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Case Reports in Cardiology

Kareem Genena, Mir Ali, Donald Christmas, Henry Siu
While acute coronary syndromes most commonly occur secondary to unstable atherosclerotic plaque, coronary aneurysms, also known as coronary artery ectasia (CAE), represent a less common etiology. Whereas coronary atherosclerosis accounts for about 50% of CAE, the remaining 50% are either congenital or secondary to a host of inflammatory and connective tissue disorders, with Kawasaki disease being a well-known association. Patients with CAE have worse outcomes than the general population regardless of the presence of associated atherosclerotic coronary artery disease...
2018: Case Reports in Cardiology
Oreoluwa Oladiran, Salik Nazir
Left ventricular dysfunction is a rare side effect of bevacizumab occurring in 2-4% of cases. We report the case of a 68-year-old woman who presented to the emergency department (ED) with sudden onset of shortness of breath, orthopnea, and paroxysmal nocturnal dyspnea. She was tachypneic and in respiratory distress. Physical examination revealed jugular venous distention, diffuse expiratory wheeze, and bipedal edema. She had been started on bevacizumab for the treatment of hereditary hemorrhagic telangiectasia 1 month prior to presentation...
2018: Case Reports in Cardiology
Yu Yamada, Tomoko Ishizu, Hidekazu Tsuneoka, Yutaka Eki, Hitoshi Horigome
The prognosis of tetralogy of Fallot (TOF) treated only with Blalock-Taussig shunt (BTS) operation is unclear. A woman with TOF underwent classic BTS operation at 10 years of age. Despite no medication, she delivered two children and worked without apparent heart failure. At 72 years of age, she complained of dyspnea on exertion and leg edema. The cardiac angiogram revealed a well-patent BTS and severely stenotic right ventricular outflow tract. Right heart catheterization showed adequately maintained pulmonary blood flow with slight pulmonary arterial hypertension...
2018: Case Reports in Cardiology
Jonathan Sen, Michael Mok, Mark Perrin
Transcatheter aortic valve implantation (TAVI) is an effective intervention for severe aortic stenosis in patients at intermediate or high surgical risk, but damage to the native conduction system such as left bundle branch block (LBBB) may offset its benefits. New onset LBBB is associated with a higher risk of cardiovascular morbidity and mortality. His-bundle pacing (HBP) may be useful to treat TAVI-induced LBBB but has yet to be reported. We present the case of a 76-year-old man with severe symptomatic aortic stenosis treated with TAVI...
2018: Case Reports in Cardiology
Ahmed S Yassin, Ahmed Subahi, Hossam Abubakar, Ahmed Rashed, Mohamed Shokr
Background . Takotsubo cardiomyopathy is associated with increased risk of ventricular arrhythmias, atrial fibrillation, and bradyarrhythmias. However, sinus node dysfunction is relatively infrequent in the setting of takotsubo cardiomyopathy. Case Report . We are reporting a case of a 73-year-old woman with a history of asymptomatic sinus bradycardia who developed sick sinus syndrome complicated by takotsubo cardiomyopathy. Conclusion . Acute symptomatic sick sinus syndrome in patients with preexisting silent sinus node dysfunction can trigger takotsubo cardiomyopathy...
2018: Case Reports in Cardiology
E Fry, J Urbanczyk, J Price, R Digiovanni, M Jepson, D Gantt
Purulent pericarditis is a rare disease in the era of antibiotics, with Streptococcus pyogenes being a possible, though uncommon etiology. Even more uncommon are mycotic aneurysms secondary to group A strep purulent pericarditis and bacteremia. We report a case of an 18-year-old female with a history of strep pharyngitis develop Streptococcus pyogenes purulent pericarditis with subsequent ventricular fibrillation (VF). Following initial stabilization, she ultimately developed a 4.8 cm mycotic aneurysm of the ascending aorta, with resultant compression of the pulmonary trunk and right pulmonary arteries...
2018: Case Reports in Cardiology
Oreoluwa Oladiran, Jared Segal, Ifeanyi Nwosu, Salik Nazir
Rivaroxaban is a direct oral anticoagulant (DOAC) approved as an important alternative to warfarin in patients with nonvalvular atrial fibrillation. We report the case of an 87-year-old man with past medical history of nonvalvular atrial fibrillation on rivaroxaban and recently started amiodarone for pulseless ventricular tachycardia who presented to our hospital with intermittent chest pain and was diagnosed with spontaneous hemopericardium causing cardiac tamponade. The culprit drugs were discontinued, and the patient was treated with emergent pericardiocentesis...
2018: Case Reports in Cardiology
Koroush Khalighi, Munish Sharma, Amit Toor, Rubinder S Toor, Gary Costacurta
A 19-year-old man with the left main coronary artery (LMCA) arising from the right sinus of Valsalva presented with recurrent episodes of syncope and myocardial infarction (MI). Anomalous aortic origin of a coronary artery (AAOCA) is an uncommon but extremely important differential diagnosis that should not be missed in patients presenting with syncope, MI, ventricular arrhythmias, or cardiac arrest. A definitive diagnosis with coronary angiography and prompt surgical intervention is imperative in such symptomatic patients...
2018: Case Reports in Cardiology
George Mawardi, Anbukarasi Maran
The prevalence of anomalous circumflex coronary arteries is rare. Identifying the presence of an anomalous coronary is quite easy when there is no severe stenosis. However, in the presence of severe stenosis, there is limited anterograde flow, which makes it challenging to visualize the course of the stenotic artery, and it can be assumed to be a chronic total occlusion (CTO). This case demonstrates how the anomalous circumflex artery with severe stenosis masqueraded as a CTO and the patient was treated medically for several years, despite continued symptoms...
2018: Case Reports in Cardiology
Phoo Pwint Nandar, Asim Kichloo, Thein Tun Aung, Kevin D Kravitz
Congenital absence of the left atrial appendage is a rare congenital cardiac anomaly which is usually an incidental finding. We present a rare case of congenital absence of the left atrial appendage in a 77-year-old female patient with atrial fibrillation, and we will discuss the role of anticoagulation in the patient with congenital absence of the left atrial appendage based on the scientific data and theoretic background.
2018: Case Reports in Cardiology
Paurush Ambesh, Dikshya Sharma, Aditya Kapoor, Aviva-Tobin Hess, Vijay Shetty, Gerald Hollander, Jacob Shani, Stephan Kamholz, Arjun Saradna, Isaac Akkad, Chukwudi Obiagwu
It is vital to recognize correctly, chest pain of cardiac etiology. Most commonly, it is because of blood supply-demand inequity in the myocardium. However, the phenomenon of myocardial bridging as a cause of cardiac chest pain has come to attention reasonably recently. Herein, a coronary artery with a normal epicardial orientation develops a transient myocardial course. If the cardiac muscle burden is substantial, the respective artery gets compressed during each cycle of systole, thereby impeding blood flow in the artery...
2018: Case Reports in Cardiology
James J Glazier, Amir Kaki, Theodore L Schreiber
We report successful treatment of a patient, who, during diagnostic angiography, developed an ostial left main coronary artery dissection with stump occlusion of the vessel. First, mechanical circulatory support with an Impella CP device was established. Then, patency of the left coronary system was achieved by placement of stents in the left anterior descending, left circumflex, and left main coronary arteries. On completion of the procedure, left ventricular systolic function, as assessed by echocardiography, was normal...
2018: Case Reports in Cardiology
Ayodeji Dina, Peter Barlis, William van Gaal
Chest pain and troponin elevation may be due to an acute coronary syndrome, myocarditis, acute cardiomyopathy, or other less common conditions. Management differs depending on the aetiology, and the pathophysiologic diagnosis has direct implications on treatment and patient outcomes. History and clinical examination is supplemented by selected investigations including the electrocardiogram, chest X-ray, echocardiography, coronary angiography, and even myocardial perfusion scintigraphy or cardiac magnetic resonance imaging...
2018: Case Reports in Cardiology
Ramy Mando, Julian J Barbat, Alessandro Vivacqua
Myxomas are the most common benign cardiac neoplasms in adults. The vast majority of cardiac myxomas arise from the left atrium near the fossa ovalis of the intra-atrial septum. There have been reports of myxomas arising from the ventricles accounting for about 5% of cases. In our literature review, we have found 55 reported cases of myxomas originating from the mitral valve reported in the adult population dating back to 1871. The majority of these cases presented with embolic complications or syncope. We present an incidental mitral valve myxoma which we excised in efforts to prevent debilitating complications...
2018: Case Reports in Cardiology
Yehia Saleh, Basma Hammad, Abdallah Almaghraby, Ola Abdelkarim, Mohamed Seleem, Mahmoud Abdelnaby, Hoda Shehata, Mahmoud Hammad, Bassem Ramadan, Mohamed Elshafei, Eman Elsharkawy, Mohamed Ayman Abdel-Hay
Carney complex is a rare autosomal dominant disorder characterized by multiple tumors, including cardiac and extracardiac myxomas, skin lesions, and various endocrine disorders. We are reporting a 21-year-old female patient with past surgical history significant for excision of a cutaneous myxoma who presented with multicentric cardiac myxomas involving the four cardiac chambers. She also presented with endocrinal disorders in the form of an enlarged right lobe of the thyroid, hyperthyroid state, and an incidentally noted adrenal cyst; hence, she was diagnosed with carney complex syndrome...
2018: Case Reports in Cardiology
Mohammad Mowaswes, Tawfik Khoury, Ziv Lahav, Ashraf Sanduka, Ayelet Shapira-Daniels, Oz M Shapira
Pericardial cyst is an uncommon clinical-pathological entity, most often a congenital condition. We describe a case of an acquired iatrogenic pericardial pseudocyst following permanent pacemaker implantation secondary to atrial myocardial perforation. Diagnosis was achieved by a plain chest film, echocardiography, and computed tomography and confirmed intraoperatively. The pseudocyst was resected via a midline sternotomy approach. The patient recovered uneventfully. In a follow-up of 18 months, the patient is doing well...
2018: Case Reports in Cardiology
Dominika M Zoltowska, Guramrinder Thind, Yashwant Agrawal, Vishal Gupta, Jagadeesh Kumar Kalavakunta
May-Thurner syndrome is an underrecognized anatomical variant that can lead to increased propensity for venous thrombosis in the lower extremities. We present a case of a 67-year-old female who presented with transient ischemic attack. Initial workup including CT scan of the head, MRI scan of the head, and magnetic resonance angiogram of the head and neck was unremarkable. A transthoracic echocardiogram with bubble study was also normal. Subsequently, a transesophageal echocardiogram was performed that revealed a patent foramen ovale with right-to-left shunt...
2018: Case Reports in Cardiology
Olufolahan Carrena, Oluchukwu Oluoha, Amr Wahba, Derek Eshun, Maria Endsley, Henry Okafor
Introduction: The Chiari network is an uncommon vestigial structure of the heart that is often clinically insignificant. We present an unusual case of infective endocarditis affecting only the Chiari network in a patient who presented with septic emboli to the lungs and brain. Case summary: A 61-year-old man was admitted with a 2-month history of hemoptysis, pleuritic chest pain, and right upper extremity numbness and weakness. He was found to have multifocal bilateral pulmonary opacities and an abscess collection in the brain...
2018: Case Reports in Cardiology
Jayakumar Sreenivasan, Muhammad Ayub, Neha Yadav, Yasmeen Golzar
Iatrogenic aortocoronary arteriovenous fistula is a very rare complication of coronary artery bypass grafting in which one of the arterial grafts inadvertently forms a fistulous tract with a cardiac vein, shunting blood from the anastomosed coronary artery. We report a patient with an iatrogenic left internal mammary artery graft to cardiac vein fistula presenting with recurrent angina three years after a three-vessel coronary artery bypass grafting.
2018: Case Reports in Cardiology
Sowmya Palam, Ridhima Kapoor, Jacquelyn Kulinski
A 62-year-old man presented with 2 weeks of progressive dyspnea and chest pain. He was previously diagnosed with high-grade invasive urothelial carcinoma (UC) of the bladder and underwent neoadjuvant chemotherapy followed by radical cystectomy 10 months earlier, resulting in pathologic complete remission. Clinical evaluation and echocardiographic imaging was consistent with a diagnosis of cardiac tamponade. Due to a history of malignancy, the patient was referred for a surgical pericardial window, to include biopsy of the pericardium...
2018: Case Reports in Cardiology
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