European Heart Journal: Case Reports最新文献

{"title":"From oesophageal cancer to constrictive pericarditis: oesophagopericardial fistula complicated by <i>Streptococcus equi</i> infection-a case report.","authors":"Sofia Esteves, Ana Rita Figueiredo, Joana Rigueira, Catarina Sousa, Fausto J Pinto","doi":"10.1093/ehjcr/ytag700","DOIUrl":"10.1093/ehjcr/ytag700","url":null,"abstract":"<p><strong>Background: </strong>Oesophagopericardial fistula is a rare but life-threatening condition that may lead to purulent pericarditis, which in turn carries a high risk of progression to constrictive pericardial disease.</p><p><strong>Case summary: </strong>A 50-year-old horse handler with advanced oesophageal carcinoma presented with acute chest pain, fever, and shock. Echocardiography showed a large pericardial effusion and pericardiocentesis yielded purulent fluid. <i>Streptococcus equi</i> was isolated. Computed tomography confirmed an oesophagopericardial fistula. The patient underwent percutaneous drainage, broad-spectrum antimicrobial therapy, and endoscopic stent placement. Despite initial improvement, he developed effusive-constrictive physiology and later refractory septic shock, leading to death.</p><p><strong>Discussion: </strong>This case highlights a rare zoonotic cause of purulent pericarditis and its progression to constrictive physiology despite appropriate management.</p><p><strong>Take-home messages: </strong>Early recognition, multidisciplinary management, and follow-up imaging are essential in complex pericardial infections.</p>","PeriodicalId":11910,"journal":{"name":"European Heart Journal: Case Reports","volume":"10 9","pages":"ytag700"},"PeriodicalIF":0.7,"publicationDate":"2026-09-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13623217/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149079710","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":"Rapid interval progression of familial atrial myxoma despite negative screening.","authors":"Monisha Dsouza, Rajesh Gopalan Nair, Rajesh Sadanandan","doi":"10.1093/ehjcr/ytag692","DOIUrl":"10.1093/ehjcr/ytag692","url":null,"abstract":"<p><p>A 14-year-old girl with biopsy-proven extracardiac myxomas presented with recurrent cardioembolic stroke due to a rapidly developing giant left atrial myxoma. A pathogenic PRKAR1A variant and maternal history confirmed familial Carney complex. Urgent surgical excision prevented further embolization, emphasizing the aggressive and unpredictable nature of familial cardiac myxomas.</p>","PeriodicalId":11910,"journal":{"name":"European Heart Journal: Case Reports","volume":"10 9","pages":"ytag692"},"PeriodicalIF":0.7,"publicationDate":"2026-09-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13623234/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149079822","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 many faces of atrioventricular block in myocarditis: a case series and proposed clinical strategy highlighting cardiovascular magnetic resonance-guided diagnosis, device selection, and disease monitoring.","authors":"Michiel J Bom, Luuk H G A Hopman, Vokko P van Halm, Suzan F M Nijman, Mariette Labots, Michel W P Tsang-A-Sjoe, Lourens F H J Robbers, P Stefan Biesbroek","doi":"10.1093/ehjcr/ytag699","DOIUrl":"10.1093/ehjcr/ytag699","url":null,"abstract":"<p><strong>Background: </strong>Atrioventricular (AV) conduction disorders are a relatively rare complication in acute myocarditis. Although frequently transient in nature, persistent AV block has been reported. Cardiac magnetic resonance (CMR) imaging is critical in the diagnostic work-up and follow-up of myocarditis. This case series describes the use of CMR imaging to guide diagnosis, device selection, and disease monitoring.</p><p><strong>Case summary: </strong>Four patients with complete AV block due to acute myocarditis underwent serial CMR imaging for diagnosis, disease monitoring, and device timing and selection. Recovery of AV conduction was variable in the presented cases. Cardiac magnetic resonance imaging was able to identify two distinct clinical scenarios of disease progress and subsequent AV conduction recovery: first, two patients (Cases 1 and 2) in which resolution of myocardial inflammation was paralleled by resolution of AV conduction disorders and, second, a patient (Case 3) in which AV block persisted even after resolution of inflammation due to the development of myocardial fibrosis. However, in one patient (Case 4), CMR was unable to adequately detect the disease progress, i.e. a patient with persistent AV block despite resolution of inflammation and no signs of myocardial fibrosis.</p><p><strong>Discussion: </strong>This case series illustrates the variable clinical course of AV conduction disorders in the context of acute myocarditis. Cardiac magnetic resonance imaging was essential in the identification of underlying myocarditis, offering insights in the disease course, and may therefore be used as an adjunctive tool for device selection. However, mismatch between CMR findings and AV conduction disorders may occur and warrants further investigation.</p>","PeriodicalId":11910,"journal":{"name":"European Heart Journal: Case Reports","volume":"10 9","pages":"ytag699"},"PeriodicalIF":0.7,"publicationDate":"2026-09-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13614263/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149059435","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 the electrocardiogram goes quiet: transient low voltage in systemic capillary leak syndrome-associated myocardial oedema-a case report.","authors":"Peter Kordis, Vanja Persic, Andreja Cerne Cercek, Milica Lukic, Misa Fister","doi":"10.1093/ehjcr/ytag694","DOIUrl":"10.1093/ehjcr/ytag694","url":null,"abstract":"<p><strong>Background: </strong>Systemic capillary leak syndrome (SCLS) is a rare disorder characterized by acute episodes of hypotension, haemoconcentration, and hypoalbuminemia.</p><p><strong>Case summary: </strong>A 50-year-old woman presented with shock triggered by influenza B infection. Despite aggressive fluid resuscitation, she developed multiorgan failure and was diagnosed with severe SCLS requiring venoarterial extracorporeal membrane oxygenation due to myocardial oedema. Electrocardiography demonstrated diffuse low QRS voltage, while echocardiography revealed severe biventricular dysfunction with marked myocardial oedema. The patient was treated with immunoglobulins, corticosteroids, and plasmapheresis. Following clinical recovery, QRS voltages normalized, and cardiac function fully recovered.</p><p><strong>Discussion: </strong>SCLS is an immune-mediated rare cause of distributive shock. Cardiac involvement is uncommon but associated with high mortality. This case suggested that reversible low QRS voltage may serve as an electrocardiographic clue to myocardial oedema and severe cardiac involvement.</p>","PeriodicalId":11910,"journal":{"name":"European Heart Journal: Case Reports","volume":"10 9","pages":"ytag694"},"PeriodicalIF":0.7,"publicationDate":"2026-09-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13614268/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149059367","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":"A heart in a cage: cardiac compression and cardiovascular manifestations of pectus excavatum-a case report.","authors":"Carlos Salazar, Jorge Tolosa-Cubillos, Victor Benenati, German Gomez","doi":"10.1093/ehjcr/ytag682","DOIUrl":"https://doi.org/10.1093/ehjcr/ytag682","url":null,"abstract":"","PeriodicalId":11910,"journal":{"name":"European Heart Journal: Case Reports","volume":"10 10","pages":"ytag682"},"PeriodicalIF":0.7,"publicationDate":"2026-09-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13652020/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149166268","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 unexpected therapeutic overlap: long-term control of KCNK3-associated pulmonary arterial hypertension during treatment of systemic hypertension-a case report.","authors":"Leonardo Carli, Michele di Leo, Federico Donato, Chiara Barozzi, Fabio Dardi","doi":"10.1093/ehjcr/ytag679","DOIUrl":"10.1093/ehjcr/ytag679","url":null,"abstract":"<p><strong>Background: </strong>Pulmonary arterial hypertension (PAH) is a progressive disorder characterized by obliterative pulmonary vascular remodelling. Pathogenic variants in KCNK3 represent a recognized cause of heritable PAH (hPAH). Loss-of-function mutations lead to membrane depolarization, increased calcium influx, and enhanced pulmonary vasoconstriction. Calcium channel blockers (CCBs) are recommended for patients demonstrating a positive acute vasoreactivity test.</p><p><strong>Case summary: </strong>A 50-year-old man carrying a pathogenic KCNK3 (E34K) mutation was referred to a tertiary PAH centre during familial screening after two of his children were diagnosed with PAH and were non-responders to acute vasoreactivity testing. He was mildly symptomatic, World Health Organization functional class (WHO-FC) II, with preserved exercise capacity, 6-min walk distance (6MWD) of 580 m, and normal NT-proBNP levels. Echocardiography showed mild right ventricular dilatation with preserved systolic function. Right heart catheterization (RHC) confirmed mild pre-capillary pulmonary hypertension with a positive acute vasoreactivity testing response. Considering the mild haemodynamic impairment, the underlying KCNK3 mutation, and prior clinical improvement during amlodipine therapy for systemic hypertension, high-dose amlodipine was initiated. At 6-month follow-up, the patient improved to WHO-FC I, with increased 6MWD and haemodynamic improvement on repeat RHC.</p><p><strong>Discussion: </strong>This case describes a favourable clinical and haemodynamic response to CCB therapy in KCNK3-associated PAH. It highlights phenotypic variability within familial KCNK3-related disease and indicates that longitudinal data may help identify patients who could benefit from targeted therapies despite borderline haemodynamic profiles.</p>","PeriodicalId":11910,"journal":{"name":"European Heart Journal: Case Reports","volume":"10 9","pages":"ytag679"},"PeriodicalIF":0.7,"publicationDate":"2026-09-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13600608/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149037535","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":"A case report of right ventricular cardiomyopathy with right ventricular diverticulum and atrial septal defect associated with biallelic PLD1 gene variants.","authors":"Yong Liu, Meng Zhang, Tingliang Liu","doi":"10.1093/ehjcr/ytag688","DOIUrl":"10.1093/ehjcr/ytag688","url":null,"abstract":"","PeriodicalId":11910,"journal":{"name":"European Heart Journal: Case Reports","volume":"10 9","pages":"ytag688"},"PeriodicalIF":0.7,"publicationDate":"2026-09-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13614265/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149059458","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":"Left bundle branch pacing in double-chambered left ventricle and perimembranous ventricular septal aneurysm: a case report.","authors":"Kristina Brečko, Anja Zupan Mežnar, Nejc Pavšič, Mojca Bervar, David Žižek","doi":"10.1093/ehjcr/ytag681","DOIUrl":"https://doi.org/10.1093/ehjcr/ytag681","url":null,"abstract":"<p><strong>Background: </strong>Double-chambered left ventricle and perimembranous ventricular septal aneurysm are rare congenital heart abnormalities that often remain undetected until adulthood. Both abnormalities can be associated with conduction disorders requiring cardiac pacing. To our knowledge, this is the first case report of a patient with both a double-chambered left ventricle and a perimembranous ventricular septal aneurysm, undergoing left bundle branch area pacing (LBBAP) due to complete atrioventricular (AV) block.</p><p><strong>Case summary: </strong>A 31-year-old man with complete AV block was admitted to our centre, where diagnostic evaluation revealed a complex congenital heart defect: a large perimembranous septal aneurysm and a double-chambered left ventricle. Due to high predicted pacing burden, conduction system pacing with LBBAP was attempted. In addition to the standard technique, transoesophageal echocardiography (TEE) was used intraoperatively to facilitate safe positioning of the LBBAP lead. Finally, engagement of the conduction system was confirmed and preserved at the 1-year follow-up, with stable pacing parameters.</p><p><strong>Discussion: </strong>Conduction system pacing in congenital heart defects can be technically challenging due to complex anatomy. This case highlights LBBAP as a feasible physiological pacing option, even in complex and rare congenital heart defects. To minimize procedural risk, careful preprocedural multimodality imaging and intraoperative utilization of TEE were essential for optimal lead positioning in the setting of abnormal septal structures.</p>","PeriodicalId":11910,"journal":{"name":"European Heart Journal: Case Reports","volume":"10 9","pages":"ytag681"},"PeriodicalIF":0.7,"publicationDate":"2026-09-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13600610/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149037470","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 arrest as the first sign of thyrotoxicosis: a case report of angiographically proven coronary vasospasm.","authors":"Lieselot Wauters, Stephanie De Deckere, Frederik Lahaye, Rudi De Paep, Frederic De Roeck","doi":"10.1093/ehjcr/ytag684","DOIUrl":"10.1093/ehjcr/ytag684","url":null,"abstract":"<p><strong>Background: </strong>Cardiovascular manifestations of thyrotoxicosis are common, typically presenting as tachyarrhythmias or high-output physiology. Coronary artery spasm (CAS) is an uncommon but increasingly recognized complication, usually causing transient ischaemia rather than malignant ventricular arrhythmias. Cardiac arrest due to thyrotoxicosis-induced CAS is exceedingly rare. Early recognition is vital because management differs from that of typical acute coronary syndromes (ACS).</p><p><strong>Case summary: </strong>A 63-year-old man suffered an out-of-hospital cardiac arrest with an initial shockable rhythm, achieving return of spontaneous circulation (ROSC) after a single defibrillation. Initial evaluation revealed inferior ST-segment elevation, leading to urgent coronary angiography, which demonstrated severe right coronary artery spasm that resolved after intracoronary nitrate administration. Laboratory studies confirmed significant hyperthyroidism, and recurrent ST-segment changes in the intensive care unit further supported thyrotoxicosis-induced CAS as the underlying mechanism. The patient made a full neurological and cardiac recovery following temperature management, intensification of antithyroid therapy, and vasodilator treatment.</p><p><strong>Discussion: </strong>This case underscored an unusual presentation of cardiac arrest triggered by thyrotoxicosis-related CAS in the absence of underlying coronary artery disease. Elevated thyroid hormone levels can impair endothelial function and heighten vascular smooth muscle reactivity, creating a predisposition to diffuse, therapy-resistant vasospasm. Recognizing this reversible yet potentially fatal condition is crucial, as prompt initiation of antithyroid therapy and vasodilators can rapidly alleviate ischaemia and reduce the risk of recurrence. The favourable outcome in this patient illustrates how early identification of the underlying cause can guide swift and effective management.</p>","PeriodicalId":11910,"journal":{"name":"European Heart Journal: Case Reports","volume":"10 10","pages":"ytag684"},"PeriodicalIF":0.7,"publicationDate":"2026-09-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13674800/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149215393","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":"Loeffler endocarditis complicated by cardiogenic shock and angioinvasive <i>Fusarium fujikuroi</i> infection: a case report.","authors":"Jack Simmons, Ahmed K Saleh, Preston Nicely, William Morgan, Stephen Clarkson","doi":"10.1093/ehjcr/ytag670","DOIUrl":"https://doi.org/10.1093/ehjcr/ytag670","url":null,"abstract":"<p><strong>Background: </strong>Loeffler endocarditis is a form of restrictive cardiomyopathy that affects up to half of patients with hypereosinophilic syndromes. Patients undergoing treatment of Loeffler endocarditis with immunosuppression are at increased risk of mixed cardiogenic and septic shock due to its restrictive ventricular physiology and treatment with immunosuppressive therapy.</p><p><strong>Case summary: </strong>A 64-year-old female with peripheral eosinophilia and heart failure with mildly reduced ejection fraction reported 6 months of fatigue, worsening lower extremity oedema, palpitations, dyspnoea on exertion, and orthopnoea. She was diagnosed with Loeffler endocarditis based on cardiac magnetic resonance imaging and was initiated on high-dose prednisone and rituximab. While undergoing treatment of a subsequent angioinvasive fungal infection, she developed mixed cardiogenic and septic shock requiring inotropic support and broad-spectrum antimicrobials. She was eventually weaned off inotropic support and was continued on long-term posaconazole for the angioinvasive fungal infection.</p><p><strong>Discussion: </strong>Patients undergoing treatment of Loeffler endocarditis with immunosuppression are at an increased risk of mixed cardiogenic and septic shock. Late-stage Loeffler endocarditis predisposes to cardiogenic shock due to restrictive ventricular physiology and thrombi obliterating the ventricular cavities, while immunosuppressive therapy increases risk of opportunistic infections. If immunosuppression is initiated before ventricular fibrosis occurs, progression of Loeffler endocarditis can be halted or reversed.</p>","PeriodicalId":11910,"journal":{"name":"European Heart Journal: Case Reports","volume":"10 10","pages":"ytag670"},"PeriodicalIF":0.7,"publicationDate":"2026-09-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13695071/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149264656","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}