Myxomas are the most common primary cardiac tumors; the most common localization is the left atrium, and may cause mitral flow obstruction so their clinical presentation could mimic severe mitral stenosis; trans thoracic echocardiography allows the diagnosis; we report a case of left atrial myxoma revealed by atrial tachycardia concomitant with dyspnea and signs of chronic right heart failure; despite surgical resection of the tumor, our patient had developed tachycardiomyopathy with severe left ventricular dysfunction,  which recovered two months later, after intensive administration of antiarrhythmic treatment.

Corona virus disease 2019 infection exhibits a tropism for the respiratory tract, however several cardiac damages have been reported, such as coronary disease, cardiac arrhythmias and myocarditis; this latter has become more frequent after the outbreak of the COVID-19 pandemic, and may be the only manifestation of COVID 19 infection, the diagnosis is not always obvious especially for focal myocarditis and can be misdiagnosed as an acute coronary syndrome in some patients.

We reported five patients, admitted between June 2020 and January 2021, in our cardiology department for isolated acute focal myocarditis secondary to COVID 19 infection without respiratory or other damages, the diagnosis was not evident at first, but further investigations such as: electrocardiographic evolution, magnetic resonance imagery, coronary computed tomography angiography, and COVID 19 antibody testing, were in favor of the diagnosis of focal myocarditis secondary to COVID 19 infection.

Cardiac magnetic resonance imaging showed, delayed contrast enhancement in the lateral wall of the left ventricle, for all five patients, so fibrosis is preferentially located in the lateral wall, and the outcome was favorable without hemodynamic or arrhythmic complications.

Background: Blood loss occurs frequently and remains a challenge in spinal surgery. As significant intra and postoperative hemorrhage negatively affects patient outcomes by increasing coagulopathy, postoperative hematoma, and anemia. The need for allogenic blood transfusions can lead to potential transfusion reactions and infections, in addition to increasing long-term mortality rates. Although there are many randomized control trials and meta-analysis investigating the role of tranexamic acid (TXA), we could not find any study that investigated the role of TXA in patients with medical comorbidities. Therefore, tackling the role of TXA in patients with single or multiple comorbidities is of valuable outcome to our locality as most of the patients have indeed associated comorbidities.

Objectives: to investigate the role of tranexamic acid in decreasing perioperative blood loss in patients with multiple comorbidities as compared to otherwise healthy individuals.

Patients and methods: A single center randomized control trial. We included patients that were about to undergo simple decompressive surgeries for lumbar canal stenosis and fixation with decompression for spondylolisthesis. Patients were randomly categorized into cases (who received TXA) and controls who received NS. Patients then were subcategorized according to comorbidities and types of surgeries. Intraoperative blood loss was calculated using the suction drain and the gauze while the post operative bleeding was calculated using the drain output.

Results: There was 441.84 ml (49.6 %) decrease in intraoperative bleeding for patients who received TXA as compared to controls regardless the type of surgery and regardless the presence or absence of comorbidities. Hypertensive patients had 52.7 % reduction in intraoperative bleeding when received TXA, Diabetic patients showed 44.4 % reduction in bleeding, Obese patients showed 51.1% reduction and patients with multiple comorbidities showed 51% reduction in intraoperative bleeding while healthy individuals showed 38.9% reduction in intraoperative bleeding.

Conclusion: TXA was even more effective in decreasing intraoperative bleeding in patients with multiple comorbidities as compared to healthy individuals.

Fourty patients were diagnosed with Cytomegalovirus in pregnant with fever, weariness, and lymphadenitis. ELISA was recycled to check CMV IgG antibodies. A entire of 40 patients sera infested by means of lymphadenitis plus 40 regulator sera joined hip this learning be present calculated in place of IL-17 and IL-1β levels in their blood. The results point to significant transformation amongst patients and control for IL-17, while no difference between them at IL-1β.

Background: Typical Atrial Flutter in acute coronary syndrome with ST segment elevation is very rare and never reported as a separate electrocardiographic entity, but associated with atrial fibrillation.

Its incidence isn’t reported in the literature, and no data about its predictive factors or related mortality, also its epidemiological data is lacking in Algeria.

Aims: The main objective of our study is the determination of the frequency of typical atrial flutter in acute coronary syndrome with ST segment elevation, the secondary objective was the analysis of its predictive factors, and related mortality.

Methods and materials:  In this prospective study, conducted in the cardiology department of Hussein Dey hospital (Algiers-Algeria), 467 patients with acute coronary syndrome with elevated ST segment (87 women and 380 men) were enrolled between 28 February 2014 and 16 July 2015. The average age is 60 ± 13 years; at admission, a Holter recorder was attached for continuous ECG monitoring during 48 hours

Kruskal’s ANNOVA or H tests were used for comparison of quantitative variables, χ2 test or Fisher’s exact test, were used for qualitative variables, all tests were performed with 1^st species risk of 5%.

Results:  The frequency of typical atrial flutter is 0.4 % (2 patients), CI 95%: [0%-1%], multivariate analysis identified right heart failure as the only predictive factor.

The risk of mortality expressed by Hazard Ration (HR) is 27 (CI95%: [3.5-207], p = 0.001); right heart failure is the only predictive factor of mortality identified in our study.

Conclusion: typical atrial flutter is very rare in acute coronary syndrome with elevated ST segment, its predictive factor according to our study is right heart failure, and its occurrence increases the risk of hospital mortality.

Hypcalcemia is a rare cause of dilated cardiomyopathy, but should be suspected in the presence of an obvious long QT interval on the surface ECG; we report a case of 46 years-old-woman, with surgical history of thyroidectomy 6 years ago, admited in our cardiology departement for mangement of congestive heart failure secondary to dilated cardiomyopathy,  her surface  ECG showed sinus rhythm with  long QT interval, his blood tests showed severe hypocalcemia and  low serum concentration of parathyroid hormone (PTH), cardiac magnetic resonance imaging was in favor of non ischemic dilated cardiomyopathy.

Concomitant with conventionel heart failure treatement, our patient had received parenteral   calcium supplementation, vitamin D, levothyrox; after four weeks, heart failure symptomes  were relieved, the intervalle QT has shortened, but persistant severe left ventricular systolic dysfuction. 

Hypoparathyroidism is frequent after thyroidectomy, and could be responsible of severe hypocalcemia which in turn may induce irreversible dilated cardiomyopathy. 

Chronic thromboembolic pulmonary hypertension occurs after one or more episodes of pulmonary embolism. A rigorous diagnostic approach makes it possible to identify this condition, to evaluate its functional and hemodynamic impact and to determine the degree of extension of the vascular damage. Surgical pulmonary endarterectomy in specialized centers remains the treatment of choice in certain cases. Other therapeutic modalities include transplantation, pulmonary angioplasty, and pharmacological treatments with pulmonary vasodilators. We report the case of OA aged 25, followed since the age of 10 for post-embolic PAH. She was hospitalized at this age in pediatrics for the first episode of pulmonary embolism. The initial etiological assessment was without abnormalities. One year after pulmonary embolism, pulmonary pressures were still elevated despite effective anticoagulation. The patient was started on sildenafil at the age of 11. The evolution was stable. At the age of 16, she was referred to us for care. Her cardiovascular assessment revealed suprasystemic PAH; the patient was then put on a combination of sintrom, sildenafil and bosentan. The thrombophilia assessment is without abnormalities. Currently, she is 25 years old, she is in NYHA functional class II on dual therapy, she has presented several right heart decompensations following non-compliance with treatment and dietary deviation. We discussed a surgical endarterectomy at her home but unfortunately the damage is distal and old. Through this case, we will review this entity of PAH by discussing the different modes of expression and the medical, surgical and interventional therapeutic management (pulmonary angiopalstia with a balloon).