Nihat Şen

Assessment of subclinical left ventricular dysfunction in patients with psoriasis by speckle tracking echocardiography: A Speckle Tracking Study

Psoriasis is a systemic inflammatory disease and is reportedly associated with adverse cardiovascular risks. Left ventricular (LV) function has not been studied comprehensively in psoriasis.

ROMATIZMAL MITRAL KAPAK HASTALIĞINA BAĞLI DEV SOL ATRIUM

Giris: Dev sol atrium, sol atrium capinin 65 mm’den buyuk olmasi olarak tanimlanir(1) ve genelde romatizmal kapak hastalarinda gorulur(2). Hastalarin cogu ilerleyici nefes darligi, disfaji, carpinti ve tromboembolik olaylar ile basvurur(3). Bu hastalarda sol atrium icerisinde kan akiminin durgun hale gelmesi ve atrial fibrilasyon gibi ritm bozuklugun yaygin olmasi nedeniyle trombus olusumu ve embolik olaylar sik gorulur. Hastalarin bir kisminda dev sol atriumun sol ventrikulun hareketlerini etkileyerek hemodinamik bozukluklara neden olabilecegi dusunulmektedir(4). Bizim olgumuzda romatizmal mitral kapak hastaligina bagli olarak dev sol atrium goruldu. Progressif olarak artan nefes darligi ile basvuran olgumuzun INR duzeyi efektif olmasina ragmen sol atrium icerisinde spontan eko kontrast mevcuttu.

SEPTİC PULMONARY EMBOLİSM DUE TO TRİCUSPİD VALVE ENDOCARDİTİS İN A DRUG ADDİCT

A 24 years old male who has heroin addiction history for four years admitted to emergency service with fever, malaise and shortness of breath. His physical appearance was pale and physical examination revealed 38,5o C body temperature, 120/70 mmHg blood pressure, 3/6 systolic murmur at the left sternal border, diffuse inspiratory rales, absence of respiratory sound at the base of the left lung. Transthoracic echocardiography showed tricuspid vegetation at a size of 3.0x1.9x1.2 cm and mild tricuspid regurgitation, other heart valves and cardiac chambers were morphologically and functionally normal (Fig. 1) Computerized tomography showed multiple cavitary lesions throughout the lung and pleural effussion at the base of left lung (Fig. 2). Anamnesis and echocardiographic findings confirmed the diagnosis as tricuspid valve endocarditis. Vancomycin 1gr twice daily and sefoperazon/sulbactam 1 gr twice daily was started as the initial treatment. Serial blood cultures drawn from the patient were negative probably due to previous antibiotic usage. Fever persisted and vegetation size could not be reduced despite antibiotic treatment for two weeks. Patient was sent to another center for surgical treatment.

SAĞ KORONER ARTERDEN KÖKEN ALAN SOL ANA KORONER ARTERİN 64 KESİTLİ BİLGİSAYARLI TOMOGRAFİ İLE GÖRÜNTÜLENMESİ

OZET Koroner arter cikis anomalileri siklikla benign bir durum olup herhangi bir nedenle yapilan koroner anjiografi sirasinda saptanmaktadir. Nadir olarak gorulen bazi tipleri seyirleri dolayisiyla ciddi klinik sonuclara neden olabilmektedir. Kirk uc yasinda bayan hasta son zamanlarda gittikce artan efor anginasi sikayeti ile basvurdu. Agrisinin tipik karakterde olmasi nedeniyle yapilan koroner anjiografide sol ana koroner arterin sag sinus valsalvadan ciktigi saptandi. Yapilan 64 kesitli bilgisayarli tomografi (BT) ‘de sol ana koroner arterin pulmoner arterin on tarafinda seyrettigi tespit edildi. Biz koroner arter anomalisi olan bu hastada yeni goruntuleme tekniklerinin onemini vurgulamayi amacladik. Anahtar Kelimeler: Koroner anomali, sol ana koroner arter, cok kesitli bilgisayarli tomografi