A case report of a male person of 24 years with suspected Salmonella induced coronary arteritis

Salmonella infection can cause a wide spectrum of disease which can range from a gastroenteritis, enteric fever (caused by typhoid and paratyphoid serotypes), bacteremia, focal infections, to a convalescent lifetime carrier state. Salmonella induced enteritis is common in this subcontinent. One third of untreated patients experience complications and account for three fourths of deaths associated with salmonellosis. But Salmonella induced coronary arteritis is rare and the initial diagnosis of those patients can be troublesome. Coronary arteritis may lead to fatal thrombosis, myocarditis, coronary artery aneurism, myocardial ischaemia, myocardial infarction & death. We reported a male person of 24 years who presented with high grade continued fever with rose spots, loose motion and vomiting and later on the tenth day of febrile illness he developed chest pain with subsequent ECG changes (ST elevation in V3-V5 chest leads) and elevated Troponin I level(41.20 ng/ml) which lead to the diagnosis of myocardial infarction. DOI: http://dx.doi.org/10.3329/jdmc.v23i1.22713 J Dhaka Medical College, Vol. 23, No.1, April, 2014, Page 143-146

A Giant Coronary Artery Aneurysm with Coronary Arteriovenous Fistula in Asymptomatic Elderly Patient

Coronary Arteriovenous Fistula (CAF) is a rare defect that occurs in 0.1-0.2% of patients undergoing coronary angiography; Coronary Artery Aneurism (CAA) also occurs in approximately 15–19% of patients with CAF. It is usually congenital, but in rare occasions it occurs after chest trauma, cardiac surgery, or coronary interventions. The case described is that of a 72-year-old woman, without previous history of cardiovascular disease, who presented a huge cardiac mass. A multimodal approach was necessary to diagnose a giant CAA with CAF responsible for compression and displacement of cardiac structures. Due to likely congenitally origin of the lesion and the absence of symptoms correlated to the CAA and to the CAF we decided to avoid invasive interventions and to treat the patient with medical therapy.