre" => "Rui" "apellidos" => "Cruz Ferreira" ] ] ] ] ] "idiomaDefecto" => "en" "Traduccion" => array:1 [ "en" => array:9 [ "pii" => "S2174204915000616" "doi" => "10.1016/j.repce.2015.03.006" "estado" => "S300" "subdocumento" => "" "abierto" => array:3 [ "ES" => true "ES2" => true "LATM" => true ] "gratuito" => true "lecturas" => array:1 [ "total" => 0 ] "idiomaDefecto" => "en" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2174204915000616?idApp=UINPBA00004E" ] ] "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S0870255115000384?idApp=UINPBA00004E" "url" => "/08702551/0000003400000003/v4_201503200652/S0870255115000384/v4_201503200652/en/main.assets" ] ] "itemSiguiente" => array:18 [ "pii" => "S2174204915000628" "issn" => "21742049" "doi" => "10.1016/j.repce.2015.03.007" "estado" => "S300" "fechaPublicacion" => "2015-03-01" "aid" => "604" "copyright" => "Sociedade Portuguesa de Cardiologia" "documento" => "simple-article" "licencia" => "http://creativecommons.org/licenses/by-nc-nd/4.0/" "subdocumento" => "crp" "cita" => "Rev Port Cardiol. 2015;34:211.e1-3" "abierto" => array:3 [ "ES" => true "ES2" => true "LATM" => true ] "gratuito" => true "lecturas" => array:2 [ "total" => 2548 "formatos" => array:3 [ "EPUB" => 171 "HTML" => 1910 "PDF" => 467 ] ] "en" => array:13 [ "idiomaDefecto" => true "cabecera" => "<span class="elsevierStyleTextfn">Case report</span>" "titulo" => "When inappropriate becomes beneficial" "tienePdf" => "en" "tieneTextoCompleto" => "en" "tieneResumen" => array:2 [ 0 => "en" 1 => "pt" ] "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "211.e1" "paginaFinal" => "211.e3" ] ] "titulosAlternativos" => array:1 [ "pt" => array:1 [ "titulo" => "Quando o inapropriado se torna saudável" ] ] "contieneResumen" => array:2 [ "en" => true "pt" => true ] "contieneTextoCompleto" => array:1 [ "en" => true ] "contienePdf" => array:1 [ "en" => true ] "resumenGrafico" => array:2 [ "original" => 0 "multimedia" => array:7 [ "identificador" => "fig0005" "etiqueta" => "Figure 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 3759 "Ancho" => 3240 "Tamanyo" => 2589488 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0015" class="elsevierStyleSimplePara elsevierViewall">Implantable cardioverter-defibrillator (ICD) electrogram with (1) start of electrical interference and (2) ICD shock delivery and termination of interference.</p>" ] ] ] "autores" => array:1 [ 0 => array:2 [ "autoresLista" => "José David Arroja, Marc Zimmermann" "autores" => array:2 [ 0 => array:2 [ "nombre" => "José David" "apellidos" => "Arroja" ] 1 => array:2 [ "nombre" => "Marc" "apellidos" => "Zimmermann" ] ] ] ] ] "idiomaDefecto" => "en" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2174204915000628?idApp=UINPBA00004E" "url" => "/21742049/0000003400000003/v2_201504010220/S2174204915000628/v2_201504010220/en/main.assets" ] "itemAnterior" => array:19 [ "pii" => "S2174204915000525" "issn" => "21742049" "doi" => "10.1016/j.repce.2014.10.003" "estado" => "S300" "fechaPublicacion" => "2015-03-01" "aid" => "600" "copyright" => "Sociedade Portuguesa de Cardiologia" "documento" => "article" "licencia" => "http://creativecommons.org/licenses/by-nc-nd/4.0/" "subdocumento" => "ssu" "cita" => "Rev Port Cardiol. 2015;34:201-8" "abierto" => array:3 [ "ES" => true "ES2" => true "LATM" => true ] "gratuito" => true "lecturas" => array:2 [ "total" => 5009 "formatos" => array:3 [ "EPUB" => 160 "HTML" => 4005 "PDF" => 844 ] ] "en" => array:13 [ "idiomaDefecto" => true "cabecera" => "<span class="elsevierStyleTextfn">Review article</span>" "titulo" => "Galectin-3, a prognostic marker – and a therapeutic target?" "tienePdf" => "en" "tieneTextoCompleto" => "en" "tieneResumen" => array:2 [ 0 => "en" 1 => "pt" ] "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "201" "paginaFinal" => "208" ] ] "titulosAlternativos" => array:1 [ "pt" => array:1 [ "titulo" => "Galectina-3: indicador de prognóstico. Alvo de intervenção terapêutica?" ] ] "contieneResumen" => array:2 [ "en" => true "pt" => true ] "contieneTextoCompleto" => array:1 [ "en" => true ] "contienePdf" => array:1 [ "en" => true ] "resumenGrafico" => array:2 [ "original" => 0 "multimedia" => array:7 [ "identificador" => "fig0010" "etiqueta" => "Figure 2" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr2.jpeg" "Alto" => 1380 "Ancho" => 1487 "Tamanyo" => 95453 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0055" class="elsevierStyleSimplePara elsevierViewall">Median galectin-3 levels among heart failure patients who died (n=17) within 60 days and those who survived (n=192). Results from the PRIDE subanalysis. Reproduced with permission from van Kimmenade et al.<a class="elsevierStyleCrossRef" href="#bib0150"><span class="elsevierStyleSup">3</span></a></p>" ] ] ] "autores" => array:1 [ 0 => array:2 [ "autoresLista" => "Ana Rita Pereira, Luiz Menezes Falcão" "autores" => array:2 [ 0 => array:2 [ "nombre" => "Ana Rita" "apellidos" => "Pereira" ] 1 => array:2 [ "nombre" => "Luiz" "apellidos" => "Menezes Falcão" ] ] ] ] ] "idiomaDefecto" => "en" "Traduccion" => array:1 [ "pt" => array:9 [ "pii" => "S0870255115000359" "doi" => "10.1016/j.repc.2014.10.005" "estado" => "S300" "subdocumento" => "" "abierto" => array:3 [ "ES" => true "ES2" => true "LATM" => true ] "gratuito" => true "lecturas" => array:1 [ "total" => 0 ] "idiomaDefecto" => "pt" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S0870255115000359?idApp=UINPBA00004E" ] ] "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2174204915000525?idApp=UINPBA00004E" "url" => "/21742049/0000003400000003/v2_201504010220/S2174204915000525/v2_201504010220/en/main.assets" ] "en" => array:19 [ "idiomaDefecto" => true "cabecera" => "<span class="elsevierStyleTextfn">Case report</span>" "titulo" => "Multiple mechanical complications in ST-segment elevation myocardial infarction with angiographically normal coronary arteries" "tieneTextoCompleto" => true "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "209.e1" "paginaFinal" => "209.e3" ] ] "autores" => array:1 [ 0 => array:4 [ "autoresLista" => "André Viveiros Monteiro, Ana Galrinho, Luísa Moura Branco, José Fragata, Rui Cruz Ferreira" "autores" => array:5 [ 0 => array:4 [ "nombre" => "André" "apellidos" => "Viveiros Monteiro" "email" => array:1 [ 0 => "andreviveirosmonteiro@gmail.com" ] "referencia" => array:2 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff0005" ] 1 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">*</span>" "identificador" => "cor0005" ] ] ] 1 => array:3 [ "nombre" => "Ana" "apellidos" => "Galrinho" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff0005" ] ] ] 2 => array:3 [ "nombre" => "Luísa" "apellidos" => "Moura Branco" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff0005" ] ] ] 3 => array:3 [ "nombre" => "José" "apellidos" => "Fragata" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">b</span>" "identificador" => "aff0010" ] ] ] 4 => array:3 [ "nombre" => "Rui" "apellidos" => "Cruz Ferreira" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff0005" ] ] ] ] "afiliaciones" => array:2 [ 0 => array:3 [ "entidad" => "Cardiology Department, Hospital of Santa Marta, Lisbon, Portugal" "etiqueta" => "a" "identificador" => "aff0005" ] 1 => array:3 [ "entidad" => "Cardiothoracic Surgery Department, Hospital of Santa Marta, Lisbon, Portugal" "etiqueta" => "b" "identificador" => "aff0010" ] ] "correspondencia" => array:1 [ 0 => array:3 [ "identificador" => "cor0005" "etiqueta" => "⁎" "correspondencia" => "Corresponding author." ] ] ] ] "titulosAlternativos" => array:1 [ "pt" => array:1 [ "titulo" => "Enfarte agudo do miocárdio com supradesnivelamento de ST com múltiplas complicações mecânicas e artérias coronárias angiograficamente normais" ] ] "resumenGrafico" => array:2 [ "original" => 0 "multimedia" => array:7 [ "identificador" => "fig0005" "etiqueta" => "Figure 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 1066 "Ancho" => 1624 "Tamanyo" => 136553 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0025" class="elsevierStyleSimplePara elsevierViewall">Transthoracic echocardiogram showing a large apical aneurysm of the left ventricle and a pseudoaneurysm in the right ventricle.</p>" ] ] ] "textoCompleto" => "<span class="elsevierStyleSections"><span id="sec0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0025">Introduction</span><p id="par0005" class="elsevierStylePara elsevierViewall">In the contemporary era of primary angioplasty, mechanical complications after ST-segment elevation myocardial infarction (STEMI) such as ventricular septal defect (VSD) and ventricular aneurysm are increasingly only found in anecdotal reports. Nevertheless, the outcome remains extremely poor without prompt surgical intervention.<a class="elsevierStyleCrossRefs" href="#bib0030"><span class="elsevierStyleSup">1–5</span></a> Total occlusion of the infarct-related artery with minimal collaterals is the common underlying angiographic pattern.<a class="elsevierStyleCrossRefs" href="#bib0030"><span class="elsevierStyleSup">1,2</span></a> Only 1–12% of all acute coronary events have normal coronary arteries or non-significant coronary disease on angiography. Prognosis in this population is usually favorable without mechanical complications. Absence of coronary artery disease in postinfarction mechanical complications is extremely rare and very few cases have been reported in the literature.<a class="elsevierStyleCrossRefs" href="#bib0045"><span class="elsevierStyleSup">4,5</span></a></p></span><span id="sec0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0030">Case report</span><p id="par0010" class="elsevierStylePara elsevierViewall">In this report, we describe the case of an 82-year-old man, with a previous aortic valve replacement with a bioprosthesis four years previously. He was admitted for anterior STEMI with normal coronary arteries on angiography and apical ballooning. At this time the transthoracic echocardiogram (TTE) revealed a normally functioning aortic prosthesis and the apex was akinetic. He was followed at another institution where, at the first month follow-up visit, he complained of fatigue and dyspnea. TTE showed a VSD and an apical aneurysm of the left ventricle (LV) and the patient was transferred to our institution. In our department a complete TTE displayed a dilated LV, with normal global systolic function and hyperkinesia of the basal and mid segments. A large apical aneurysm was visualized with a LV to right ventricle (RV) turbulent flow suggestive of a shunt with a gradient of 90–97 mmHg (<a class="elsevierStyleCrossRef" href="#fig0005">Figure 1</a>). Contrast TTE with Sonovue<span class="elsevierStyleSup">®</span> (<a class="elsevierStyleCrossRef" href="#fig0010">Figure 2</a>) and cardiac magnetic resonance imaging (<a class="elsevierStyleCrossRef" href="#fig0015">Figure 3</a>) were performed for further characterization, both showing a large LV apical aneurysm with a thrombus and a VSD with two jets of a turbulent flow to an apical RV pseudoaneurysm, also with a thrombus inside. The patient underwent corrective surgery with a Dor procedure (endoventricular circular patch plasty) combined with VSD closure and resection of the RV pseudoaneurysm (<a class="elsevierStyleCrossRef" href="#fig0020">Figure 4</a>). The procedure was successful and the postoperative course was uneventful.</p><elsevierMultimedia ident="fig0005"></elsevierMultimedia><elsevierMultimedia ident="fig0010"></elsevierMultimedia><elsevierMultimedia ident="fig0015"></elsevierMultimedia><elsevierMultimedia ident="fig0020"></elsevierMultimedia></span><span id="sec0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0035">Discussion</span><p id="par0015" class="elsevierStylePara elsevierViewall">Postinfarction VSD is usually associated with multivessel coronary artery disease with significant stenosis in all major vessels. In the case reported, although the angiographic pattern was completely normal, STEMI was complicated by a VSD, LV aneurysm and RV pseudoaneurysm. VSD usually occurs in the first two weeks after infarction, with a peak in the first 24 hours and between the third and fifth day post-infarction.<a class="elsevierStyleCrossRefs" href="#bib0030"><span class="elsevierStyleSup">1–3</span></a> It is associated with signs of pulmonary congestion, biventricular failure, and hypotension, which were not observed in our patient during that period. Clinical features associated with an increased risk of VSD include lack of development of a collateral network, advanced age, hypertension, anterior wall infarction and possibly fibrinolysis.<a class="elsevierStyleCrossRef" href="#bib0050"><span class="elsevierStyleSup">5</span></a> Medical treatment is usually not effective and early surgical closure of the rupture is recommended.<a class="elsevierStyleCrossRef" href="#bib0030"><span class="elsevierStyleSup">1</span></a> The pathophysiology, clinical characteristics, and prognosis of STEMI with angiographically normal coronary arteries are still under investigation. Smoking, cocaine abuse, hypercoagulable states, myocardial bridging, trauma, endothelial dysfunction and vasospasm, together with acute myocarditis, are among the most frequently reported causes, but none were present in this patient. Nevertheless, the apparently normal coronary arteriogram could be explained by disruption with thrombosis of a plaque at a site of outward remodeling of the artery followed by spontaneous lysis or distal embolization of the thrombus into the microcirculation after fragmentation. The compensatory enlargement or positive remodeling maintained the lumen caliber of the coronary artery affected by atherosclerosis, explaining the normal angiographic pattern.</p><p id="par0020" class="elsevierStylePara elsevierViewall">STEMI with angiographically normal coronary arteries appears to be less severe, with fewer complications during the acute and late phases compared with infarction due to severe atherosclerotic disease.<a class="elsevierStyleCrossRef" href="#bib0050"><span class="elsevierStyleSup">5</span></a> Although its incidence has decreased considerably since the advent of early mechanical reperfusion, STEMI complications are associated with a high rate of mortality and urgent need for early surgical repair. This case report discusses the unusual presentation of STEMI with normal coronary arteries and severe mechanical complications successfully treated with surgery.</p></span><span id="sec0020" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0040">Ethical disclosures</span><span id="sec0025" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0045">Protection of human and animal subjects</span><p id="par0025" class="elsevierStylePara elsevierViewall">The authors declare that the procedures followed were in accordance with the regulations of the relevant clinical research ethics committee and with those of the Code of Ethics of the World Medical Association (Declaration of Helsinki).</p></span><span id="sec0030" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0050">Confidentiality of data</span><p id="par0030" class="elsevierStylePara elsevierViewall">The authors declare that they have followed the protocols of their work center on the publication of patient data.</p></span><span id="sec0035" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0055">Right to privacy and informed consent</span><p id="par0035" class="elsevierStylePara elsevierViewall">The authors declare that no patient data appear in this article.</p></span></span><span id="sec0040" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0060">Conflicts of interest</span><p id="par0040" class="elsevierStylePara elsevierViewall">The authors have no conflicts of interest to declare.</p></span></span>" "textoCompletoSecciones" => array:1 [ "secciones" => array:10 [ 0 => array:3 [ "identificador" => "xres469289" "titulo" => "Abstract" "secciones" => array:1 [ 0 => array:1 [ "identificador" => "abst0005" ] ] ] 1 => array:2 [ "identificador" => "xpalclavsec491900" "titulo" => "Keywords" ] 2 => array:3 [ "identificador" => "xres469288" "titulo" => "Resumo" "secciones" => array:1 [ 0 => array:1 [ "identificador" => "abst0010" ] ] ] 3 => array:2 [ "identificador" => "xpalclavsec491901" "titulo" => "Palavras-chave" ] 4 => array:2 [ "identificador" => "sec0005" "titulo" => "Introduction" ] 5 => array:2 [ "identificador" => "sec0010" "titulo" => "Case report" ] 6 => array:2 [ "identificador" => "sec0015" "titulo" => "Discussion" ] 7 => array:3 [ "identificador" => "sec0020" "titulo" => "Ethical disclosures" "secciones" => array:3 [ 0 => array:2 [ "identificador" => "sec0025" "titulo" => "Protection of human and animal subjects" ] 1 => array:2 [ "identificador" => "sec0030" "titulo" => "Confidentiality of data" ] 2 => array:2 [ "identificador" => "sec0035" "titulo" => "Right to privacy and informed consent" ] ] ] 8 => array:2 [ "identificador" => "sec0040" "titulo" => "Conflicts of interest" ] 9 => array:1 [ "titulo" => "References" ] ] ] "pdfFichero" => "main.pdf" "tienePdf" => true "fechaRecibido" => "2014-07-11" "fechaAceptado" => "2014-08-16" "PalabrasClave" => array:2 [ "en" => array:1 [ 0 => array:4 [ "clase" => "keyword" "titulo" => "Keywords" "identificador" => "xpalclavsec491900" "palabras" => array:4 [ 0 => "Ventricular septal defect" 1 => "Ventricular aneurysm" 2 => "Myocardial infarction" 3 => "Normal coronary arteries" ] ] ] "pt" => array:1 [ 0 => array:4 [ "clase" => "keyword" "titulo" => "Palavras-chave" "identificador" => "xpalclavsec491901" "palabras" => array:4 [ 0 => "Rutura interventricular" 1 => "Aneurisma ventricular" 2 => "Enfarte do miocárdio" 3 => "Artérias coronárias normais" ] ] ] ] "tieneResumen" => true "resumen" => array:2 [ "en" => array:2 [ "titulo" => "Abstract" "resumen" => "<span id="abst0005" class="elsevierStyleSection elsevierViewall"><p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">This case report discusses an unusual presentation of ST-segment elevation myocardial infarction (STEMI) with normal coronary arteries and severe mechanical complications successfully treated with surgery. An 82-year-old man presented STEMI with angiographically normal coronary arteries and no major echocardiographic alterations at discharge. At the first month follow-up, he complained of fatigue and dyspnea, and contrast echocardiography complemented by cardiac magnetic resonance imaging revealed a large left ventricular apical aneurysm with a thrombus communicating by two jets of a turbulent flow to an aneurysmatic formation of the right ventricular apex. The patient underwent a Dor procedure, which was successful.</p><p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">Ventricular septal defects and ventricular aneurysms are rare but devastating complications of STEMI, with almost all patients presenting multivessel coronary artery disease. Interestingly in this case, the angiographic pattern was normal.</p></span>" ] "pt" => array:2 [ "titulo" => "Resumo" "resumen" => "<span id="abst0010" class="elsevierStyleSection elsevierViewall"><p id="spar0015" class="elsevierStyleSimplePara elsevierViewall">O presente caso clínico discute a apresentação incomum de um enfarte agudo do miocárdio com supradesnivelamento de ST (EAMCST) com complicações mecânicas graves e artérias coronárias normais tratado cirurgicamente com sucesso. Um homem de 82 anos sofreu um EAMCST com artérias coronárias angiograficamente normais e sem alterações ecocardiográficas de relevo aquando da alta. Na consulta do primeiro mês pós enfarte, por queixas de cansaço e dispneia, realizou um ecocardiograma complementado por uma ressonância magnética cardíaca que revelaram um grande aneurisma apical do ventrículo esquerdo, com trombo, comunicando através de dois jatos de fluxo turbulento com uma formação aneurismática do ápice do ventrículo direito. O paciente foi submetido a um procedimento de Dor com sucesso.</p><p id="spar0020" class="elsevierStyleSimplePara elsevierViewall">A rutura do septo interventricular e os aneurismas ventriculares permanecem eventos raros mas devastadores com a quase maioria dos pacientes apresentado doença coronária multivaso. Curiosamente neste caso, o padrão angiográfico era normal.</p></span>" ] ] "multimedia" => array:4 [ 0 => array:7 [ "identificador" => "fig0005" "etiqueta" => "Figure 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 1066 "Ancho" => 1624 "Tamanyo" => 136553 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0025" class="elsevierStyleSimplePara elsevierViewall">Transthoracic echocardiogram showing a large apical aneurysm of the left ventricle and a pseudoaneurysm in the right ventricle.</p>" ] ] 1 => array:7 [ "identificador" => "fig0010" "etiqueta" => "Figure 2" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr2.jpeg" "Alto" => 1159 "Ancho" => 1626 "Tamanyo" => 140225 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0030" class="elsevierStyleSimplePara elsevierViewall">Transthoracic echocardiogram with SonoVue<span class="elsevierStyleSup">®</span> contrast showing a ventricular septal defect connecting a large apical aneurysm of the left ventricle with a pseudoaneurysm in the right ventricle.</p>" ] ] 2 => array:7 [ "identificador" => "fig0015" "etiqueta" => "Figure 3" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr3.jpeg" "Alto" => 1141 "Ancho" => 1626 "Tamanyo" => 134896 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0035" class="elsevierStyleSimplePara elsevierViewall">4-chamber triple inversion recovery fast spin echo and delayed enhancement images showing communication between a left ventricular aneurysm and a right ventricular pseudoaneurysm.</p>" ] ] 3 => array:7 [ "identificador" => "fig0020" "etiqueta" => "Figure 4" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr4.jpeg" "Alto" => 1251 "Ancho" => 1627 "Tamanyo" => 192311 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0040" class="elsevierStyleSimplePara elsevierViewall">Intraoperative photograph of ventricular septal defect closure and resection of the right ventricular pseudoaneurysm.</p>" ] ] ] "bibliografia" => array:2 [ "titulo" => "References" "seccion" => array:1 [ 0 => array:2 [ "identificador" => "bibs0005" "bibliografiaReferencia" => array:5 [ 0 => array:3 [ "identificador" => "bib0030" "etiqueta" => "1" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Survival after surgical repair of ischemic ventricular septal rupture" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:3 [ 0 => "Y. Abu-Omar" 1 => "P. Bhinda" 2 => "C.K. Choong" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1177/0218492312438739" "Revista" => array:6 [ "tituloSerie" => "Asian Cardiovasc Thorac Ann" "fecha" => "2012" "volumen" => "20" "paginaInicial" => "404" "paginaFinal" => "408" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/22879546" "web" => "Medline" ] ] ] ] ] ] ] ] 1 => array:3 [ "identificador" => "bib0035" "etiqueta" => "2" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Fatal myocardial infarction in a 88-year-old woman" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:3 [ 0 => "A.V. Macedo" 1 => "P.J. Moffa" 2 => "E.E. Filho" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:4 [ "tituloSerie" => "Arq Bras Cardiol" "fecha" => "2005" "volumen" => "85" "paginaInicial" => "2" ] ] ] ] ] ] 2 => array:3 [ "identificador" => "bib0040" "etiqueta" => "3" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Percutaneous device closure of post-infarction ventricular septal defect with aneurysm" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:3 [ 0 => "C.J. Burrell" 1 => "L.A. Zacharkiw" 2 => "J.V. Giovanni" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1136/hrt.2003.013847" "Revista" => array:5 [ "tituloSerie" => "Heart" "fecha" => "2004" "volumen" => "90" "paginaInicial" => "731" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/15201237" "web" => "Medline" ] ] ] ] ] ] ] ] 3 => array:3 [ "identificador" => "bib0045" "etiqueta" => "4" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Postinfarction ventricular septal defect in a patient without coronary lesions" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:3 [ 0 => "G. Nappi" 1 => "L.S. Santo" 2 => "M. Torella" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "Ann Thorac Surg" "fecha" => "2003" "volumen" => "75" "paginaInicial" => "1315" "paginaFinal" => "1317" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/12683587" "web" => "Medline" ] ] ] ] ] ] ] ] 4 => array:3 [ "identificador" => "bib0050" "etiqueta" => "5" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Postinfarction ventricular septal rupture following thrombolysis: long-term survival in the presence of normal coronary arteries. A case report" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:3 [ 0 => "D. Alexopoulos" 1 => "C. Olympios" 2 => "G. Hahalis" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "Angiology" "fecha" => "1996" "volumen" => "47" "paginaInicial" => "295" "paginaFinal" => "297" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/8638875" "web" => "Medline" ] ] ] ] ] ] ] ] ] ] ] ] ] "idiomaDefecto" => "en" "url" => "/21742049/0000003400000003/v2_201504010220/S2174204915000616/v2_201504010220/en/main.assets" "Apartado" => array:4 [ "identificador" => "9919" "tipo" => "SECCION" "en" => array:2 [ "titulo" => "Case Reports" "idiomaDefecto" => true ] "idiomaDefecto" => "en" ] "PDF" => "https://static.elsevier.es/multimedia/21742049/0000003400000003/v2_201504010220/S2174204915000616/v2_201504010220/en/main.pdf?idApp=UINPBA00004E&text.app=https://revportcardiol.org/" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2174204915000616?idApp=UINPBA00004E" ]
Year/Month | Html | Total | |
---|---|---|---|
2024 November | 6 | 3 | 9 |
2024 October | 29 | 20 | 49 |
2024 September | 35 | 23 | 58 |
2024 August | 43 | 27 | 70 |
2024 July | 40 | 31 | 71 |
2024 June | 26 | 19 | 45 |
2024 May | 35 | 13 | 48 |
2024 April | 25 | 24 | 49 |
2024 March | 22 | 16 | 38 |
2024 February | 26 | 21 | 47 |
2024 January | 22 | 19 | 41 |
2023 December | 19 | 24 | 43 |
2023 November | 24 | 20 | 44 |
2023 October | 15 | 15 | 30 |
2023 September | 15 | 19 | 34 |
2023 August | 20 | 17 | 37 |
2023 July | 17 | 15 | 32 |
2023 June | 22 | 11 | 33 |
2023 May | 37 | 26 | 63 |
2023 April | 14 | 3 | 17 |
2023 March | 27 | 24 | 51 |
2023 February | 24 | 20 | 44 |
2023 January | 30 | 19 | 49 |
2022 December | 25 | 16 | 41 |
2022 November | 33 | 28 | 61 |
2022 October | 36 | 25 | 61 |
2022 September | 26 | 36 | 62 |
2022 August | 31 | 34 | 65 |
2022 July | 31 | 30 | 61 |
2022 June | 22 | 20 | 42 |
2022 May | 33 | 31 | 64 |
2022 April | 20 | 31 | 51 |
2022 March | 25 | 34 | 59 |
2022 February | 22 | 26 | 48 |
2022 January | 27 | 20 | 47 |
2021 December | 18 | 34 | 52 |
2021 November | 35 | 32 | 67 |
2021 October | 26 | 37 | 63 |
2021 September | 26 | 26 | 52 |
2021 August | 23 | 29 | 52 |
2021 July | 18 | 34 | 52 |
2021 June | 32 | 19 | 51 |
2021 May | 28 | 29 | 57 |
2021 April | 81 | 32 | 113 |
2021 March | 49 | 15 | 64 |
2021 February | 58 | 17 | 75 |
2021 January | 35 | 16 | 51 |
2020 December | 38 | 10 | 48 |
2020 November | 32 | 13 | 45 |
2020 October | 18 | 14 | 32 |
2020 September | 51 | 9 | 60 |
2020 August | 18 | 4 | 22 |
2020 July | 48 | 6 | 54 |
2020 June | 47 | 3 | 50 |
2020 May | 38 | 1 | 39 |
2020 April | 37 | 9 | 46 |
2020 March | 42 | 10 | 52 |
2020 February | 129 | 9 | 138 |
2020 January | 25 | 6 | 31 |
2019 December | 33 | 3 | 36 |
2019 November | 37 | 9 | 46 |
2019 October | 27 | 8 | 35 |
2019 September | 65 | 13 | 78 |
2019 August | 37 | 5 | 42 |
2019 July | 27 | 11 | 38 |
2019 June | 57 | 7 | 64 |
2019 May | 26 | 6 | 32 |
2019 April | 50 | 23 | 73 |
2019 March | 147 | 13 | 160 |
2019 February | 109 | 13 | 122 |
2019 January | 132 | 3 | 135 |
2018 December | 152 | 10 | 162 |
2018 November | 129 | 13 | 142 |
2018 October | 202 | 14 | 216 |
2018 September | 52 | 14 | 66 |
2018 August | 56 | 9 | 65 |
2018 July | 38 | 3 | 41 |
2018 June | 76 | 8 | 84 |
2018 May | 58 | 5 | 63 |
2018 April | 115 | 2 | 117 |
2018 March | 100 | 13 | 113 |
2018 February | 65 | 3 | 68 |
2018 January | 79 | 3 | 82 |
2017 December | 120 | 5 | 125 |
2017 November | 67 | 7 | 74 |
2017 October | 31 | 8 | 39 |
2017 September | 34 | 6 | 40 |
2017 August | 34 | 12 | 46 |
2017 July | 29 | 11 | 40 |
2017 June | 43 | 10 | 53 |
2017 May | 55 | 15 | 70 |
2017 April | 35 | 2 | 37 |
2017 March | 47 | 16 | 63 |
2017 February | 43 | 2 | 45 |
2017 January | 46 | 3 | 49 |
2016 December | 56 | 11 | 67 |
2016 November | 34 | 21 | 55 |
2016 October | 25 | 5 | 30 |
2016 September | 34 | 7 | 41 |
2016 August | 18 | 3 | 21 |
2016 July | 17 | 3 | 20 |
2016 June | 16 | 1 | 17 |
2016 May | 23 | 4 | 27 |
2016 April | 27 | 1 | 28 |
2016 March | 38 | 15 | 53 |
2016 February | 43 | 21 | 64 |
2016 January | 39 | 13 | 52 |
2015 December | 39 | 10 | 49 |
2015 November | 44 | 15 | 59 |
2015 October | 36 | 18 | 54 |
2015 September | 22 | 9 | 31 |
2015 August | 27 | 14 | 41 |
2015 July | 35 | 5 | 40 |
2015 June | 29 | 8 | 37 |
2015 May | 24 | 10 | 34 |
2015 April | 38 | 15 | 53 |