Takotsubo cardiomyopathy, also known as "takotsubo syndrome," refers to transient apical ballooning syndrome, stress cardiomyopathy, or broken heart syndrome and is a recently recognized syndrome typically characterized by transient and reversible left ventricular dysfunction that develops in the setting of acute severe emotional or physical stress. Increased catecholamine levels have been proposed to play a central role in the pathogenesis of the disease, although the specific pathophysiology of this condition remains to be fully determined. At present, there have been very few reports of recurrent takotsubo cardiomyopathy. In this case report, we present a patient with multiple recurrences of takotsubo syndrome triggered by severe emotional stress that presented with recurrent loss of consciousness, QT prolongation, and polymorphic ventricular tachycardia () and left ventricular apical thrombus.

SummaryBackground: The number of patients with congenital cardiac disease reaching adulthood is increasing steadily. Many adults with such disease face both medical and surgical difficulties.Hypothesis: This retrospective study was undertaken to assess the frequency and outcome of congenital heart disease (CHD) in unoperated adults.Methods: The charts of all patients with unoperated CHD, who were admitted to a tertiary care center in Beirut, Lebanon, between 1980 and 2000 were reviewed. Of these, 206 patients (52% men, age at admittance 18-71 years [32.8 ± 13.3 years]) with a diagnosis of CHD were evaluated. Atrial septal defect (ASD) was the most common cardiac malformation with a relative frequency of 53%, followed by ventricular septal defects (11%), tetralogy of Fallot (11%), aortic anomalies (7%), pulmonary stenosis (6%), and Ebstein anomaly (4%). Most patients were symptomatic upon presentation, with dyspnea on exertion being the most common presenting symptom. Twenty-seven patients (13%) had cyanotic CHD. Of 179 acyanotic patients, 113 (63%), and 17 of 27 cyanotic patients (63%) underwent surgical intervention. In-hospital surgical complications for the acyanotic group included cerebrovascular accident (2%) and heart block (1%). Total surgical mortality was 4 of 130 (3%). One patient with tetralogy of Fallot presented with endocarditis and died.

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INTRODUCTION: Parotid cancers are characterized by a great histological diversity and they pose diagnostic, therapeutic and evolutionary problems. We deliver through this study our experience on the management of malignant parotid tumors. MATERIALS AND METHODS: This is a retrospective, descriptive and analytical study carried out over a period of 12 years in the ENT department of Fann teaching hospital. RESULTS: The mean age at diagnosis was 48 years with a sex-ratio of 1.6. The time to symptom progression was approximately 47 months. Parotid swelling was present in all patients and peripheral facial palsy was found in 31% of patients. Ultrasound of the parotid region was performed in 11 patients, i.e. 34%, and computed tomography in 18 patients, i.e. 56%. Fine needle aspiration was performed in 11 patients. Parotid cancers accounted for 44% of all parotid tumors. Sixty-eight percent of patients consulted at the T4 stage. Seventy-one percent of patients received surgical treatment. The most common histologic type was muco-epidermoid carcinoma. Five patients received radiotherapy. The postoperative effects were dominated by PFP (18%). Seven cases of death were recorded. CONCLUSION: The management of parotid cancer still poses diagnostic and above all therapeutic problems. The combination of radiotherapy surgery, very rarely encountered in our study, provides a better prognosis and better survival.