Charles E Denbow

Myxoma of right femoral vein origin presenting as a right atrial mass with syncope

and respiratory muscle weakness. No known drug(s) associated with rhabdomyolysis, itself rare,4 were administered, nor were any metabolic factors present that are capable of potentiating this event. When rhabdomyolysis has been reported in patients undergoing longterm therapy, no acute causative factor is apparent.3,4 Rosenberg and colleagues,5 however, have documented intraoperative rhabdomyolysis associated with pravastatin in cases in which the operation was thought to be the trigger. Although speculative, 7 years of uneventful simvastatin therapy in this case, together with the report by Rosenberg’s group, indicates to us that the timing of this complication and operation were not coincidental. R E F E R E N C E S 1. Walker JF. World wide experience with simvastatin/lovastatin. Eur Heart J 1992;13(suppl B);21-2. 2. Campeau L, Knatterud G, Hunninghake B, Domanski N. Optimising cholesterol lowering therapy: contribution of the post coronary artery bypass graft trial. Eur Heart J 1997;18:1683-5. 3. Garnett WR. Interactions with hydroxy methylglutaryl coenzyme A reductase inhibitors. Am J Health Syst Pharm 1995;52:163944. 4. Kogan AD, Orenstein S. Lovastatin induced acute rhabdomyolysis. Postgrad Med J 1996;66:294-6. 5. Rosenberg AD, Neuwirth MJ, Kagen LJ, Singh K, Fischer HD, Bernstein RL. Intraoperative rhabdomyolysis in a patient receiving Pravostatin, a hydroxy-III-methylglutaryl co-enzyme A (HMG coA) reductase inhibitor. Anaesth Analg 1995;81:1089-91. The Journal of Thoracic and Cardiovascular Surgery Volume 116, Number 4 Brief communications 655

Pulmonary artery pressure and the acute chest syndrome in homozygous sickle cell disease.

OBJECTIVE--To investigate whether attacks of acute chest syndrome affected pulmonary artery pressure in patients homozygous for sickle cell disease. MAIN OUTCOME MEASURES--Pulmonary artery pressure, assessed by non-invasive echocardiographic techniques. PATIENTS--20 patients with homozygous sickle cell disease with a history of at least six episodes of acute chest syndrome and in 20 age, sex, and height matched controls with homozygous sickle cell disease without a history of acute chest syndrome. RESULTS--There was no difference in any of the echocardiographic or Doppler indices between these two groups. CONCLUSIONS--Repeated attacks of acute chest syndrome by the mean age of 12 (range eight to 16) years have not had a discernible effect upon pulmonary artery pressure.