European Heart Journal: Case Reports最新文献_第10页

Variations of partial anomalous pulmonary venous connection. 部分肺静脉连接异常的变化。

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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. 隐匿于先天性心脏病和神经发育障碍的肝外门系统分流1例。

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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. 安德沙奈逆转脑出血导致st段心肌梗死1例。

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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":"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. 慢性血液透析患者因再感染而复发的孤立性肺动脉瓣感染性心内膜炎：一个指标病例的描述和处理考虑。

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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

The thrilling journey of a broken needle. 一根断针的惊险旅程。

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European Heart Journal: Case Reports Pub Date : 2025-03-24 eCollection Date: 2025-04-01 DOI: 10.1093/ehjcr/ytaf141

Decai Zeng, Xiangling Cao, Ji Wu

引用次数: 0

Surgical bailout for underexpanded transcatheter mitral valve replacement: addressing hemodynamic challenges. 经导管扩张不足二尖瓣置换术的外科救助：解决血流动力学挑战。

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European Heart Journal: Case Reports Pub Date : 2025-03-24 eCollection Date: 2025-04-01 DOI: 10.1093/ehjcr/ytaf143

Chadi Aludaat, Arnaud Gay, Quentin Landolff

引用次数: 0

Is altitude friend or foe in unrepaired congenital heart disease? A case report. 海拔对未修复的先天性心脏病是友还是敌？一份病例报告。

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European Heart Journal: Case Reports Pub Date : 2025-03-24 eCollection Date: 2025-03-01 DOI: 10.1093/ehjcr/ytaf115

Rebecca Fisher, Kali Hopkins, Krittika Pant, Arjun Kapoor, Ali N Zaidi

{"title":"Is altitude friend or foe in unrepaired congenital heart disease? A case report.","authors":"Rebecca Fisher, Kali Hopkins, Krittika Pant, Arjun Kapoor, Ali N Zaidi","doi":"10.1093/ehjcr/ytaf115","DOIUrl":"10.1093/ehjcr/ytaf115","url":null,"abstract":"Background: Some unrestrictive congenital shunts put patients at high risk for developing irreversible pulmonary vascular disease if not closed in the first year of life. Living at high altitude also places patients at risk for developing pulmonary hypertension. There are anecdotal data that living at high altitude may be protective against the development of shunt-related pulmonary vascular disease.Case summary: A 20-year-old female from Ecuador was found to have a large patent ductus arteriosus (PDA) and pulmonary hypertension after a murmur was auscultated. She had been living at altitude until 6 months prior. She was found to have a large PDA, systemic pulmonary artery (PA) pressure, and an elevated pulmonary vascular resistance index (PVRi) (33 wu ∗ m2) with minimal shunting (Qp:Qs 1:1). Vasodilatory testing with inhaled nitric oxide (iNO) and 100% FiO2 showed continued systemic PA pressure but a dramatic decrease in PVRi (12.5 wu ∗ m2) with an increase in left-to-right shunt (Qp:Qs 2:1). Living at high altitude causes hypoxic vasoconstriction. This vasoconstriction, which is typically reversible on descent to sea level, may decrease the left-to-right shunt and the irreversible downstream vascular changes that would normally occur in the setting of an unrestrictive PDA. Given the significant acute drop of this patient's vascular resistance with pulmonary vasodilator testing, she was started on oral pulmonary vasodilators. However, months later, the patient became increasingly symptomatic and repeat catheterization showed worsening cardiac function. Pulmonary vasodilators were stopped and the decision was made not to close the PDA.Discussion: Living at high altitude may be protective against the development of congenital shunt-related irreversible pulmonary vascular disease. However, in this case, it may not have been enough due to the complexity of anatomy.","PeriodicalId":11910,"journal":{"name":"European Heart Journal: Case Reports","volume":"9 3","pages":"ytaf115"},"PeriodicalIF":0.8,"publicationDate":"2025-03-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11931610/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143700052","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

Peripheral intravascular lithotripsy in transcatheter aortic valve implantation: a case report. 经导管主动脉瓣植入术中的外周血管内碎石1例。

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European Heart Journal: Case Reports Pub Date : 2025-03-24 eCollection Date: 2025-04-01 DOI: 10.1093/ehjcr/ytaf137

Vaibhav J Bhastana, Swaroop Bharadi, Rajeev Menon, Anuj Kapadiya

{"title":"Peripheral intravascular lithotripsy in transcatheter aortic valve implantation: a case report.","authors":"Vaibhav J Bhastana, Swaroop Bharadi, Rajeev Menon, Anuj Kapadiya","doi":"10.1093/ehjcr/ytaf137","DOIUrl":"https://doi.org/10.1093/ehjcr/ytaf137","url":null,"abstract":"Background: The presence of severe calcific atherosclerosis at the iliofemoral axis may preclude transcatheter aortic valve replacement (TAVR) by the transfemoral (TF) approach. Intravascular lithotripsy (IVL) is a novel technology that fractures intimal/medial calcium, increasing vessel compliance and enabling TF-TAVR in selected patients with peripheral artery disease.Case summary: A 76-year-old female presented with severe degenerative calcific aortic valvular stenosis. The patient was planned for TAVR due to high surgical risk status. However, computed tomography analysis revealed significant aortoiliac calcific narrowing, which limited TF access. Intravascular lithotripsy was performed to modify the calcific stenosis in the aortoiliac region, after which TAVR was successfully completed via the transfemoral route. This intervention was crucial in allowing TAVR to be performed at a low risk. The procedure was successful, and the patient was doing well at 8-month follow-up.Discussion: Peripheral IVL appears to be a safe and effective solution for TAVR candidates with co-existing iliofemoral calcifications. Using peripheral IVL to facilitate TF access should be part of the TAVR algorithm, to maintain the safety profile and superior outcomes of traditional TF-TAVR. More research is needed to improve the understanding of anatomical selection for IVL in TAVR candidates. Operators performing IVL-assisted TF-TAVR should be familiar with endovascular interventions and bailout solutions, not so much to treat IVL-treated lesions, but to be able to treat any vascular complication that may occur at the puncture site.","PeriodicalId":11910,"journal":{"name":"European Heart Journal: Case Reports","volume":"9 4","pages":"ytaf137"},"PeriodicalIF":0.8,"publicationDate":"2025-03-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11983100/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143997033","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

Anti-interleukin-5 efficacy in an inclisiran-triggered eosinophilic myocarditis: a case report. 抗白细胞介素-5在斜西兰诱发的嗜酸性心肌炎中的疗效：1例报告。

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European Heart Journal: Case Reports Pub Date : 2025-03-21 eCollection Date: 2025-04-01 DOI: 10.1093/ehjcr/ytaf127

Francesco Tartaglia, Maria Rita Messina, Stefania Rizzo, Enrico Heffler, Cristina Panico

{"title":"Anti-interleukin-5 efficacy in an inclisiran-triggered eosinophilic myocarditis: a case report.","authors":"Francesco Tartaglia, Maria Rita Messina, Stefania Rizzo, Enrico Heffler, Cristina Panico","doi":"10.1093/ehjcr/ytaf127","DOIUrl":"10.1093/ehjcr/ytaf127","url":null,"abstract":"Background: Eosinophilic myocarditis is a rare condition that can be associated with hypersensitivity reactions. Endomyocardial biopsy (EMB) is required for diagnosis, especially when cardiac magnetic resonance (CMR) is inconclusive. Immunosuppressive treatment is usually limited to corticosteroids.Case summary: Two days following an inclisiran injection for dyslipidaemia management, a 72-year-old Caucasian male with a history of coronary artery disease experienced progressive shortness of breath. Suspecting a hypersensitivity reaction to inclisiran, corticosteroids were administered. After discontinuing corticosteroids, the patient experienced recurrent dyspnoea. Laboratory tests indicated eosinophilia, increased serum immunoglobulin E (IgE), and positive specific serum IgE for Aspergillus fumigatus. Imaging tests and a lung biopsy revealed pulmonary aspergillosis, while CMR showed myocardial inflammation. The patient was initially treated with itraconazole and steroid therapy. However, he was re-hospitalized for worsening of the cardiac and respiratory condition after tapering steroids. A diagnosis of severe eosinophilic asthma associated with allergic bronchopulmonary aspergillosis was established. Löffler's endocarditis related to Aspergillus-induced eosinophilia was suspected and confirmed by repeated CMR and an EMB. Mepolizumab, an interleukin-5 (IL-5) inhibitor, was initiated resulting in symptom resolution and absence of inflammation at the 6-month follow-up CMR.Discussion: This case describes an uncommon response to inclisiran that resulted in Aspergillus-induced, steroid-dependent, eosinophilic systemic inflammation, resulting in severe asthma and endocarditis. It demonstrates how biological IL-5 inhibitors are effective in treating both components, emphasizing the necessity of a multidisciplinary strategy.","PeriodicalId":11910,"journal":{"name":"European Heart Journal: Case Reports","volume":"9 4","pages":"ytaf127"},"PeriodicalIF":0.8,"publicationDate":"2025-03-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11973448/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143802664","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

Successful management of iliac artery perforation during peripheral angioplasty: a case report. 外周血管成形术中髂动脉穿孔的成功治疗一例报告。

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European Heart Journal: Case Reports Pub Date : 2025-03-20 eCollection Date: 2025-03-01 DOI: 10.1093/ehjcr/ytaf126

Saroj Kumar Sahoo, Debasis Panda, Debasis Acharya, Ramachandra Barik, Subhas Pramanik

{"title":"Successful management of iliac artery perforation during peripheral angioplasty: a case report.","authors":"Saroj Kumar Sahoo, Debasis Panda, Debasis Acharya, Ramachandra Barik, Subhas Pramanik","doi":"10.1093/ehjcr/ytaf126","DOIUrl":"10.1093/ehjcr/ytaf126","url":null,"abstract":"Background: Peripheral artery disease is commonly managed with percutaneous balloon angioplasty, now the standard for replacing open surgical methods. Although generally effective, this procedure can lead to complications, including the rare but potentially fatal vessel perforation. Prompt identification and intervention are crucial to avoid severe outcomes. This case report presents a rare instance of iliac artery perforation during angioplasty, successfully managed with a covered stent.Case summary: A 58-year-old male with poorly controlled type 2 diabetes mellitus presented with a non-healing ulcer and claudication in the left lower limb. Computed tomography (CT) angiography revealed complete occlusion of the left external iliac artery and significant stenosis of the right external iliac artery. During peripheral angioplasty, vessel perforation occurred after post-stenting balloon dilation, causing haemodynamic instability. Immediate management included balloon tamponade and deployment of a covered stent to seal the perforation. The patient's condition stabilized, and he was discharged with medications, including antiplatelets, anticoagulants, and statins. A follow-up CT angiography one month later showed a patent stent with good distal blood flow, and the patient remained clinically well.Discussion: Iliac artery perforation, though rare, is a severe complication of peripheral angioplasty demanding prompt and effective intervention to avert mortality and morbidity. This case demonstrates successful management using a covered stent, emphasizing the necessity of meticulous pre-procedural planning and intraoperative vigilance. The report also highlights the value of intravascular imaging and advanced techniques for vascular bed preparation in minimizing the risk of such complications during angioplasty.","PeriodicalId":11910,"journal":{"name":"European Heart Journal: Case Reports","volume":"9 3","pages":"ytaf126"},"PeriodicalIF":0.8,"publicationDate":"2025-03-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11940739/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143718121","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