Luis A Areiza, Juan F Rodriguez
Coronary chronic total occlusions are challenging lesions with high rates of complications related to percutaneous intervention. We describe a successful angioplasty in a patient with a recent coronary perforation, using multiple techniques, such as stick and swap with Stingray, subintimal transcatheter withdrawal, and investment.
2023: Case Reports in Cardiology
Mohamed Laimoud, Ziyad Alanazi, Fayez Alahmadi, Abdullah Aldalaan
BACKGROUND: Pulmonary veno-occlusive disease (PVOD) is a rare form of pulmonary arterial hypertension characterized by diffuse venous vasculopathy and increased pulmonary vascular resistance resulting in right-sided heart failure. Case Presentation . A 22-year-old female patient started to have dyspnea with minimal effort and was diagnosed to have pre-capillary pulmonary hypertension (PH) with right-sided heart failure. Initially, she was diagnosed to have idiopathic PH. She developed life-threatening pulmonary oedema and cardiogenic shock after pulmonary vasodilator therapy...
2023: Case Reports in Cardiology
Nikita Jhawar, Abhiram Prasad, S Michael Gharacholou
Ischemic symptoms may be explained by a multitude of coronary pathologies, including coronary artery tortuosity, atherosclerosis, fibromuscular dysplasia, vasculitis, coronary vasospasm, or microvascular disease. We present an unusual case of coronary kinking in a patient presenting with exertional jaw pain in the absence of atherosclerotic risk factors. Multimodality imaging, coronary imaging, and coronary physiology helped establish the diagnosis and guide management.
2023: Case Reports in Cardiology
Dimitrios Siamkouris, Elmar Offers, Marc Schloesser, Gjoko Ilieski, Stergios Tzikas
Conduction restoration in second- and third-degree atrioventricular (AV) block after revascularization in acute coronary syndrome (ACS) setting is well established, however this is not the case in non-ACS setting. We present a case of a patient referred for permanent pacemaker implantation, due to high degree AV block (HAVB), who restored his conduction possibly due to targeted revascularization. Thus, this case sheds insight in the reversibility potential of HAVB after revascularization in non-ACS patients, which although signified in current literature, is still far from being a recommendation, due to lack of robust scientific confirmation...
2023: Case Reports in Cardiology
Masahiro Koide, Kento Fukui, Hikaru Sugimoto, Yuki Takeda, Koji Sogabe, Yukinori Kato, Hiroki Kitajima, Satoshi Akabame
The Impella, a percutaneous left ventricular assist device, has been reported to minimize the risk of hemodynamic compromise and improve clinical outcomes during percutaneous coronary intervention (PCI) in complex high-risk indicated patients (CHIPs). Optical coherence tomography (OCT) provides information on calcified plaque thickness, which is helpful in determining the indication and endpoint of atherectomy during PCI for calcified lesions. However, there are few reports on OCT-guided aggressive rotational atherectomy with Impella assistance in CHIPs...
2023: Case Reports in Cardiology
R Dalla Pozza, M Hermann, N A Haas
Interventional treatment of restrictive atrial septal defects in complex heart disease is considered state-of-the-art therapy up to date. Nevertheless, dedicated balloons are lacking so far, as several products have been withdrawn from the market. We report on off-label use of a balloon embolectomy catheter used successfully in a preterm patient and discuss whether this device might be used in other patients as well as it seems to be promising due to its shape and versatility.
2023: Case Reports in Cardiology
Mintje Bohné, Sebastian Bohnen, Stephan Willems, Karin Klingel, Dietmar Kivelitz, Edda Bahlmann
BACKGROUND: Lymphocytic myocarditis is a rare form of myocarditis, associated with a high mortality rate due to a high risk of sudden cardiac death. Lymphocytic myocarditis might present as a relevant extrapulmonary manifestation after coronavirus disease 2019 (COVID-19) infection. Case presentation . We report a case of a 26-year-old male with lymphocytic myocarditis, presenting with a 1-month history of increasing fatigue, palpitations, and shortness of breath. Eight weeks before, he was tested positive for SARS-CoV-2...
2023: Case Reports in Cardiology
Nicholas Huerta, Salman Malik, Christopher Haas
Idiopathic third-degree atrioventricular (AV) block in a relatively young patient is an uncommon phenomenon. Even more rare is when the third-degree heart block is alternating with the first- and second-degree AV blocks. In this case, we present a 39-year-old man with varying degrees of AV block, alternating the third-degree, second-degree, and first-degree AV blocks. The patient underwent an extensive workup for underlying etiologies, and results were inconclusive. A pacemaker was implanted and set for physiologic pacing via left bundle branch area pacing (LBBAP)...
2023: Case Reports in Cardiology
Shota Tokuno, Kenjiro Miyamoto, Ryuichi Usui
INTRODUCTION: The superior vena cava (SVC) is an important non-pulmonary venous foci of atrial fibrillation (AF) and is known as the arrhythmogenic site of scar-related atrial tachycardia (AT). Scar-related ATs may occur after catheter ablation and open heart surgery; however, idiopathic AT rarely occurs. Case Presentation . A 77-year-old male with terminal diabetic nephropathy complained of dialysis-induced hypotension due to AF and was admitted to our hospital for catheter ablation...
2023: Case Reports in Cardiology
Vijay Yadav, Ratna Mani Gajurel, Chandra Mani Poudel, Paras Thapa, Manju Sharma, Suraj Shrestha
BACKGROUND: Contemporaneous acute myocardial infarction (AMI) and acute ischemic stroke (AIS), termed cardio-cerebral infarction (CCI), is a rare medical emergency. The effectual management of this situation is exigent since early management of one condition will inevitably delay the other. Case Presentation . A 60-year-old woman presented to our hospital with concurrent AMI of the inferior left ventricular wall, complicated by cardiogenic shock and transient complete heart block, and AIS of more than 4...
2023: Case Reports in Cardiology
Esben Merrild, Mette Winther, Jonathan Nørtoft Dahl, Tine Sneibjerg Ebsen, Steffen Leth, Simon Winther
A 45-year-old woman was admitted with severe pain in the right leg and dyspnea. Her medical history included previous Staphylococcus aureus endocarditis, biological aortic valve replacement, and intravenous drug abuse. She was febrile but did not have any focal signs of infection. Blood tests showed raised infectious markers and troponin levels. Electrocardiogram showed sinus rhythm without signs of ischemia. Ultrasound revealed thrombosis of the right popliteal artery. The leg was not critically ischemic, and therefore, treatment with dalteparin was chosen...
2023: Case Reports in Cardiology
Bernhard M Boehm, Jochen Gaa, Petra Hoppmann, Eimo Martens, Dominik S Westphal
Background . Atrial fibrillation (AF) is a common arrhythmia in elderly patients and is associated with increased risk of mortality. The pathogenesis of AF is complex and based on multiple genetic and environmental factors. Genome-wide association studies identified several loci in AF patients, indicating the complex genetic architecture of this disease. In rare cases, familial forms of AF have been described. Today, pathogenic variants in at least 11 different genes are associated with monogenic AF. Case presentation ...
2023: Case Reports in Cardiology
Daniel L Hess, Gaither W Horde, Karan Sarode, William S Morgan, Salmaan Z Kamal, Jubal R Watts, Gregory D Chapman
Coronary artery bypass graft (CABG) pseudoaneurysms are a rare but often unrecognized clinical entity. They are prone to rupture and hemodynamic compromise and should therefore be on the differential in the appropriate patient. We present a case of a gentleman with a recent CABG surgery who presented with acute onset dyspnea and a large pleural effusion. Imaging revealed a saphenous vein graft pseudoaneurysm embedded in a mediastinal hematoma. Four weeks later, prior to planned stenting, the pseudoaneurysm had spontaneously closed...
2023: Case Reports in Cardiology
Alex Scripcariu, Denis Gaty, Philippe Maury
Coronary artery compression/damage by cardiac pacing/defibrillation leads is very rare and often an unknown complication of pacemaker implantation. Here, we present the case of a 71-year-old woman with late discovery of an asymptomatic compression of the left anterior descending (LAD) coronary artery by a defibrillation lead implanted ten years before. This dissuaded us in removing this now malfunctioning lead with high threshold, and an additional right ventricular (RV) lead was implanted along with atrial and left ventricular (LV) leads for allowing resynchronization therapy...
2023: Case Reports in Cardiology
Timothy J O'Toole, Faisal Dadi, Patrick Kietrsunthorn, Jason Foerst, Ali Hama Amin
In this case report, we describe a 55-year-old female patient with worsening exertional dyspnea who is referred to the cardiology department, due to the appearance of worsening pulmonary vascular disease on computed tomography (CT) of the chest. Previous transthoracic echocardiograms (TTE) identified right ventricle enlargement, but no other structural abnormalities. She completed cardiac magnetic resonance (CMR) imaging, which identified a large secundum atrial septal defect (ASD). She subsequently underwent surgical planning and correction of the lesion with improvement of her symptoms...
2023: Case Reports in Cardiology
Eru Sujakhu, Rajendra Shilpakar, Dhruba Shrestha
VACTERL association is typically defined by the presence of at least three of the congenital malformations that make up the term including: vertebral defects, anal atresia, cardiac defects, tracheoesophageal fistula (TEF), renal anomalies, and limb deformities. Patients with VACTERL are typically managed through immediate-postnatal-surgical correction of the specific congenital anomalies (typically anal atresia, specific types of cardiac malformations, and/or TEF), followed by long-term medical management of the congenital malformations...
2023: Case Reports in Cardiology
M Gruszczynski, A Müller-Burri, A Häussler, A Breitenstein, H Rodriguez Cetina Biefer, O Dzemali
Significant lead-induced tricuspid regurgitation after cardiovascular implantable electronic devices is not uncommon. Absolute or relative contraindications to place the lead in the right ventricle after tricuspid valve (TV) surgery still remains a challenge. We report about successful lead extraction followed by transvenous implantable cardioverter defibrillator lead placement in the side branches of coronary sinus after TV reconstruction. Furthermore, we discuss therapeutic options to deliver concomitant anti-bradycardia therapy, technical pitfalls, and surgical approaches...
2023: Case Reports in Cardiology
Himax Patel, Sean Harrell, Haitham Hreibe, Musa Sharkawi, Wael AlJaroudi
Leadless pacing systems have revolutionized the field of electrophysiology given its low complication rates and almost non-existent rate of infections compared with traditional pacemakers. These devices boast resistance to infections given its unique features; however, as described in this report, device-related infection from these leadless devices is still possible. In patients with leadless pacing system that is persistently bacteremic in the future, evaluation of the device with transesophageal echocardiogram or intracardiac echocardiography should be performed, and if vegetation is noted on the device, device extraction should highly be considered, along with empiric intravenous antibiotics...
2023: Case Reports in Cardiology
Taylor J Kratochvil, Jeffrey A Robinson
An 8-year-old previously healthy male was diagnosed with thrombotic thrombocytopenic purpura (TTP) and increased serum cardiac troponin I. Telemetry recorded non-sustained ventricular tachycardia, without ST-segment changes or other abnormalities on serial electrocardiogram. This case illustrates that cardiac monitoring by telemetry should be considered in high-risk TTP with elevated cardiac troponin.
2023: Case Reports in Cardiology
João Ferreira Reis, Luís Almeida Morais, Lídia Sousa, António Fiarresga
In the midst of the coronavirus disease-2019 (COVID-19) pandemic, an 84-year-old female patient was admitted due to non-exertional syncope preceded by retrosternal pain. She had experienced a prolonged episode of oppressive chest pain 6 days before her presentation, but due to the concern of contracting COVID-19, she did not present for medical care. Upon admission to the emergency department, the patient was in circulatory shock, with her physical examination being remarkable for the presence of a holosystolic murmur...
2023: Case Reports in Cardiology
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