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Case Reports in Cardiology

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https://www.readbyqxmd.com/read/29333299/ventricular-fibrillation-following-varicella-zoster-myocarditis
#1
Adam Ioannou, Irene Tsappa, Sofia Metaxa, Constantinos G Missouris
Varicella-zoster virus (VZV) infection can rarely lead to serious cardiac complications and life-threatening arrhythmias. We present a case of a 46-year-old male patient who developed VZV myocarditis and presented with recurrent syncopal episodes followed by a cardiac arrest. He had a further collapse eight years later, and cardiac magnetic resonance imaging (MRI) demonstrated mild mid-wall basal and inferolateral wall fibrosis. He was treated with an implantable cardioverter defibrillator (ICD) and represented two years later with ICD shocks, and interrogation of the device revealed ventricular fibrillation episodes...
2017: Case Reports in Cardiology
https://www.readbyqxmd.com/read/29318051/st-segment-elevation-is-not-always-myocardial-infarction-a-case-of-focal-myopericarditis
#2
Cyrus M Munguti, Samuel Akidiva, Jacob Wallace, Hussam Farhoud
Protocols exist on how to manage STEMI patients, with well-established timelines. There are times when patients present with chest pain, ST segment elevation, and biomarker elevation that are not due to coronary artery disease. These conditions usually present with normal coronary angiography. We present a case that was clinically indistinguishable from STEMI and that was diagnosed with focal myopericarditis on cardiac MRI.
2017: Case Reports in Cardiology
https://www.readbyqxmd.com/read/29302368/d-shaped-left-ventricle-anatomic-and-physiologic-implications
#3
Eder Hans Cativo Calderon, Tuoyo O Mene-Afejuku, Rachna Valvani, Diana P Cativo, Devendra Tripathi, Hans A Reyes, Savi Mushiyev
Right ventricular loading/pressure influences left ventricular function because the two ventricles pump in series and because they are anatomically arranged in parallel, sharing the common ventricular septum. Flattening of the interventricular septum detected during echocardiographic examination is called D-shaped left ventricle. We present a case of an elderly male of African descent, who presented with increased shortness of breath. Transthoracic echocardiogram showed flattening and left sided deviation of interventricular septum causing a decreased size in left ventricle, secondary to volume/pressure overload in the right ventricle...
2017: Case Reports in Cardiology
https://www.readbyqxmd.com/read/29277845/subacute-right-ventricular-perforation-by-pacemaker-lead-causing-left-sided-hemothorax-and-epicardial-hematoma
#4
Abdelrahman Ahmed, Mohamed Shokr, Randy Lieberman
We report a case of right ventricular wall perforation by a pacemaker lead in a 78-year-old female 18 days after a permanent pacemaker insertion. This injury necessitated explant of the perforating lead and implantation of a new one with surgical backup. We review the literature and discuss the possible risk and protective factors including lead models that were associated with higher incidence of perforation. We review the traditional pacing parameters and their lack of reliability to diagnose perforation and the need for low threshold to utilize imaging in appropriate clinical scenarios...
2017: Case Reports in Cardiology
https://www.readbyqxmd.com/read/29238620/angiovac-system-used-for-vegetation-debulking-in-a-patient-with-tricuspid-valve-endocarditis-a-case-report-and-review-of-the-literature
#5
Hossam Abubakar, Ahmed Rashed, Ahmed Subahi, Ahmed S Yassin, Mohamed Shokr, Mahir Elder
AngioVac is a vacuum-based device approved in 2014 for percutaneous removal of undesirable materials from the intravascular system. Although numerous reports exist with regard to the use of the AngioVac device in aspiration of iliocaval, pulmonary, upper extremity, and right-sided heart chamber thrombi, very few data are present demonstrating its use in treatment of right-sided endocarditis. In this case report, we describe the novel device used in debulking a large right-sided tricuspid valve vegetation reducing the occurrence of septic embolisation and enhancing the efficacy of antibiotics in clearance of bloodstream infection...
2017: Case Reports in Cardiology
https://www.readbyqxmd.com/read/29214082/congenital-absence-of-left-circumflex-artery-a-case-report-and-review-of-the-literature
#6
Setri Fugar, Lydia Issac, Alexis Kofi Okoh, Christelle Chedrawy, Nadia El Hangouche, Neha Yadav
Congenital absence of the left circumflex artery is a rare coronary anomaly with few reported cases in the literature. These patients are usually diagnosed incidentally when they undergo coronary angiography or coronary CT to rule out underlying coronary artery disease. In this article, we report a case of a 46-year-old man who was incidentally found to have a congenitally absent left circumflex artery with a superdominant right coronary artery after a workup was initiated for frequent premature ventricular contractions and regional wall motion on echocardiogram...
2017: Case Reports in Cardiology
https://www.readbyqxmd.com/read/29209541/a-rare-manifestation-of-asymptomatic-ebstein-s-anomaly-with-tricuspid-valve-endocarditis
#7
Carmel Moazez, Vicken Zeitjian, Christian Breburda, Ranjini Roy
Ebstein's anomaly is a rare congenital heart disease that presents with apical displacement of the septal and posterior leaflets of the tricuspid valve. It has a wide spectrum of clinical presentations and has been shown to manifest itself any time from birth to adulthood. Our patient is a 43-year-old male with a history of intravenous heroin abuse who presented to the emergency department with worsening shortness of breath and lower extremity edema. He denied any prior cardiac history. A transthoracic echo showed normal left ventricular function, but a large 2...
2017: Case Reports in Cardiology
https://www.readbyqxmd.com/read/29209540/deglutition-syncope-two-case-reports-attributed-to-vagal-hyperactivity
#8
Sukhdeep Bhogal, Pooja Sethi, Yasir Taha, Muralidhar Papireddy, Akhilesh Mahajan, Syed Imran M Zaidi, Vijay Ramu, Timir Paul
Deglutition syncope is a relatively rare cause of syncope that belongs to the category of neurally mediated reflex syncopal syndromes. The phenomenon is related to vagal reflex in context to deglutition causing atrioventricular block and acute reduction in cardiac output leading to dizziness or syncope. We present case series of two cases of deglutition syncope, of which first was managed medically and second with pacemaker implantation.
2017: Case Reports in Cardiology
https://www.readbyqxmd.com/read/29130002/right-atrial-fibroelastoma-presenting-as-typical-atrial-flutter-rare-disease-in-unusual-location
#9
Ahmad Abuarqoub, Ghada Elshimy, Muhammed Shittu, Aiman Hamdan, Fayez Shamoon
Typical atrial flutter as initial presentation of papillary fibroelastoma involving the cavotricuspid isthmus is not described before in literature. To our knowledge only 14 cases have been reported in literature involving the right atrium. Very unusual location is at the junction between inferior vena cava (IVC) and right atria as only 1 case has been reported.
2017: Case Reports in Cardiology
https://www.readbyqxmd.com/read/29119025/parachute-like-mitral-valve-tuberculoma-a-rare-presentation
#10
Arslan Masood, Gul Zaman Khan, Irfan Bashir, Zubair Akram
There have been anecdotal reports of tuberculous cardiac involvement, mainly in cases of military tuberculosis or immune deficient individuals. The spectrum of clinical presentations of tuberculous cardiac involvements includes incidental detection of single and multiple well-circumscribed tuberculomas, symptomatic obstructive lesions, AV conduction abnormalities, and even sudden death. We present a case of cardiac tuberculoma in an immune-competent person who presented with worsening dyspnea. The unique morphology of this mass posed an imaging challenge that required 4-dimensional (4D) echocardiography and cardiac magnetic resonance (CMR) detail to differentiate the mass from an anterior mitral leaflet (AML) aneurysm...
2017: Case Reports in Cardiology
https://www.readbyqxmd.com/read/29109869/postintervention-dyspnea-after-radiofrequency-catheter-ablation-think-of-a-phrenic-nerve-injury
#11
Liliana E Ramos-Villalobos, Luis Colin Lizalde, Manlio F Márquez, Pedro Iturralde, Francisco Castillo
Phrenic nerve injury (PNI) is a rare complication of catheter ablation therapy, most commonly observed in cryoablation of the right side pulmonary veins. We present a case of PNI after radiofrequency catheter ablation that developed acute dyspnea 24 hours after the intervention. Dyspnea is the main symptom of PNI, so the diagnosis should always be suspected if it appears after any type of catheter ablation involving the trajectory of the phrenic nerve. There is no specific treatment for PNI. The only maneuver that has been reported to accelerate the recovery of PNI is early stopping of the ablation therapy...
2017: Case Reports in Cardiology
https://www.readbyqxmd.com/read/29098093/epoetin-alfa-a-cause-of-coronary-artery-thrombosis
#12
Muhammad Umer Siddiqui, Yelena Galumyan, James Klein, Zunaira Naeem, Aron Schwarcz
Introduction: Epoetin alfa is an erythrocyte-stimulating factor. We here present a case of an anemic patient, who was given epogen before a coronary artery bypass (CABG) surgery and developed periprocedural myocardial infarction. To our knowledge, there has been no previous case reported of epogen causing myocardial infarction. Case Presentation: 66-year-old female presented with substernal chest pain. EKG showed ST segment elevations in aVf and L-III. Patient underwent left heart catheterization (LHC) and had triple vessel disease...
2017: Case Reports in Cardiology
https://www.readbyqxmd.com/read/29098092/coronary-artery-hematoma-treated-with-fenestration-using-a-novel-nse-alpha%C3%A2-scoring-balloon
#13
Naohiro Funayama, Takao Konishi, Tadashi Yamamoto, Daisuke Hotta
The optimal management of coronary intramural hematoma has not been defined. We described a case in which coronary occlusion developed due to an intramural hematoma after percutaneous coronary intervention for mid left circumflex artery (LCX). Intravascular ultrasound (IVUS) demonstrated the progression of the intramural hematoma and a totally compressed true lumen. Our approach was based on fenestration with a scoring balloon (NSE Alpha, Goodman, Japan), which allowed the deployment of an additional stent to be avoided...
2017: Case Reports in Cardiology
https://www.readbyqxmd.com/read/29093975/case-report-of-multiembolic-cerebrovascular-event-associated-with-ramp-study-echocardiogram
#14
Brian C Butera, Luanda P Grazette, Tracy Lawrence, Michael E Bowdish, Andrew J Yoon
The incidence of ramp test echocardiogram-associated embolic events in the setting of therapeutic anticoagulation is likely rare and has not been reported. We present such a case in a patient with a HeartMate II left ventricular assist device (LVAD) whose serial head computed tomography images, deteriorating clinical course, and the multiembolic nature of the event suggest causality. If the pretest probability of pump thrombosis in an individual LVAD patient is sufficiently high, the potential risks of performing a ramp study echocardiogram may not be warranted, even in the setting of adequate anticoagulation...
2017: Case Reports in Cardiology
https://www.readbyqxmd.com/read/29093974/aorto-right-ventricular-shunt-after-tavr-rare-complication-of-common-procedure
#15
Abdelkader Almanfi, Ahmad Qurie, Neil Strickman
Background: The primary treatment of symptomatic aortic stenosis is aortic valve replacement. Instead of open chest surgery, transcatheter aortic valve replacement (TAVR) is an alternative intervention for high-risk surgical candidates. Clinical Case: A 92-year-old male presented with progressive exertional dyspnea and recurrent syncopal attacks secondary to severe AS. The patient underwent successful transfemoral TAVR with 29 mm Edwards SAPIEN XT valve. His postoperative course was complicated by aorto-right ventricular shunt...
2017: Case Reports in Cardiology
https://www.readbyqxmd.com/read/29085680/a-rare-association-of-takotsubo-cardiomyopathy-with-high-degree-atrioventricular-block
#16
Eder Hans Cativo, Rachna Valvani, Tuoyo O Mene-Afejuku, Diana P Cativo, Savi Mushiyev
Here we present a case of a patient who got trapped in an elevator; on initial evaluation patient was found with bradycardia; on further evaluation electrocardiogram (EKG) showed new onset 2nd-degree Mobitz type 2 AV block. On admission patient developed ischemic changes on EKG and troponin elevation. Transthoracic echocardiogram showed reduced ejection fraction as well as apical inferior, anterior, lateral, and septal hypokinesia. Coronary angiography showed nonobstructive coronary artery disease and ventriculogram demonstrated anterolateral and apical hypokinesia suggesting takotsubo cardiomyopathy (TCM)...
2017: Case Reports in Cardiology
https://www.readbyqxmd.com/read/29082045/h-capsulatum-a-not-so-benign-cause-of-pericarditis
#17
Paolo K Soriano, Muhammad Iqbal, Shakthishri Kandaswamy, Sami Akram, Abhishek Kulkarni, Tamer Hudali
The common causes of pericarditis and its course are benign in the majority of cases. Thus, further testing is usually not pursued and treatment for a presumptive viral etiology with nonsteroidal agents and steroids has been an accepted strategy. We present a patient with pericarditis who was unresponsive to first-line therapy and was subsequently found to have necrotizing granulomas of the pericardium with extensive adhesions and fungal elements seen on tissue biopsy. Serologic testing confirms active H. capsulatum infection, and he responded well to Itraconazole treatment...
2017: Case Reports in Cardiology
https://www.readbyqxmd.com/read/29057126/revascularization-of-chronic-total-occlusion-of-the-infrarenal-aorta-in-a-patient-with-triple-vessel-disease-report-of-a-case-treated-by-endovascular-approach
#18
Mahek Shah, Soumya Patnaik, Rahul Sinha, Issac Opoku-Asare, Khalid Chaudhry, Sean Janzer
Surgical management of advance aortoiliac occlusive disease is time-tested and a widely practiced strategy, particularly when there is significant coronary artery disease associated with aortoiliac occlusive disease. The technological advances in the field of percutaneous techniques have facilitated the use of nonsurgical endovascular alternatives for peripheral arterial disease in patients with significant comorbidities at high surgical risk, as illustrated in our case report. We report a case of chronic total occlusion of the aorta that was treated percutaneously with endovascular stenting...
2017: Case Reports in Cardiology
https://www.readbyqxmd.com/read/28948051/persistent-unexplained-dyspnea-a-case-of-hepatopulmonary-syndrome
#19
Alfonso Campanile, Alessandro Colombo, Maurizio Del Pinto, Claudio Cavallini
Regarding a patient with dyspnea, the history and physical examination often lead to the correct diagnosis. In some circumstances, when more than one underlying disease is present, the diagnostic process can be more challenging. We describe an unusual case of dyspnea and persistent hypoxemia related to a hepatopulmonary syndrome in a 53-year-old patient with known heart failure and chronic liver disease. Initially managed with intravenous diuretic therapy, due to signs of lung and peripheral congestion, our patient did not improve as expected; therefore we performed more advanced studies with a chest-abdomen CT scan and a right heart catheterization...
2017: Case Reports in Cardiology
https://www.readbyqxmd.com/read/28928990/detection-of-a-left-superior-vena-cava-during-a-pacemaker-implantation-in-cotonou
#20
A Sonou, M Hounkponou, L Codjo, P M Adjagba, C Houehanou, H Dohou, S Assani, Y Tchabi, M Houenassi
Persistent left superior vena cava (LSVC) is a rare congenital anomaly. Its prevalence in the general population is 0.1 to 0.5%. LSVC is 5 times rarer when accompanied by an absence of the right superior vena cava (RSVC). We present the case of a 54-year-old man who carries a persistent LSVC without RSVC. Clinically, this patient presented a regular bradycardia at 40 per minute associated with a heart failure syndrome. The electrocardiogram diagnosed a complete atrioventricular block and transthoracic echocardiography showed dilated left heart cavities and a left ventricular ejection fraction of 50%...
2017: Case Reports in Cardiology
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