European Heart Journal: Case Reports最新文献

Drug challenge test for early symptom control in patients with coronary artery spasm: a case report.

IF 0.8

European Heart Journal: Case Reports Pub Date : 2025-04-08 eCollection Date: 2025-04-01 DOI: 10.1093/ehjcr/ytaf134

Yoshiaki Kawase, Kento Kikuchi, Takuya Mizukami, Hitoshi Matsuo

{"title":"Drug challenge test for early symptom control in patients with coronary artery spasm: a case report.","authors":"Yoshiaki Kawase, Kento Kikuchi, Takuya Mizukami, Hitoshi Matsuo","doi":"10.1093/ehjcr/ytaf134","DOIUrl":"https://doi.org/10.1093/ehjcr/ytaf134","url":null,"abstract":"Background: Calcium channel blockers are the first-line treatment option, followed by long-acting nitrates or nicorandil as second-line medications for patient with coronary artery spasm (CAS). However, there are cases where symptoms cannot be controlled by a combination of these drugs. The drug choice after first- and second-line treatment options is varied and challenging.Case summary: A 70-year-old woman presented to our hospital with complaints of angina at rest. The patient was diagnosed with CAS based on a positive acetylcholine provocation test result. Nitrates were intolerable due to headaches. The combination of calcium channel blocker and nicorandil was not effective in mitigating her symptoms. Four potential symptom relief drugs-trimetazidine, shigyakusan, keishibukuryogan, and denopamine-were prescribed. Each drug was administered for one week, and symptom improvement was assessed one month later. Two drugs (shigyakusan and keishibukuryogan) were effective in relieving her symptoms, but neither was satisfactory on its own. Therefore, these two drugs were combined and added on top of the calcium channel blocker and nicorandil. Her symptoms were well controlled thereafter.Discussion: The drug challenge test, which involves prescribing various types of drugs for short durations to evaluate their effects, may be an effective option for quickly controlling symptoms in patients with refractory CAS who exhibit frequent symptoms.","PeriodicalId":11910,"journal":{"name":"European Heart Journal: Case Reports","volume":"9 4","pages":"ytaf134"},"PeriodicalIF":0.8,"publicationDate":"2025-04-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11975532/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143810877","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}

引用次数: 0

Early Supera stent fracture after treatment of popliteal artery occlusion caused by artificial knee joint: a case report.

IF 0.8

European Heart Journal: Case Reports Pub Date : 2025-04-04 eCollection Date: 2025-04-01 DOI: 10.1093/ehjcr/ytaf114

Yuki Shima, Narumi Taninobu, Kazunori Mushiake, Hiroyuki Tanaka, Kazushige Kadota

{"title":"Early Supera stent fracture after treatment of popliteal artery occlusion caused by artificial knee joint: a case report.","authors":"Yuki Shima, Narumi Taninobu, Kazunori Mushiake, Hiroyuki Tanaka, Kazushige Kadota","doi":"10.1093/ehjcr/ytaf114","DOIUrl":"10.1093/ehjcr/ytaf114","url":null,"abstract":"Background: The Supera stent, a self-expanding interwoven nitinol stent, has greater radial force than conventional stents, resulting in high patency and reduced stent fracture. There have been few reports of early stent fracture, and it is considered an effective device in the popliteal artery.Case summary: We present a case of popliteal artery occlusion due to Supera stent fracture. An 86-year-old woman presented to our department with intermittent claudication after 6 months of Supera stent implantation. Ultrasonography demonstrated popliteal artery occlusion secondary to Supera stent fracture. Fluoroscopy revealed that the stent had fractured at the site closest to the artificial knee joint and might have been in contact with a vessel. In addition, the popliteal artery was slightly deviated medially in the P2 segment, suggesting popliteal artery entrapment syndrome. Because additional stenting was considered a risk for further stent failure, it was decided to complete endovascular treatment with balloon angioplasty alone and then consider bypass treatment.Discussion: Although the Supera stent is a useful stent, it would be prudent to avoid popliteal artery stenting in the presence of abnormal vascular running or artificial joint is observed.","PeriodicalId":11910,"journal":{"name":"European Heart Journal: Case Reports","volume":"9 4","pages":"ytaf114"},"PeriodicalIF":0.8,"publicationDate":"2025-04-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11969065/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143794975","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}

引用次数: 0

Beyond the blueprint: decoding calmodulinopathy-a case report showcasing the utility of multifaceted treatments.

IF 0.8

European Heart Journal: Case Reports Pub Date : 2025-04-01 DOI: 10.1093/ehjcr/ytaf140

Saikiran Kakarla, Madhusoodanan Jalaja Aswathy, Madhusoodanan Pillai Sreelekshmi, Machilakath Panangandi Shabeer, Narayanan Namboodiri

{"title":"Beyond the blueprint: decoding calmodulinopathy-a case report showcasing the utility of multifaceted treatments.","authors":"Saikiran Kakarla, Madhusoodanan Jalaja Aswathy, Madhusoodanan Pillai Sreelekshmi, Machilakath Panangandi Shabeer, Narayanan Namboodiri","doi":"10.1093/ehjcr/ytaf140","DOIUrl":"10.1093/ehjcr/ytaf140","url":null,"abstract":"Background: Calmodulinopathies are adrenergically-induced life-threatening arrhythmias. Available therapies are disquietingly insufficient, especially for CALM-LQTS (calmodulinopathy-associated long QT syndrome). This case report illustrates a novel mutation in CALM-LQTS and its response to multimodality treatment strategies.Case summary: The proband was the first child born to a nonconsanguineous Indian couple, a 26-year-old woman and a 30-year-old man. The child was delivered prematurely, and at birth, a functional 2:1 atrioventricular block was noted with sinus bradycardia with a corrected QT by Bazzet's of 716 ms. Clinical exome sequencing of the proband revealed a novel missense variant c.287A>G in exon 5 of the CALM3 gene in a heterozygous state, resulting in an Asp96Gly change. The OMIM phenotype associated with it is long QT syndrome 16 (#618782). Despite receiving a dose of 4.5 mg/kg/day of propranolol, the child still had a persistent long QTc. Mexiletine was started at the trial dose of 1.5 mg/kg/day, and after 1 h, QTc was reduced to 507 ms from 560 ms. After a left-cardiac sympathectomy, he remains asymptomatic after 1.3 years of follow-up with a QTc value of 490 ms.Discussion: CALM3 pathogenic variants are gain-of-function variants mainly affecting amino acids residing in the Ca2-binding loops. Earlier data suggested the role of the Nav1.5 channel in leading to persistent Na+ leaks resulting in LQTS. However, they only focused on LQTS-CALM1 and CALM2 models and did not include CALM3-related genes. Despite similarities, the precise impact of CaM on Nav1.5 channels still needs to be defined as CaV1.2. The exact role of mexiletine is not fully understood.","PeriodicalId":11910,"journal":{"name":"European Heart Journal: Case Reports","volume":"9 4","pages":"ytaf140"},"PeriodicalIF":0.8,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11969334/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143794955","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}

引用次数: 0

A calcified, eroded, and thrombosed Mustard: recurrent embolic strokes in a patient with dextro-transpostion of the great arteries corrected by atrial switch-case report.

IF 0.8

European Heart Journal: Case Reports Pub Date : 2025-03-27 eCollection Date: 2025-04-01 DOI: 10.1093/ehjcr/ytaf150

Francisco Javier Ruperti-Repilado, Amadeo Wals-Rodriguez, Miguel Angel Japon, Antonio Gonzalez-Calle, Pastora Gallego

{"title":"A calcified, eroded, and thrombosed Mustard: recurrent embolic strokes in a patient with dextro-transpostion of the great arteries corrected by atrial switch-case report.","authors":"Francisco Javier Ruperti-Repilado, Amadeo Wals-Rodriguez, Miguel Angel Japon, Antonio Gonzalez-Calle, Pastora Gallego","doi":"10.1093/ehjcr/ytaf150","DOIUrl":"https://doi.org/10.1093/ehjcr/ytaf150","url":null,"abstract":"Background: After an atrial switch operation, baffle complications such as stenosis and dehiscence are common. While thromboembolic events attributed to baffle leaks are well known, thrombosis at the pulmonary venous baffle as a source of cardioembolic stroke has not been previously reported.Case summary: We describe the case of a 43-year-old Caucasian male with recurrent cardioembolic strokes due to a calcified, broken, and thrombosed baffle with floaty, anticoagulant-resistant thrombi adhered to the side of the pulmonary venous return of Mustard patch. Surgery was the only curative option due to thrombi recurrence under different regimes of anticoagulation.Discussion: A case of recurrent cardioembolic strokes long after Mustard surgery due to thrombi on a heavily calcified pericardial patch is presented. A fracture in the patch led to the exposure of thrombogenic material, which had accumulated around the pacemaker (PM) leads on the systemic venous side of the baffle. This exposure allowed thrombotic material to reach the pulmonary venous side, ultimately entering the subaortic right ventricle and the systemic circulation. In the Mustard procedure, the material used for the baffle construction is prone to degeneration and calcification over time. We hypothesize that chronic mechanical stress from the PM leads might have contributed to the gradual erosion and fracture and consequently thrombosis of the heavily calcified patch, leading to recurrent strokes. Surgery became necessary as aggressive anticoagulation failed to prevent thrombus recurrence.","PeriodicalId":11910,"journal":{"name":"European Heart Journal: Case Reports","volume":"9 4","pages":"ytaf150"},"PeriodicalIF":0.8,"publicationDate":"2025-03-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11975534/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143810872","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}

引用次数: 0

Giant intracardiac thrombus-in-transit in a woman with sudden respiratory-haemodynamic compromise following cesarean section for eclampsia: a case report.

IF 0.8

European Heart Journal: Case Reports Pub Date : 2025-03-26 eCollection Date: 2025-04-01 DOI: 10.1093/ehjcr/ytaf145

Olga Morelli, Dan M Gorfil, Yaron D Barac, Yaron Shapira, Alon Shechter

{"title":"Giant intracardiac thrombus-in-transit in a woman with sudden respiratory-haemodynamic compromise following cesarean section for eclampsia: a case report.","authors":"Olga Morelli, Dan M Gorfil, Yaron D Barac, Yaron Shapira, Alon Shechter","doi":"10.1093/ehjcr/ytaf145","DOIUrl":"10.1093/ehjcr/ytaf145","url":null,"abstract":"Background: Intracardiac thrombus-in-transit is a potentially fatal condition, seldom detected in real time.Case summary: We present a case of a 30-year-old pregnant woman with thalassemia intermedia and asplenia, who experienced a combined respiratory-haemodynamic collapse following an emergent caesarean section performed for eclampsia, and in whom a large mass transversing a patent foramen ovale was observed on bedside echocardiography. In view of the patient's unstable condition, mass' size and location as well as accompanying inter-atrial communication-all of which contributed to an imminent threat to cerebral circulation-and temporal proximity to abdominal surgery and epidural anaesthesia, an immediate open-heart surgery was decided upon that included mass excision and patent foramen ovale closure, and after which the patient quickly and fully recovered. Histopathologic examination of the mass revealed a mixture of thrombotic and amniotic fluid elements. Acute pulmonary embolism was eventually confirmed by computed tomography performed on post-operative day 2.Discussion: Early echocardiography and surgical intervention, as dictated by a multidisciplinary collaboration, allowed for a favourable outcome in our patient, emphasizing their pivotal role in the management of a life-threatening presentation of an intracardiac thrombus-in-transit.","PeriodicalId":11910,"journal":{"name":"European Heart Journal: Case Reports","volume":"9 4","pages":"ytaf145"},"PeriodicalIF":0.8,"publicationDate":"2025-03-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11971474/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143794990","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}

引用次数: 0

Spontaneous isolated brachiocephalic artery dissection with subsequent type-A acute aortic dissection.

IF 0.8

European Heart Journal: Case Reports Pub Date : 2025-03-25 eCollection Date: 2025-04-01 DOI: 10.1093/ehjcr/ytaf142

Hisato Takagi

引用次数: 0

Variations of partial anomalous pulmonary venous connection.

IF 0.8

European Heart Journal: Case Reports Pub Date : 2025-03-25 eCollection Date: 2025-04-01 DOI: 10.1093/ehjcr/ytaf133

Leqing Chen, Yukun Cao, Lixia Wang, Heshui Shi

引用次数: 0

Extrahepatic portosystemic shunt concealed in congenital heart disease and neurodevelopmental disorder: a case report.

IF 0.8

European Heart Journal: Case Reports Pub Date : 2025-03-25 eCollection Date: 2025-04-01 DOI: 10.1093/ehjcr/ytaf135

Toshinobu Ifuku, Hazumu Nagata, Yusaku Nagatomo, Ichiro Sakamoto, Keigo Nakatani

{"title":"Extrahepatic portosystemic shunt concealed in congenital heart disease and neurodevelopmental disorder: a case report.","authors":"Toshinobu Ifuku, Hazumu Nagata, Yusaku Nagatomo, Ichiro Sakamoto, Keigo Nakatani","doi":"10.1093/ehjcr/ytaf135","DOIUrl":"10.1093/ehjcr/ytaf135","url":null,"abstract":"Background: Neurodevelopmental disorders (NDDs) are often associated with congenital heart diseases (CHDs). Congenital portosystemic shunt (CPSS) is a rare abnormality of the portal system in which toxic substances that are not adequately metabolized by the liver circulate throughout the body and can cause non-specific neuropsychiatric symptoms. We describe a case of CHD and NDD in which neuropsychiatric symptoms due to extrahepatic CPSS became evident in adulthood.Case summary: A 24-year-old man underwent a thorough examination for liver dysfunction. He had a history of repaired tetralogy of Fallot and autism spectrum disorder. He was also diagnosed with depression at 21 years of age. Abdominal contrast-enhanced computed tomography revealed an abnormal vessel descending from the main trunk of the portal vein and entering the left common iliac vein, which was diagnosed as a CPSS. Hyperammonaemia, focal nodular hyperplasia of the liver, and high signal intensity in the bilateral globus pallidus on T1-weighted brain magnetic resonance imaging were also observed. Transcatheter occlusion of the CPSS with a multilayer device (Vascular Plug II; AGA Medical Corporation, Plymouth, MN, USA) significantly improved neuropsychiatric symptoms, abnormal blood data, and head and liver lesions.Discussion: Some of the neuropsychiatric symptoms in this patient were thought to have been caused by portosystemic encephalopathy (PSE) associated with CPSS. The symptoms of PSE and NDD are sometimes similar and difficult to differentiate. Although complications of CHD and NDD are common, screening for secondary treatable neuropsychiatric disorders, such as PSE, should be considered.","PeriodicalId":11910,"journal":{"name":"European Heart Journal: Case Reports","volume":"9 4","pages":"ytaf135"},"PeriodicalIF":0.8,"publicationDate":"2025-03-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11969214/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143794986","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}

引用次数: 0

Andexanet alfa for reversal of intracerebral haemorrhage resulting in ST-segment myocardial infarction: a case report.

IF 0.8

European Heart Journal: Case Reports Pub Date : 2025-03-24 eCollection Date: 2025-04-01 DOI: 10.1093/ehjcr/ytaf136

Shaheen Mehrara, Ravi Patel, Nathan DeRon

{"title":"Andexanet alfa for reversal of intracerebral haemorrhage resulting in ST-segment myocardial infarction: a case report.","authors":"Shaheen Mehrara, Ravi Patel, Nathan DeRon","doi":"10.1093/ehjcr/ytaf136","DOIUrl":"https://doi.org/10.1093/ehjcr/ytaf136","url":null,"abstract":"Background: Direct oral anticoagulants, such as direct factor Xa inhibitors, are commonly used to treat and prevent blood clots in patients with atrial fibrillation. Andexanet alfa reverses direct factor Xa inhibitors to help treat various thromboembolic conditions. Although it efficiently reverses anticoagulation by preventing life-threatening bleeding events, the use of andexanet alfa in today's clinical practice is limited due to the risk of thromboembolism and cost.Case summary: A 76-year-old male presented with atrial fibrillation with rapid ventricular response and was started on Eliquis after a successful direct current cardioversion. Subsequently, the patient developed intracerebral haemorrhage, which required the administration of andexanet alfa. Ultimately, the patient suffered an ST-segment elevation myocardial infarction from complete occlusion of the mid-left anterior descending artery. His hospital course was complicated by acute hypoxic respiratory failure, septic shock, and renal failure. The family elected for comfort care measures and the patient expired shortly after.Discussion: This case emphasizes the need for individualized clinical assessment and collaboration with an interdisciplinary team regarding the use of andexanet alfa, as well as strategies to ensure thrombotic risk is effectively minimized. Current European Society of Cardiology Guidelines do not have recommendations for the use of andexanet alfa for the reversal of anticoagulation due to its uncertain risk profile. This case emphasizes the increased risk of thrombotic complications associated with andexanet alfa and highlights the importance of the continued need to research its use, which may help elucidate or revise current guidelines.","PeriodicalId":11910,"journal":{"name":"European Heart Journal: Case Reports","volume":"9 4","pages":"ytaf136"},"PeriodicalIF":0.8,"publicationDate":"2025-03-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11975805/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143810874","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}

引用次数: 0

Recurrent isolated pulmonic valve infective endocarditis in a patient on chronic haemodialysis due to reinfection: description of an index case and management considerations.

IF 0.8

European Heart Journal: Case Reports Pub Date : 2025-03-24 eCollection Date: 2025-04-01 DOI: 10.1093/ehjcr/ytaf138

Sapana Yonghang, Mitesh Karn, Ana Maritza Marulanda Prado, Ronny Cohen

引用次数: 0