Broncholithiasis

No abstract

Cardiac lipomas are rare benign primary tumors of the heart [1]. We describe a case in which the preoperative diagnosis was made by using CT. Case ReportA 28-year-old man was referred for evaluation of ventricular tachycardia, which had been diagnosed after an episode of syncope. When the patient was i 0 years old, he was told he had an enlarged heart, and he underwent a cardiac catheterization at that time, details of which are not available.Physical examination was normal. A chest radiograph showed an enlarged heart (Fig. iA). An initial two-dimensional echocardiogram showed normal ventricular size and function. The distal aspect of the ventricular septum had abnormal motion. Cardiac catheterization showed normal right and left ventricular function. The left anterior descending coronary artery was displaced anteriorly by an epicardial mass, which also stretched the septal perforators. A second echocardiogram showed an echogenic mass external to the heart that extended from the anterior intraventricular groove circumferentially to the inferior posterior wall.To evaluate the mass further, both noncontrast CT and dynamic CT during a 100-mI bolus injection of 61 % iopamidol were performed.Scans showed a large, low-density mass located along the left side of the heart, beginning at the anterior intraventricular groove and extending posteriorly to the left atrium. The mass covered the entire anterior wall and most of the lateral wall of the left ventricle. The density of the mass was -1 07 H. No contrast enhancement of the mass was seen. The left anterior descending coronary artery and smaller branch vessels were displaced away from the ventricular wall by the mass (Figs.

Elevated fibrinopeptide A levels in unstable angina reflected active intracoronary thrombus formation and were present in patients with angina of new onset as well as crescendo angina. Reversible ST changes are accompanied by thrombin activity and angiographic thrombus formation. However, a sizable percentage of patients with unstable angina had no evidence of thrombus and these patients may have had transient platelet aggregation without fibrin thrombus formation.

Three cases of left ventricular aneurysm secondary to external violence are reported. Each patient presented with a pseudoaneurysm of the left ventricle, following penetrating trauma in two instances and blunt trauma in the third instance. The interval between injury and diagnosis ranged from 5 months to 24 years. Two patients underwent successful resection of the aneurysm. Repair was not attempted in the third patient. Only 16 cases of post-traumatic left ventricular aneurysm have previously been reported. In 13 of the 19 cases available for review, the trauma was blunt and in six penetrating. The aneurysm could be determined to be a true aneurysm in five instances and a false aneurysm in eight instances. Complications (rupture, cardiac failure, embolism, and arrhythmia) proved fatal in eight cases. Each of the eight patients subjected to aneurysmectomy survived.