European Heart Journal: Case Reports最新文献

{"title":"Successful extravascular implantable cardioverter defibrillator implantation in a patient with ankylosing spondylitis and severe thoracic deformity: a case report.","authors":"Jia He, Qiming Liu, Zean Zhu, Zhenjiang Liu, Zhihong Wu","doi":"10.1093/ehjcr/ytag758","DOIUrl":"https://doi.org/10.1093/ehjcr/ytag758","url":null,"abstract":"<p><strong>Background: </strong>Severe thoracic deformity in ankylosing spondylitis (AS) can complicate implantable cardioverter defibrillator (ICD) implantation and device selection. Substernal EV-ICD implantation requires careful anatomical assessment and individualized procedural planning.</p><p><strong>Case summary: </strong>A 57-year-old male with severe AS and dilated cardiomyopathy was referred for primary prevention ICD implantation. Given the high complication risks associated with conventional approaches, EV-ICD was selected. A tailored positioning strategy was employed to accommodate the thoracic deformity. Intraoperative resistance during substernal dissection was successfully overcome through meticulous re-dissection. Favourable intraoperative electrical parameters were obtained, including an R-wave sensing amplitude of 5.6 mV without P-wave oversensing and successful defibrillation at 30 J on the first attempt. At 6-month follow-up, device performance remained stable without sensing anomalies or inappropriate shocks.</p><p><strong>Discussion: </strong>This case demonstrates the technical feasibility of EV-ICD implantation in a carefully selected patient with severe AS-associated thoracic deformity. Preoperative CT assessment, tailored patient positioning, careful dissection, and surgical backup enabled successful implantation and stable device performance during 6 months of follow-up.</p>","PeriodicalId":11910,"journal":{"name":"European Heart Journal: Case Reports","volume":"10 10","pages":"ytag758"},"PeriodicalIF":0.7,"publicationDate":"2026-10-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13690091/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149264584","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":"Case report: surgical total cardiac denervation for refractory vasospastic angina: first report with pre- and post-operative autonomic assessment.","authors":"Mitchell Hobers, Erik Lipsic, Riemer H J A Slart, Mike J L de Jongste, Theo J Klinkenberg","doi":"10.1093/ehjcr/ytag691","DOIUrl":"https://doi.org/10.1093/ehjcr/ytag691","url":null,"abstract":"<p><strong>Background: </strong>Refractory vasospastic angina (VSA) can persist despite maximal medical therapy and partial autonomic denervation. Surgical total cardiac denervation (STCD) is a novel surgical approach resulting in disappearance of the anginal pain perception.</p><p><strong>Case summary: </strong>We report the first clinically successful STCD supported by objective pre- and post-operative autonomic assessment using heart rate variability (HRV) and iodine-123 metaiodobenzylguanidine (¹²³I-MIBG) scintigraphy. A 53-year-old woman with severe treatment-refractory VSA remained highly symptomatic. Pre-operative HRV and ¹²³I-MIBG both demonstrated preserved autonomic innervation. Following STCD, anginal symptoms resolved and ST-T segment changes became painless. Concomitantly, HRV markedly decreased and ¹²³I-MIBG showed significantly reduced tracer uptake, confirming complete sympathetic denervation. After a 9-month follow-up, the patient remains free of symptoms.</p><p><strong>Conclusion: </strong>We present the first proof-of-concept case of STCD as a novel approach for refractory VSA. Further experience is required to evaluate broader efficacy, as well as long-term durability and safety.</p>","PeriodicalId":11910,"journal":{"name":"European Heart Journal: Case Reports","volume":"10 10","pages":"ytag691"},"PeriodicalIF":0.7,"publicationDate":"2026-10-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13662397/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149192076","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":"Severe dynamic left-ventricular outflow-tract obstruction unmasked by transcatheter aortic valve implantation: a case report.","authors":"Zongmei Gao, Minghui Yuan, Yi Li, Jingli Lu, Ruijian Li","doi":"10.1093/ehjcr/ytag755","DOIUrl":"10.1093/ehjcr/ytag755","url":null,"abstract":"<p><strong>Background: </strong>Relieving the fixed afterload of severe aortic stenosis can unmask a previously concealed dynamic outflow-tract obstruction.</p><p><strong>Case summary: </strong>A 69-year-old man with severe aortic stenosis (valve area 0.65 cm²; 109/64 mmHg), mild concentric hypertrophy (septum 15 mm), and no baseline systolic anterior motion (SAM) underwent transcatheter aortic valve implantation (TAVI). The invasive peak-to-peak gradient fell from 64 to 7 mmHg, but echocardiography immediately afterwards showed new SAM and severe dynamic left-ventricular-outflow-tract (LVOT) obstruction (170/67 mmHg) with hypotension. Treatment was load-directed (volume expansion, avoidance of vasodilators and inotropes, beta-blockade), with a cardiac myosin inhibitor as an adjunct. Over 4 months the resting LVOT gradient fell to 22/13 mmHg and the provoked peak to 29 mmHg, with SAM no longer seen and preserved ejection fraction.</p><p><strong>Discussion: </strong>Recognizing this load-dependent obstruction during the procedure and restoring loading, rather than escalating inotropes, is the key lesson.</p>","PeriodicalId":11910,"journal":{"name":"European Heart Journal: Case Reports","volume":"10 10","pages":"ytag755"},"PeriodicalIF":0.7,"publicationDate":"2026-10-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13696958/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149264629","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":"Cardiac hydatidosis: enigmatic presentation of enigmatic diagnosis: a case report.","authors":"Anurodh Dadarwal, Aditya Kapoor, Shantanu Pande, Ankit Sahu","doi":"10.1093/ehjcr/ytag740","DOIUrl":"https://doi.org/10.1093/ehjcr/ytag740","url":null,"abstract":"<p><strong>Background: </strong>In endemic countries, hydatid disease is often overlooked because of its non-specific clinical presentation and the limited use of multimodality imaging. Unusual anatomical locations and atypical presentations further complicate diagnosis. Multimodality imaging not only helps to confirm the diagnosis but also plays a crucial role in treatment planning.</p><p><strong>Case summary: </strong>A 45-year-old man from a rural area presented with a 2-year history of haemoptysis and exertional dyspnoea. He had received antitubercular therapy for 1 year without improvement. Subsequent computed tomography angiography at a secondary care centre suggested pulmonary thromboembolism, and he was referred to our centre for further evaluation. He also had a history of foul-smelling cough and peripheral eosinophilia, without any identifiable risk factors for pulmonary thromboembolism. Routine echocardiography revealed a large multi-cystic mass attached to the basal interventricular septum and protruding into the right ventricular outflow tract. Hydatid disease was strongly suspected and subsequently confirmed by serological testing and transoesophageal echocardiography. Cardiac computed tomography and magnetic resonance imaging were performed to better define the nature, location, and extent of the lesion. The patient was treated with albendazole followed by uneventful surgical excision and remains asymptomatic on follow-up.</p><p><strong>Conclusion: </strong>This case illustrates a rare presentation of cardiac hydatidosis masquerading as pulmonary embolism. Multimodality imaging was essential in characterizing the lesion, defining its anatomic extent, and guiding management. Surgical excision can be performed safely when carefully planned, and perioperative chemotherapy reduces the risk of recurrence.</p>","PeriodicalId":11910,"journal":{"name":"European Heart Journal: Case Reports","volume":"10 10","pages":"ytag740"},"PeriodicalIF":0.7,"publicationDate":"2026-10-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13711670/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149285865","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":"The clinical chameleon: eosinophilic myocarditis presenting as acute coronary syndrome-a case report.","authors":"Denise Belén Magnifico, Ignacio Melem, Sergio Baratta, Renzo Melchiori","doi":"10.1093/ehjcr/ytag752","DOIUrl":"https://doi.org/10.1093/ehjcr/ytag752","url":null,"abstract":"<p><strong>Background: </strong>Eosinophilic myocarditis is a rare inflammatory cardiomyopathy that may clinically mimic acute coronary syndrome and should be considered in patients with non-obstructive coronary arteries, often resulting in diagnostic delay.</p><p><strong>Case summary: </strong>A 27-year-old man presented with recurrent chest pain and was initially misdiagnosed with a panic attack. On admission, laboratory evaluation revealed marked peripheral eosinophilia (1800/mm³), mildly elevated troponin, and increased serum IgE levels. Echocardiography demonstrated reduced left ventricular ejection fraction and a large apical intracavitary thrombus. Coronary angiography revealed normal coronary arteries. Cardiac magnetic resonance imaging showed myocardial oedema and circumferential subendocardial late gadolinium enhancement consistent with eosinophilic myocarditis. Extensive aetiological workup was negative. Although endomyocardial biopsy showed non-specific findings, the diagnosis was established through multimodal integration of clinical, imaging, and laboratory data. High-dose corticosteroid therapy and anticoagulation resulted in rapid clinical improvement, recovery of ventricular function, and near-complete thrombus resolution.</p><p><strong>Discussion: </strong>Eosinophilic myocarditis should be considered in young patients presenting with chest pain and non-obstructive coronary arteries. Multimodality imaging-particularly cardiac magnetic resonance-plays a key role in diagnosis, while early corticosteroid therapy may lead to rapid clinical and functional recovery.</p><p><strong>Conclusion: </strong>This case underscores the importance of maintaining a high index of clinical suspicion for EM in young patients presenting with chest pain and peripheral eosinophilia. A multimodal diagnostic approach integrating cMRI findings, laboratory data, and exclusion of alternative aetiologies is essential when biopsy results are inconclusive. Early immunosuppressive therapy is key to reversing myocardial damage and preventing progression to end-stage heart failure.</p>","PeriodicalId":11910,"journal":{"name":"European Heart Journal: Case Reports","volume":"10 10","pages":"ytag752"},"PeriodicalIF":0.7,"publicationDate":"2026-10-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13715626/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149295636","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":"The normal D-dimer paradox: pulmonary artery intimal sarcoma masquerading as pulmonary embolism: a case report.","authors":"Maicol Cortez-Sandoval, Milagros Palomino, Dayana Hernandez, Jorge M Aldea Saldaña, Oscar Rodríguez-Fernández","doi":"10.1093/ehjcr/ytag750","DOIUrl":"https://doi.org/10.1093/ehjcr/ytag750","url":null,"abstract":"<p><strong>Background: </strong>Pulmonary artery intimal sarcoma is an exceptionally rare and aggressive malignancy that can closely mimic pulmonary embolism. Overlapping clinical and imaging features frequently lead to diagnostic anchoring and delayed recognition, with devastating prognostic consequences.</p><p><strong>Case summary: </strong>A 50-year-old woman presented with a nine-month history of progressive dyspnoea and cough and was admitted with hypotension, jugular venous distension, peripheral oedema, and systolic murmurs. Laboratory testing revealed a D-dimer level of 0.5 μg/mL (reference range 0.1-0.6 μg/mL). Transthoracic echocardiography showed right ventricular dilatation and a mass involving the pulmonary valve and main pulmonary artery. Computed tomography pulmonary angiography demonstrated an expansile lesion of the main pulmonary artery extending into both branches, with extraluminal involvement and new pulmonary nodules. Despite therapeutic anticoagulation for presumed pulmonary embolism, there was no clinical or radiological improvement. Histological diagnosis was obtained through biopsy of a breast lesion, revealing a high-grade sarcoma with vascular differentiation consistent with pulmonary artery intimal sarcoma. Given extensive local invasion and poor functional status (ECOG 4), curative treatment was not feasible, and the patient died 30 days after definitive diagnosis.</p><p><strong>Discussion: </strong>In the present case, pulmonary artery intimal sarcoma should be considered in patients with an atypical or refractory pulmonary embolism phenotype, particularly when a normal D-dimer level accompanies progressive pulmonary artery obstruction. Diagnostic clues include lack of response to anticoagulation, an expansile rather than occlusive intraluminal lesion, and extraluminal extension. Early recognition allows timely referral to specialized centres, which is critical given the poor prognosis once advanced local invasion has developed.</p>","PeriodicalId":11910,"journal":{"name":"European Heart Journal: Case Reports","volume":"10 10","pages":"ytag750"},"PeriodicalIF":0.7,"publicationDate":"2026-10-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13695059/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149264638","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":"Mixing point thrombus during veno-arterial extracorporeal membrane oxygenation support.","authors":"Micah T Long, John T Dollerschell, Joshua L Hermsen, Joshua J Sebranek","doi":"10.1093/ehjcr/ytag722","DOIUrl":"https://doi.org/10.1093/ehjcr/ytag722","url":null,"abstract":"","PeriodicalId":11910,"journal":{"name":"European Heart Journal: Case Reports","volume":"10 10","pages":"ytag722"},"PeriodicalIF":0.7,"publicationDate":"2026-10-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13662404/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149192012","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":"ECG Challenge: When Aberrancy Reveals the Diagnosis.","authors":"Davis Meyer, Andrea N Keithler","doi":"10.1093/ehjcr/ytag743","DOIUrl":"https://doi.org/10.1093/ehjcr/ytag743","url":null,"abstract":"","PeriodicalId":11910,"journal":{"name":"European Heart Journal: Case Reports","volume":"10 10","pages":"ytag743"},"PeriodicalIF":0.7,"publicationDate":"2026-10-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13690088/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149264645","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 ruptured sinus of Valsalva and tricuspid paravalvular leak following surgical tricuspid valve replacement.","authors":"Ruitao Li, Wenxia Zhou, Yuan Feng","doi":"10.1093/ehjcr/ytag731","DOIUrl":"https://doi.org/10.1093/ehjcr/ytag731","url":null,"abstract":"","PeriodicalId":11910,"journal":{"name":"European Heart Journal: Case Reports","volume":"10 10","pages":"ytag731"},"PeriodicalIF":0.7,"publicationDate":"2026-10-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13715629/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149295653","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":"Role of digital health in the personalized management of heart failure due to Fontan failure: a case report.","authors":"Elena Cavarretta, Maria Teresa Quarta, Gianfranco Butera, Antonio Amodeo, Rachele Adorisio","doi":"10.1093/ehjcr/ytag733","DOIUrl":"10.1093/ehjcr/ytag733","url":null,"abstract":"<p><strong>Background: </strong>Heart failure (HF) represents a major cause of morbidity and mortality in patients with Fontan circulation. Chronic venous congestion, impaired preload, and limited cardiac output reserve make clinical assessment and intermittent invasive evaluations insufficient to capture early haemodynamic deterioration. Pharmacological treatment lack of robust evidence in this subgroup of patients. In this challenging setting, implantable invasive haemodynamic monitoring systems may provide continuous, real-life information capable of guiding personalized HF management.</p><p><strong>Case summary: </strong>A 26-year-old Fontan male developed protein losing enteropathy and recurrent hospitalizations for decompensated heart failure. Therefore, the patient was candidate to heart transplantation. Over time, episodes of acute HF increased with an escalating requirement of dosage of diuretics. At 22 years of age, another episode of acute decompensated HF prompted a catheter-based intervention with Fontan conduit re-dilatation and re-fenestration with an Atrial Flow Regulator (AFR) implant, and a pulmonary artery pressure monitoring system (CardioMEMS™) was deployed to telemonitor pulmonary artery pressures and adjust the diuretic therapy accordingly. Up to date, 4 years from the intervention, the use of this remote monitoring system was feasible and effective in tailoring medical therapy to prevent further hospitalizations for acute HF. The patient is in clinical follow-up with regular controls.</p><p><strong>Discussion: </strong>Systems allowing continuous or repeated assessment of haemodynamic status in real-life conditions may support personalized treatment adjustments, improve symptom control, and potentially reduce HF-related hospitalizations in patients with failing Fontan circulation.</p>","PeriodicalId":11910,"journal":{"name":"European Heart Journal: Case Reports","volume":"10 10","pages":"ytag733"},"PeriodicalIF":0.7,"publicationDate":"2026-10-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13696955/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149264588","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}