Clinical Cardiology Cases

Dr. Ihab Suliman

A 30-year-old man presented with multiple asymptomatic, firm, polypoid, erythematous nodules on the upper and lower gingivae,

which had developed during the previous 10 years.

The patient had spastic quadriparesis and mental retardation, as well as epilepsy, for which he had been taking phenytoin for more than 20 years.

A 64-year-old man presented with progressive shortness of breath and exercise intolerance due to end-stage ischemic

cardiomyopathy.What is done for him?

he underwent a heterotopic cardiac transplantation. Because of the presence of severe pulmonary

hypertension, the recipient's native heart (N) was left in place and the allograft was implanted in the right chest.

The native heart maintains right circulation in spite of chronic pulmonary hypertension, while the heterotopic donor heart (D) functions as a biologic left ventricular assist device. The post-transplantation electrocardiogram shows two QRS complexes with different axes (Panel A).

ECG Double heart

What is the diagnosis?

Necrobiosis lipoidica diabeticorum May be an antibody-mediated vasculitis with

secondary collagen degeneration or the microangiopathy of diabetes (but it is not correlated with the extent of glucose control).

Treatment may include occlusive dressings, topical and subcutaneous corticosteroids, and antiplatelet therapy. Flare-ups are frequent. No treatment is completely effective.

Constrictive Pericarditis due to Childhood TB

Pericardial Effusion