We present the case of a 56-year-old patient with fever of unknown origin associated with chest and lumbar pain. Multimodality imaging revealed diffuse peri-aortitis in the thoracic aorta without involvement of the aortic valve, contributing substantially to the diagnosis of Ig G4-associated aortitis. Immunosuppressive therapy was started. Follow-up at five months with cardiac magnetic resonance imaging showed a reduction in the inflammatory process in the thoracic aorta.
Presentamos el caso de un paciente de 56 años, con cuadro febril de origen desconocido asociado a dolor torácico y lumbar. La imagen multimodal demostró periaortitis difusa en la aorta torácica sin afectación de la válvula aórtica, lo que contribuyó sustancialmente al diagnóstico de aortitis asociada a Ig4. Se inició tratamiento inmunosupresor. El seguimiento a los 5 meses, la resonancia magnética cardíaca mostró una reducción del proceso inflamatorio en la aorta torácica.

暂无摘要。

BACKGROUND: The altered maternal inflammatory milieu and changes in maternal vascular structure (arterial stiffness) and function may affect the fetal heart in pregnant women diagnosed with inflammatory bowel disease (IBD).
OBJECTIVE: To investigate fetal cardiac functions in IBD pregnancies and to reveal the relationship between IBD duration and fetal cardiac functions.
METHODS: Prospective case-control study.
METHODS: The case group included 19 pregnant women with ulcerative colitis and seven with Crohn\'s disease who were in remission at the time of the study. The control group consisted of 52 healthy pregnant women matched for gestational age in the third trimester of pregnancy (at 32 to 33 weeks).
METHODS: Fetal cardiac functions. The assessment was blinded as to whether the patients were cases or controls.
RESULTS: The right ventricular E\', E\'/A\', S\', and tricuspid annular plane systolic excursion (TAPSE) were significantly lower, and E/E\', myocardial performance index (MPI\'), and isovolumetric relaxation time (IVRT\') were significantly higher in fetuses of IBD pregnancies. Diastolic functions (E/E\', E\', E\'/A\', and IVRT\'), systolic functions (S\' and TAPSE), and global function (MPI\') were changed in the case group. A significantly strong correlation was between maternal disease duration and fetal right ventricle diastolic function parameters (E/E\', E, E\', E\'/A\') in the case group (r2 = 0.780; p ≤0.001, r2 = 0.570; p ≤0.001, r2 = 0.604; p ≤0.001, r2 = 0.638; p ≤0.001, respectively).
CONCLUSIONS: Diastolic and systolic fetal cardiac functions changed in IBD pregnancies. As the disease duration increases, especially fetal cardiac diastolic functions may be affected.

OBJECTIVE: This study aimed to assess the effect of the inflammatory process on fetal cardiac functions in pregnant women with autoimmune diseases (AID).
METHODS: This prospective study included 36 pregnant women with diagnosed AID. Nineteen systemic lupus erythematosus, 12 antiphospholipid syndrome, 5 Sjögren\'s syndrome, and 72 healthy pregnancies were included. Fetal cardiac functions were evaluated with pulsed-wave, tissue Doppler, and M-mode echocardiography.
RESULTS: Sociodemographic data were similar in both groups. Significant increases were found in tricuspid E (43.5 ± 0.9, p<0.001) and A (59.2 ± 2.2, p<0.001) and E/A (0.74 ± 0.03, p<0.001), E\'/A\' (0.64 ± 0.15, p<0.001), E/E\' (6.5 ± 0.6, p<0.001), and left ventricular myocardial performance index (0.54 ± 0.03, p=0.005). We demonstrated a significant decrease in tricuspid E\' (6.7 ± 0.6, p<0.001) and S\' (6.9 ± 1, p<0.001) and in TAPSE (7.7 ± 0.5, p=0.002). We also found a significantly prolonged PR interval (130 ± 8, p<0.001). There was a significant increase in E\' (6.8, p=0.033) and a significant decrease in E/E\' ratio (6.4, p=0.027) in the group using hydroxychloroquine (HCQ) compared to non-users.
CONCLUSIONS: We found that pregnancy with autoimmune diseases affects fetal heart functions. Additionally, hydroxychloroquine may positively affect the heart of AID fetuses. This information might be useful to clinicians in the follow-up of cardiovascular diseases.

暂无摘要。

The impact of diuretics on the foetus is controversial, and thus they are not preferred during pregnancy [1]. Excessive fluid retention during late pregnancy can lead to acute pulmonary oedema (APO), which increases the foeto-maternal morbidity and mortality [2, 3]. Reported incidence is about 0.08%, which can become 1.5% in pre-eclampsia [2-4]. Although most commonly reported during late pregnancy and early puerperium, the occurrence of APO during labour is very rare [2, 3].

Leriche syndrome or aortoiliac occlusive disease is a particular obliterative arterial disease of the lower limbs, consisting of thrombotic occlusion of the aortoiliac junction. We here report the case of a 20-year-old female patient with no particular past medical history, presenting with acute lower limb ischemia. Lower extremity echo Doppler showed overall decrease in arterial blood flow without visualization of endoluminal material. Lower limb angioscaner showed arterial thrombosis of the abdominal aorta extended to bilateral external iliac arteries. The patient subsequently underwent aortic-bi-iliac bypass surgery with good evolution as well as assessments for possible thrombogenic mechanism.

An asymptomatic 5-year-old male was diagnosed with severe coarctation of the aorta despite normal peak flow velocity with pathology identified on the basis of Doppler flow profile.

暂无摘要。

Catheterization of the internal jugular vein is widely performed by both nephrologists and surgeons. It has become a routine procedure, but can be associated with serious complications. Carotid-jugular arterio-venous fistula (CJAVF) is a rare but potentially fatal complication. Very few cases have been reported in the literature. This study involved a patient with iatrogenic CJAVF following hemodialysis catheter placement performed three weeks earlier. The diagnosis was clinically suspected based on the discovery of laterocervical thrill and confirmed by echo-Doppler and angiography. The patient underwent successful open surgery. Operator experience and trainees support, in addition to the use of ultrasound guidance, can significantly reduce the occurrence of complications during jugular venous catheterization.