European Heart Journal: Case Reports最新文献_第4页

Recurrent syncope with a type 1 Brugada electrocardiogram pattern in a patient on amitriptyline: Brugada syndrome vs. phenocopy-a case report. 阿米替林患者复发性晕厥伴1型Brugada心电图型：Brugada综合征与显像- 1例报告

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European Heart Journal: Case Reports Pub Date : 2026-09-26 eCollection Date: 2026-10-01 DOI: 10.1093/ehjcr/ytag710

Muhammad K Asyraf, Philip Smyth, Sajjad Matiullah

{"title":"Recurrent syncope with a type 1 Brugada electrocardiogram pattern in a patient on amitriptyline: Brugada syndrome vs. phenocopy-a case report.","authors":"Muhammad K Asyraf, Philip Smyth, Sajjad Matiullah","doi":"10.1093/ehjcr/ytag710","DOIUrl":"https://doi.org/10.1093/ehjcr/ytag710","url":null,"abstract":"Background: Brugada syndrome is an inherited arrhythmogenic channelopathy associated with an increased risk of sudden cardiac death. Diagnosis relies on the presence of a spontaneous type 1 Brugada pattern on electrocardiogram (ECG). While multiple hypotheses have been proposed to explain its underlying mechanism, it is generally thought to be secondary to defective myocardial sodium channels. For this reason, sodium channel-blocking medications can induce a type 1 Brugada pattern, which may complicate risk stratification and raise the possibility of Brugada phenocopy.Case summary: A 44-year-old man on regular amitriptyline 75 mg for anxiety and panic disorder presented with two episodes of syncope. ECG showed classical features of a type 1 Brugada pattern. Routine blood investigations, including full blood count, renal function tests, a comprehensive electrolyte panel, and high-sensitivity troponin, were normal. Transthoracic echocardiography revealed normal cardiac structure and function. Following multidisciplinary team (MDT) discussion, and guided by the 2022 European Society of Cardiology (ESC) guidelines, a shared decision was made to proceed with implantable cardioverter-defibrillator (ICD) implantation. The patient was discharged with follow-up in the arrhythmia clinic and referred for genetic testing.Discussion: This case highlighted the diagnostic and management challenges of differentiating true Brugada syndrome from drug-induced Brugada phenocopy. Although our patient had type 1 Brugada ECG pattern in the context of amitriptyline use, his presentation with syncope complicates risk stratification. MDT discussion and reference to ESC guidelines played a key role in determining further management, which in this case was ICD implantation.","PeriodicalId":11910,"journal":{"name":"European Heart Journal: Case Reports","volume":"10 10","pages":"ytag710"},"PeriodicalIF":0.7,"publicationDate":"2026-09-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13685633/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149243822","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

Totally endoscopic septal myectomy combined with mitral valve replacement for suicide left ventricle following transcatheter aortic valve implantation: a case report. 经导管主动脉瓣植入术后全腔镜下鼻中隔切除术联合二尖瓣置换术治疗自杀左心室1例。

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European Heart Journal: Case Reports Pub Date : 2026-09-25 eCollection Date: 2026-10-01 DOI: 10.1093/ehjcr/ytag708

Shogo Maeda, Riku Kato, Toshiaki Ito

{"title":"Totally endoscopic septal myectomy combined with mitral valve replacement for suicide left ventricle following transcatheter aortic valve implantation: a case report.","authors":"Shogo Maeda, Riku Kato, Toshiaki Ito","doi":"10.1093/ehjcr/ytag708","DOIUrl":"10.1093/ehjcr/ytag708","url":null,"abstract":"Background: Dynamic left ventricular outflow tract obstruction (LVOTO) causing acute haemodynamic collapse is a rare but life-threatening complication after transcatheter aortic valve implantation (TAVI). Known as suicide left ventricle (SLV), it results from abrupt afterload reduction leading to hypercontractility and dynamic obstruction. Medical therapy is often insufficient, requiring advanced intervention.Case summary: An 88-year-old woman with symptomatic severe aortic stenosis underwent TAVI. Preprocedural echocardiography showed septal hypertrophy without significant LVOTO. Immediately after valve deployment, she developed LVOTO with systolic anterior motion and severe mitral regurgitation, leading to haemodynamic deterioration. Medical management-including volume loading, discontinuation of inotropes, and beta-blocker-was ineffective. Catheter-based therapies were unsuitable because of severe leaflet calcification. Therefore, totally endoscopic transmitral septal myectomy with mitral valve replacement was performed. Postoperative echocardiography confirmed resolution of LVOTO and mitral regurgitation. She gradually recovered and was transferred for rehabilitation on postoperative Day 132.Discussion: TAVI can cause SLV in patients with septal hypertrophy. Although transcatheter therapies are generally preferred in patients at high surgical risk, this case demonstrates that totally endoscopic surgery can be a feasible alternative when catheter-based options are not appropriate. Careful preprocedural risk assessment for SLV and consideration of alternative strategies are essential in patients at increased risk of developing this complication.","PeriodicalId":11910,"journal":{"name":"European Heart Journal: Case Reports","volume":"10 10","pages":"ytag708"},"PeriodicalIF":0.7,"publicationDate":"2026-09-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13642043/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149126963","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

Impact of residual tricuspid regurgitation after transcatheter tricuspid therapies on right and left ventricular mechanics: insights from a case series. 经导管三尖瓣治疗后残余三尖瓣返流对左右心室力学的影响：来自一系列病例的见解。

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European Heart Journal: Case Reports Pub Date : 2026-09-24 eCollection Date: 2026-09-01 DOI: 10.1093/ehjcr/ytag626

Giulio M Mondellini, Antoon J M van den Enden, Mark M P van den Dorpel, Christiaan L Meuwese, Nicolas M Van Mieghem

{"title":"Impact of residual tricuspid regurgitation after transcatheter tricuspid therapies on right and left ventricular mechanics: insights from a case series.","authors":"Giulio M Mondellini, Antoon J M van den Enden, Mark M P van den Dorpel, Christiaan L Meuwese, Nicolas M Van Mieghem","doi":"10.1093/ehjcr/ytag626","DOIUrl":"10.1093/ehjcr/ytag626","url":null,"abstract":"Background: Severe tricuspid regurgitation (TR) induces right ventricular (RV) volume overload and disrupts biventricular mechanics. Tricuspid transcatheter edge-to-edge repair (T-TEER) and transcatheter tricuspid valve replacement (TTVR) are effective strategies to reduce or eliminate TR, yet their immediate physiological effects and the impact of residual TR remain incompletely characterized. We used invasive pressure-volume (PV) analysis to assess acute biventricular responses to transcatheter tricuspid valve interventions.Case summary: Three patients with severe TR underwent TTVR (n = 1) or T-TEER (n = 2) with invasive RV and left ventricular (LV) PV assessment immediately before and after intervention. In two patients achieving ≤mild residual TR, RV end-diastolic volume decreased (241→205 mL; 81→77 mL), while RV end-systolic pressure increased (32→37 mmHg; 26→32 mmHg). Effective arterial elastance (Ea) increased markedly (0.28→0.50; 0.84→1.33 mmHg/mL), paralleled by increases in end-systolic elastance (Ees) (0.26→0.38; 0.49→0.80 mmHg/mL), consistent with an adaptive contractile response. These changes were accompanied by increased LV end-diastolic volumes (163→176 mL; 68→84 mL) and higher LV/RV volume ratios. In contrast, in the patient with residual moderate-to-severe TR, only modest changes in RV mechanical indices were observed, without an increase in LV preload (102→99 mL).Discussion: Effective TR reduction appears to be a key determinant of acute biventricular adaptation following transcatheter tricuspid valve interventions. Optimal reduction (<moderate TR) is associated with RV volume unloading, increased afterload, and a coupled rise in contractile indices, resulting in improved LV filling. In contrast, suboptimal TR reduction yields limited biventricular benefit.","PeriodicalId":11910,"journal":{"name":"European Heart Journal: Case Reports","volume":"10 9","pages":"ytag626"},"PeriodicalIF":0.7,"publicationDate":"2026-09-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13604847/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149037518","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

Complex bilateral coronary artery fistulas with multiple drainage sites: a multimodality imaging case report. 复杂的双侧冠状动脉瘘伴多个引流部位：一个多模态影像学病例报告。

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European Heart Journal: Case Reports Pub Date : 2026-09-24 eCollection Date: 2026-09-01 DOI: 10.1093/ehjcr/ytag683

Dušan Ružičić, Milenko Čanković, Nikola Komazec, Višeslav Popadić

{"title":"Complex bilateral coronary artery fistulas with multiple drainage sites: a multimodality imaging case report.","authors":"Dušan Ružičić, Milenko Čanković, Nikola Komazec, Višeslav Popadić","doi":"10.1093/ehjcr/ytag683","DOIUrl":"10.1093/ehjcr/ytag683","url":null,"abstract":"Background: Coronary artery fistulas (CAFs) are rare coronary anomalies, most often detected incidentally. Although frequently asymptomatic, complex fistulas may lead to myocardial ischaemia, heart failure, or other complications, and optimal management remains controversial.Case summary: A 68-year-old patient presented with exertional dyspnoea and dizziness. Coronary angiography revealed intermediate left anterior descending artery stenosis with negative fractional flow reserve and a large CAF. Multislice computed tomography demonstrated complex bilateral CAFs originating from both coronary arteries, with drainage into the superior vena cava, right atrium, and descending aorta. Cardiac magnetic resonance imaging showed preserved myocardial tissue characteristics without ischaemia or fibrosis. Following Heart Team discussion, conservative management with optimal medical therapy was chosen. At 2-year follow-up, the patient remained asymptomatic without adverse events.Discussion: This case illustrates an exceptionally rare presentation of bilateral CAFs with multiple atypical drainage sites. It highlights the value of multimodality imaging for comprehensive anatomical and functional assessment and supports individualized, Heart Team-guided management in the absence of clear guideline recommendations.","PeriodicalId":11910,"journal":{"name":"European Heart Journal: Case Reports","volume":"10 9","pages":"ytag683"},"PeriodicalIF":0.7,"publicationDate":"2026-09-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13610568/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149037511","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

Pulmonary artery aneurysm associated with a bicuspid pulmonary valve: a case report of an unusual cause of atypical chest pain. 肺动脉动脉瘤与二尖瓣肺动脉瓣：一个不寻常的原因不典型胸痛的病例报告。

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European Heart Journal: Case Reports Pub Date : 2026-09-24 eCollection Date: 2026-10-01 DOI: 10.1093/ehjcr/ytag716

Eryclaudia Chrystian Brasileiro Jorqueira, Vinicius de Medeiros Nobre, Nathalia Serrato Mendonça Silva, Tiago Nóbrega Morato, Antonio Aurelio de Paiva Fagundes Junior

{"title":"Pulmonary artery aneurysm associated with a bicuspid pulmonary valve: a case report of an unusual cause of atypical chest pain.","authors":"Eryclaudia Chrystian Brasileiro Jorqueira, Vinicius de Medeiros Nobre, Nathalia Serrato Mendonça Silva, Tiago Nóbrega Morato, Antonio Aurelio de Paiva Fagundes Junior","doi":"10.1093/ehjcr/ytag716","DOIUrl":"10.1093/ehjcr/ytag716","url":null,"abstract":"Background: Pulmonary artery aneurysm (PAA) is a rare condition, most commonly associated with pulmonary arterial hypertension. Its association with a bicuspid pulmonary valve is exceptionally uncommon.Case summary: A 62-year-old woman presented with recurrent chest pain and dyspnoea, with persistently elevated D-dimer levels leading to repeated investigations for pulmonary embolism. Serial imaging demonstrated progressive pulmonary artery dilatation. Multimodality imaging identified a bicuspid pulmonary valve and a 54 mm PAA. Given aneurysm size and persistent symptoms, the patient underwent pulmonary arterioplasty with aneurysm resection. Intraoperative findings required patch enlargement with bovine pericardium. The postoperative course was uneventful, with complete symptom resolution and no recurrence on follow-up.Discussion: This case highlights a rare association between PAA and bicuspid pulmonary valve and underscores the role of multimodality imaging in diagnosis. Surgical repair may be considered in symptomatic patients and in selected patients with large or progressively enlarging aneurysms.","PeriodicalId":11910,"journal":{"name":"European Heart Journal: Case Reports","volume":"10 10","pages":"ytag716"},"PeriodicalIF":0.7,"publicationDate":"2026-09-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13642045/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149126886","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

Disappearance of local ventricular components during extrastimulus pacing after ultra-low-temperature cryoablation for ventricular tachycardia: a case report. 超低温冷冻消融治疗室性心动过速后刺激外起搏时局部心室成分消失1例报告。

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European Heart Journal: Case Reports Pub Date : 2026-09-23 eCollection Date: 2026-10-01 DOI: 10.1093/ehjcr/ytag721

Kohei Ukita, Roman Mamaev, Tuğba Aktemur Özalp, Jan-Per Wenzel, Roland Richard Tilz

{"title":"Disappearance of local ventricular components during extrastimulus pacing after ultra-low-temperature cryoablation for ventricular tachycardia: a case report.","authors":"Kohei Ukita, Roman Mamaev, Tuğba Aktemur Özalp, Jan-Per Wenzel, Roland Richard Tilz","doi":"10.1093/ehjcr/ytag721","DOIUrl":"https://doi.org/10.1093/ehjcr/ytag721","url":null,"abstract":"Background: Ultra-low-temperature cryoablation (ULTC) enables the creation of deep and potentially transmural myocardial lesions and is increasingly used for ventricular tachycardia (VT) substrate modification. However, the chronic electrophysiological properties of myocardium following extreme cryothermal injury remain incompletely understood.Case summary: A 66-year-old man with dilated cardiomyopathy and a cardiac resynchronization therapy defibrillator presented with recurrent sustained VT 15 months after ULTC of the left ventricular outflow tract. During repeat ablation, high-density mapping revealed sharp local ventricular electrograms within the prior ablation region. Programmed ventricular stimulation from the right ventricular outflow tract reproducibly induced disappearance of these sharp local components during extrastimulus pacing, while the surface QRS complex remained preserved, indicating preserved global ventricular activation. The phenomenon was consistently observed across different pacing protocols. Radiofrequency ablation targeting this region resulted in elimination of the sharp local electrograms, whereas dull far-field signals persisted. After ablation, VT was no longer inducible, and the patient remained free from recurrence at 3-month follow-up.Discussion: This case demonstrates a reproducible disappearance of near-field ventricular electrograms during extrastimulus pacing in myocardium previously treated with ULTC. The findings suggest localized refractoriness or source-sink mismatch within partially injured myocardium, rather than conventional slow conduction. These observations provide novel insight into the chronic electrophysiological effects that may occur after ULTC and may have implications for substrate assessment during repeat VT ablation.","PeriodicalId":11910,"journal":{"name":"European Heart Journal: Case Reports","volume":"10 10","pages":"ytag721"},"PeriodicalIF":0.7,"publicationDate":"2026-09-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13637617/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149106104","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

Pneumopericardium after pericardiocentesis for malignant pericardial effusion. 恶性心包积液心包穿刺后心包积液。

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European Heart Journal: Case Reports Pub Date : 2026-09-23 eCollection Date: 2026-10-01 DOI: 10.1093/ehjcr/ytag713

Machiko Miyoshi, Kanae Hasegawa, Kentaro Ishida, Hiroshi Tada

引用次数: 0

Multimodality imaging for early detection of subacute myocardial rupture. 多模态成像在亚急性心肌破裂早期检测中的应用。

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European Heart Journal: Case Reports Pub Date : 2026-09-23 eCollection Date: 2026-09-01 DOI: 10.1093/ehjcr/ytag669

Giacomo Boi, Maria Francesca Marchetti, Riccardo Cau, Roberta Montisci

引用次数: 0

A late bloom at the apex: development of apical hypertrophic cardiomyopathy phenotype in advanced age. 一个晚开花在顶点：发展顶端肥厚性心肌病表型在老年。

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European Heart Journal: Case Reports Pub Date : 2026-09-23 eCollection Date: 2026-10-01 DOI: 10.1093/ehjcr/ytag723

Sachin Sapkota, Muhammad Kasim Malik, Sandesh Murali, Gregory Milligan

引用次数: 0

Isolated granulomatous pulmonary artery vasculitis associated with Hughes-Stovin syndrome: a case report. 孤立性肉芽肿性肺动脉血管炎合并Hughes-Stovin综合征1例报告。

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European Heart Journal: Case Reports Pub Date : 2026-09-22 eCollection Date: 2026-10-01 DOI: 10.1093/ehjcr/ytag677

James Healy, Nicolás Urriola, Ian Nicholson, Rajesh Puranik

{"title":"Isolated granulomatous pulmonary artery vasculitis associated with Hughes-Stovin syndrome: a case report.","authors":"James Healy, Nicolás Urriola, Ian Nicholson, Rajesh Puranik","doi":"10.1093/ehjcr/ytag677","DOIUrl":"https://doi.org/10.1093/ehjcr/ytag677","url":null,"abstract":"Background: Hughes-Stovin syndrome (HSS) is an exceptionally rare vasculitis, characterized by pulmonary artery aneurysms with in situ thrombosis and is increasingly regarded as part of the vascular Behcet spectrum. Diagnosis remains challenging due to its rarity, lack of validated diagnostic criteria, and overlap with other vasculitis.Case summary: We describe a 71-year-old male who presented with progressive dyspnoea and chest pain. Serial imaging demonstrated rapid enlargement of a main pulmonary artery aneurysm from 5 mm to 68 × 55 mm over 18 months, prompting surgical repair. Histopathological examination of the resected pulmonary artery demonstrated granulomatous arteritis with multinucleated giant cells, transmural inflammation, and disruption of the elastic lamina, confirming isolated pulmonary artery vasculitis. In the context of pulmonary artery aneurysm, normal coagulation studies and systemic exclusion of alternative causes including Behcet disease, giant cell arteritis, Takayasu arteritis, infection, and malignancy, the findings were considered most consistent with HSS. Following multidisciplinary review, immunosuppression was commenced with corticosteroid and methotrexate before transition to tocilizumab and mycophenolate mofetil. Recurrent pulmonary thrombosis despite therapeutic apixaban required conversion to therapeutic enoxaparin. At latest follow-up, the patient remained clinically stable with no evidence of active vasculitis or recurrent aneurysm.Conclusion: This case highlights a rare presentation of isolated granulomatous pulmonary artery vasculitis associated with HSS in an older patient. The case demonstrates the importance of cautious diagnostic classification and exclusion of alternative diagnoses through serial multimodal imaging, timely surgical intervention, prompt commencement of immunosuppression, and multidisciplinary care.","PeriodicalId":11910,"journal":{"name":"European Heart Journal: Case Reports","volume":"10 10","pages":"ytag677"},"PeriodicalIF":0.7,"publicationDate":"2026-09-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13652021/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149164938","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