European Heart Journal: Case Reports最新文献

{"title":"How to manage coronary sinus venous perforation during left ventricular lead implantation: a case report.","authors":"Anoop K Gupta, Jyotika Gupta, Siddhant Jain, Pooja Shah","doi":"10.1093/ehjcr/ytaf241","DOIUrl":"10.1093/ehjcr/ytaf241","url":null,"abstract":"<p><strong>Background: </strong>Coronary sinus venous branch stenosis is an uncommon entity. Balloon dilatation of venous tributary may not always be safe. We report a case of venous perforation following balloon dilatation, which was managed by glue occlusion and completion of cardiac resynchronization therapy (CRT) implantation.</p><p><strong>Case summary: </strong>A 50-year-old man was diagnosed with non-ischaemic cardiomyopathy with New York Heart Association (NYHA) Class III dyspnoea despite optimal medical therapy. The electrocardiogram showed a left bundle branch block with a QRS duration of 168 ms, and 2D echocardiography revealed dilated cardiomyopathy with a left ventricular ejection fraction of 20%. The patient was taken for CRT implantation; however, there was severe stenosis in the posterolateral vein noted during left ventricular (LV) lead implantation, hindering LV lead advancement. Following balloon dilatation, there was perforation of the vein with hypotension. The perforation was sealed with glue injection (<i>n</i>-butyl-2-cyanoacrylate), and LV lead placement was performed. At the 4-year follow-up, the patient is in NYHA Class I and the ejection fraction improved to 60%, with an excellent LV threshold and good synchronization.</p><p><strong>Discussion: </strong>Glue (<i>n</i>-butyl-2-cyanoacrylate) occlusion can manage coronary sinus perforation with suitable long-term LV lead parameters.</p>","PeriodicalId":11910,"journal":{"name":"European Heart Journal: Case Reports","volume":"9 6","pages":"ytaf241"},"PeriodicalIF":0.8,"publicationDate":"2025-06-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12138189/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144233587","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"An effective treatment for repeated coronary in-stent restenosis using rotational atherectomy after aggressive wire penetration through the calcified nodule: a case report.","authors":"Yasuo Tsuru, Takenori Domei, Makoto Hyodo, Toru Morofuji, Kenji Ando","doi":"10.1093/ehjcr/ytaf268","DOIUrl":"10.1093/ehjcr/ytaf268","url":null,"abstract":"<p><strong>Background: </strong>Lesions with calcified nodules (CNs) have a significantly higher rate of restenosis. There is no definitive and effective medication or procedural technique to suppress the progression of CNs.</p><p><strong>Case summary: </strong>A 71-year-old was referred to our hospital because of typical effort angina pectoris. Diagnostic coronary angiography identified significant severe stenosis in the middle segment of right coronary artery (RCA). In the primary percutaneous coronary intervention (PCI), intravascular ultrasound visualized the eccentric protruding high echoic structure with irregular surface indicating CNs. Percutaneous coronary intervention was successfully performed with rotational atherectomy (RA). However, one year after the PCI, effort angina was recurrent. The patient experienced recurrent restenosis three times, even after repeated PCI using RA and treatment with drug coating balloon. In the fourth PCI, we tried guide wire penetration through the CNs before RA to reduce the more amount of CNs tissue; finally, good patency was achieved. At last, follow-up angiography after final PCI showed no in-stent restenosis.</p><p><strong>Discussion: </strong>We report a case of a patient who required repeated revascularization to a severe stenotic lesion with CNs in the middle segment of the RCA. Rotational atherectomy after wire penetration into the CNs was effective to avoid a malignant cycle of restenosis.</p>","PeriodicalId":11910,"journal":{"name":"European Heart Journal: Case Reports","volume":"9 6","pages":"ytaf268"},"PeriodicalIF":0.8,"publicationDate":"2025-06-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12150021/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144265664","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Percutaneous closure of coexisting patent foramen ovale and atrial septal defect in a rare case of platypnea-orthodeoxia syndrome.","authors":"Hiroki Sugae, Isamu Mizote, Daisuke Nakamura, Yasushi Sakata","doi":"10.1093/ehjcr/ytaf275","DOIUrl":"10.1093/ehjcr/ytaf275","url":null,"abstract":"","PeriodicalId":11910,"journal":{"name":"European Heart Journal: Case Reports","volume":"9 6","pages":"ytaf275"},"PeriodicalIF":0.8,"publicationDate":"2025-06-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12168769/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144309772","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Pseudoaneurysms: a rare complication of infective endocarditis in an adolescent with bicuspid aortic valve.","authors":"Manuela Lopes, Sofia Rito, David Prieto, António Pires","doi":"10.1093/ehjcr/ytaf270","DOIUrl":"10.1093/ehjcr/ytaf270","url":null,"abstract":"","PeriodicalId":11910,"journal":{"name":"European Heart Journal: Case Reports","volume":"9 6","pages":"ytaf270"},"PeriodicalIF":0.8,"publicationDate":"2025-05-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12152536/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144274514","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Serial inflammation imaging with pericoronary adipose tissue in patients with immunoglobulin G4-related coronary periarteritis: a case report.","authors":"Satoshi Kitahara, Yu Kataoka, Yusuke Fujino","doi":"10.1093/ehjcr/ytaf271","DOIUrl":"10.1093/ehjcr/ytaf271","url":null,"abstract":"<p><strong>Background: </strong>Immunoglobulin G4-related disease (IgG4-RD) is a systemic immune-mediated inflammatory disease that infrequently involves the coronary arteries. Given that pericoronary adipose tissue (PCAT) attenuation reflects the degree of inflammation in the coronary arteries, monitoring inflammation with PCAT may enable evaluation of disease activity in IgG4-related coronary periarteritis (CP).</p><p><strong>Case summary: </strong>A 58-year-old man with a history of IgG4-RD presented with ST-segment elevation myocardial infarction. Emergent coronary angiography revealed a severe stenotic lesion in the mid-segment of his left circumflex artery (LCX). Intravascular ultrasound (IVUS) imaging demonstrated thickening of the adventitia, and optical coherence tomography (OCT) showed the formation of vasa vasorum in the proximal segment of the LCX. Along with an elevated IgG4 level (1890 mg/dL), he was diagnosed with IgG4-related CP. Coronary computed tomography angiography (CCTA) after percutaneous coronary intervention (PCI) revealed soft tissue proliferation with elevated PCAT attenuation [PCAT_LCX attenuation = -68.4 Hounsfield units (HU)] around the proximal LCX. Following the initiation of prednisolone, the IgG4 level decreased to 239 mg/dL at 8 months post-PCI. Follow-up IVUS showed reduced adventitial thickness, and most of the previously observed vasa vasorum had disappeared on OCT. Furthermore, CCTA demonstrated a reduction in PCAT_LCX attenuation (to -81.8 HU), accompanied by a reduction in soft tissue volume.</p><p><strong>Discussion: </strong>In this case, serial PCAT analysis demonstrated resolution of inflammatory activity in response to prednisolone therapy. Serial PCAT imaging may have potential for evaluating disease activity and monitoring response to anti-inflammatory therapy in patients with IgG4-RD.</p>","PeriodicalId":11910,"journal":{"name":"European Heart Journal: Case Reports","volume":"9 6","pages":"ytaf271"},"PeriodicalIF":0.8,"publicationDate":"2025-05-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12142458/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144247031","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Replacement of aneurysmal right coronary artery with reconstruction of posterior descending and right ventricular branches in coronary artery fistula draining into the coronary sinus: a case report.","authors":"Yuya Yamazaki, Hiroyuki Nakajima, Itaru Igarashi, Takeshi Arai, Daichi Takagi","doi":"10.1093/ehjcr/ytaf269","DOIUrl":"10.1093/ehjcr/ytaf269","url":null,"abstract":"<p><strong>Background: </strong>Dilated coronary arteries associated with coronary fistulas can cause late complications, such as rupture and myocardial ischaemia due to intraluminal thrombosis and distal embolism. This case report presents the successful surgical treatment of a coronary artery fistula causing a tortuous and dilated right coronary artery (RCA).</p><p><strong>Case summary: </strong>A 69-year-old female presented with congestive heart failure and atrial fibrillation detected on the electrocardiogram. Chest roentgenography showed lung congestion and cardiomegaly, with a cardiothoracic ratio of 84%. Echocardiography revealed severe mitral and tricuspid regurgitation and pulmonary hypertension. Coronary angiography revealed a dilated RCA fistula draining into the coronary sinus, with a Qp/Qs ratio of 2.3. Surgery was performed via median sternotomy. Under cardiac arrest, mitral valve replacement and tricuspid valve plasty were performed. The RCA was divided at the proximal portion, just distal to the origin of the conus branch. Through a longitudinal incision on RCA, the orifices of the posterior descending artery and the two major right ventricular branches were identified and trimmed as buttons. The dilated RCA was replaced with the saphenous vein graft, which was sequentially anastomosed with the buttons. Postoperative angiography showed visualization of the saphenous vein and right ventricular branches, with the elimination of the huge shunt flow from the RCA.</p><p><strong>Discussion: </strong>Eliminating shunt flow, resecting the dilated portion of the RCA > 10 mm in diameter, and recreating sufficient coronary perfusion to the right ventricle by replacement of RCA are crucial for favourable early and late clinical outcomes of diffusely aneurysmal coronary artery fistula.</p>","PeriodicalId":11910,"journal":{"name":"European Heart Journal: Case Reports","volume":"9 6","pages":"ytaf269"},"PeriodicalIF":0.8,"publicationDate":"2025-05-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12150284/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144265677","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"When coronary spasm strikes: a case report on the dreadful association between cannabinoids and caffeine.","authors":"Giada Colombo, Adelina Selimi, Andrea Cesari, Patrizia Pedrotti, Alice Sacco","doi":"10.1093/ehjcr/ytaf252","DOIUrl":"10.1093/ehjcr/ytaf252","url":null,"abstract":"<p><strong>Background: </strong>Coronary artery spasm (CAS) is a temporary, severe narrowing of the coronary arteries typically presenting with nitrate-responsive angina at rest, transient ischaemic ECG changes, and in some cases leading to silent myocardial ischaemia, acute myocardial infarction, life threatening arrhythmias and cardiac arrest.</p><p><strong>Case summary: </strong>A 47-years-old man with a history of chronic coronary syndrome and a working diagnosis of probable pheochromocytoma was admitted to the Emergency Department after two episodes of out-of-hospital cardiac arrest successfully resuscitated. Transient ST segment elevation was observed, and emergency coronary angiography (CA) revealed no significant coronary stenosis. His history also included past alcohol abuse and ongoing cannabinoid use. A negative gallium positron emission tomography along with normal urinary metanephrines levels ruled out the diagnosis of pheochromocytoma. During the hospital stay, the patient experienced new episodes of chest pain, followed by two episodes of in-hospital cardiac arrest successfully resuscitated. The ECG showed transient ST-segment elevation in the anterior and lateral leads. Emergency CA revealed severe dynamic vasospasm at the ostium and proximal segments of the left anterior descending artery and circumflex artery, that regressed after intracoronary nitroglycerine. Therapy with both non-dihydropyridine and dihydropyridine calcium channel blockers, alongside nitrates, was initiated. Reviewing the patient's medical history revealed that he had been consuming at least 3 L of cola daily at home. Approximately 1 h before his last two cardiac arrests, he drank another can of cola. Before discharge, he received a dual-chamber defibrillator for secondary prevention.</p><p><strong>Discussion: </strong>Life-threatening arrhythmias and recurrent cardiac arrest are rare but severe potential consequences of CAS, particularly in the presence of synergistic triggers such as caffeine and cannabinoids. Lifestyle modification and targeted pharmacotherapy in high-risk CAS patients may not be sufficient to prevent life-threatening complications.</p>","PeriodicalId":11910,"journal":{"name":"European Heart Journal: Case Reports","volume":"9 6","pages":"ytaf252"},"PeriodicalIF":0.8,"publicationDate":"2025-05-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12127843/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144208056","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"An epicardial problem case report: multimodality imaging assessment of a patient presenting with symptomatic ventricular tachycardia, secondary to a large, epicardial, lipomatous mass with myocardial infiltration.","authors":"Rajesh Varma, Simon Corbett, James Shambrook, Benoy Nalin Shah, Eunice N Onwordi","doi":"10.1093/ehjcr/ytaf175","DOIUrl":"10.1093/ehjcr/ytaf175","url":null,"abstract":"<p><strong>Background: </strong>Cardiac lipomas are considered benign and slow-growing adipose tissue tumours; however, the size and location can cause significant haemodynamic compromise and therefore can be malignant in clinical presentation.</p><p><strong>Case summary: </strong>The clinical case describes a rare presentation of a 50-year-old patient, presenting with recurrent haemodynamically compromising ventricular arrhythmia; secondary to an incredibly large, epicardial lipomatous mass, with associated combination of myocardial infiltration, left ventricular systolic impairment, and complex cardiac circulatory involvement.</p><p><strong>Discussion: </strong>The case illustrates the ESC guidelines on the benefits of complimentary multimodality cardiac imaging to assess complex pericardial disease, to improve both clinical understanding and management.</p>","PeriodicalId":11910,"journal":{"name":"European Heart Journal: Case Reports","volume":"9 5","pages":"ytaf175"},"PeriodicalIF":0.8,"publicationDate":"2025-05-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12107350/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144157569","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"U wave mimicking long QT interval: the role of lead selection, repeated electrocardiograms, and premature atrial complexes.","authors":"Fawzi Kerkouri, Florent Le Ven, Sarah Kerkouri, Jacques Mansourati","doi":"10.1093/ehjcr/ytaf264","DOIUrl":"10.1093/ehjcr/ytaf264","url":null,"abstract":"","PeriodicalId":11910,"journal":{"name":"European Heart Journal: Case Reports","volume":"9 6","pages":"ytaf264"},"PeriodicalIF":0.8,"publicationDate":"2025-05-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12142589/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144247032","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Percutaneous angioplasty for the management of iatrogenic pulmonary vein stenosis: a case series and brief review.","authors":"Saroj Timilsina, Ritesh Chandrasekaran, Michael Saindon, Houman Khalili","doi":"10.1093/ehjcr/ytaf257","DOIUrl":"10.1093/ehjcr/ytaf257","url":null,"abstract":"<p><strong>Background: </strong>Pulmonary vein stenosis (PVS) is a rare complication following pulmonary vein isolation for atrial fibrillation.</p><p><strong>Cases summary: </strong>We present two cases of iatrogenic PVS, successfully managed with balloon angioplasty and stenting. Both patients experienced significant symptom relief and improved functional status following the intervention.</p><p><strong>Discussion: </strong>We highlight the importance of early recognition and intervention in PVS, as well as the complexities involved in long-term management, including surveillance strategies and restenosis prevention.</p>","PeriodicalId":11910,"journal":{"name":"European Heart Journal: Case Reports","volume":"9 6","pages":"ytaf257"},"PeriodicalIF":0.8,"publicationDate":"2025-05-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12138244/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144233598","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}