Journal of Yeungnam Medical Science

Late complication of the Nuss procedure: recurrent cardiac tamponade: Won Jong Park, Jang Won Son, Kyu Hwan Park, You Min Kim, Jong Ho Nam, Kang Un Choi, Jung Ho Kim; Yeungnam Univ J Med. 2019;36(3):260-264. Published online June 13, 2019; DOI: https://doi.org/10.12701/yujm.2019.00241

Abstract PDF: Pectus excavatum (PE) is known as one of the most common congenital deformities of the anterior chest wall. The Nuss procedure is an effective surgical therapy to correct PE. Here, we report a case of recurrent cardiac tamponade due to hemopericardium that occurred after 16 months following the Nuss procedure. The cause of recurrent hemopericardium was thought to be local, repetitive irritation of the pericardium by the Nuss steel bar. We should keep in mind that this serious complication can occur after the Nuss procedure, even in the late phase.

Acute left main coronary artery thrombosis as an initial presentation of systemic lupus erythematosus: Kang Un Choi, Ung Kim; Yeungnam Univ J Med. 2018;35(2):227-231. Published online December 31, 2018; DOI: https://doi.org/10.12701/yujm.2018.35.2.227

Abstract PDF: Left main coronary artery (LMCA) thrombosis is rare and the cause should be determined. A previously healthy young man presented with severe chest pain and dyspnea. The electrocardiogram showed typical ST-segment elevation myocardial infarction with clinical instability. Emergency coronary angiography revealed complete LMCA occlusion by thrombosis. After reperfusion, the patient was admitted to the cardiac care unit. He was diagnosed with hemolytic anemia and tested positive for antinuclear antibodies. Systemic lupus erythematosus (SLE) and LMCA disease due to systemic thrombosis were diagnosed. Steroids were started and the patient was discharged without complications. We report this rare case of LMCA thrombosis as an initial presentation of SLE.

Bronchogenic cyst masquerading as malignant pericardial effusion with tamponade: Kang Un Choi, Byung Jun Kim, Hong Ju Kim, Jang Won Son, Jong Seon Park, Dong Gu Shin, Young Jo Kim; Yeungnam Univ J Med. 2017;34(1):91-95. Published online June 30, 2017; DOI: https://doi.org/10.12701/yujm.2017.34.1.91

Abstract PDF: We report on a rare case involving a 23-year-old female patient with mediastinal cystic mass complicated with acute pericarditis and cardiac tamponade. Pericardial fluid demonstrated lymphocyte-predominant exudate and the level of carcinoembryonic antigen (CEA) was unexpectedly elevated. Successive aspiration of mediastinal cystic mass revealed a very high level of CEA (>100,000 U/mL) and carbohydrate antigen 19-9 (>15,000 ng/mL). This patient was clinically diagnosed as an infected bronchogenic cyst complicated with pericarditis and cardiac tamponade. The treatment resulted in alleviation of her symptoms.

Unusual paradoxical embolic stroke in a patient with persistent left superior vena cava.: Tae Hun Kwon, Kang Un Choi, Byung Jun Kim, Jae Ho Cho, Jae Young Lee, Kyu Hwan Park, Sang Hee Lee, Jang Won Son; Yeungnam Univ J Med. 2015;32(2):118-121. Published online December 31, 2015; DOI: https://doi.org/10.12701/yujm.2015.32.2.118

Abstract PDF: Cardiogenic embolic stroke accounts for approximately 20% of ischemic strokes and the likelihood of its recurrence is high. Paradoxical embolism may be an important cause of cardioembolic stroke, which can be evaluated through multiple diagnostic modalities including transesophageal echocardiography (TTE) or transcranial Doppler. A persistent left superior vena cava (PLSVC) is a rare congenital vascular anomaly, which mainly drains to the right atrium via the coronary sinus. Although rare, PLSVC draining into the left heart predisposes the patient to paradoxical embolism through a right-to-left shunt. We report on a 78-year-old female patient with an ischemic stroke associated with PLSVC draining into the left atrium through the pulmonary vein, which was investigated via TTE with an agitated saline test and computed tomography.

Died immediately after corrective surgery for right ventricular acute myocardial infarction and ventricular septal rupture.: Su Mi Kim, Sung Yun Jung, Min Jung Kim, Tae Hun Kwon, Kang Un Choi, Byung Jun Kim, Jang Won Sohn, Gue Ru Hong; Yeungnam Univ J Med. 2014;31(1):9-12. Published online June 30, 2014; DOI: https://doi.org/10.12701/yujm.2014.31.1.9

Abstract PDF: Postinfarction ventricular septal rupture (VSR) is a rare but fatal complication of acute myocardial infarction. In many cases, postinfarction VSR leads to hemodynamic instability and urgent surgical treatment is necessary. Here we describe a case of a patient with right ventricular (RV) dysfunction caused by acute RV infarction and with cardiogenic shock, whose condition improved after development of postinfarction VSR, but the patient died after corrective surgery.

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