JACC. Case reports最新文献

Platypnea-Orthodeoxia Syndrome Due to Patent Foramen Ovale: A Diagnostic and Therapeutic Challenge. 由卵圆孔未闭引起的通气-正氧综合征：诊断和治疗的挑战。

JACC. Case reports Pub Date : 2025-06-27 DOI: 10.1016/j.jaccas.2025.104433

Michelle Carrasquel-Alvarez, Khaleel Quasem, Varun George, Lee Elisevich, Majid Mughal

{"title":"Platypnea-Orthodeoxia Syndrome Due to Patent Foramen Ovale: A Diagnostic and Therapeutic Challenge.","authors":"Michelle Carrasquel-Alvarez, Khaleel Quasem, Varun George, Lee Elisevich, Majid Mughal","doi":"10.1016/j.jaccas.2025.104433","DOIUrl":"https://doi.org/10.1016/j.jaccas.2025.104433","url":null,"abstract":"<p><strong>Background: </strong>Platypnea-orthodeoxia syndrome (POS) is a rare condition characterized by dyspnea and hypoxia exacerbated by an upright position. It is often associated with intracardiac or pulmonary shunting.</p><p><strong>Case summary: </strong>An 82-year-old woman presented with increasing fatigue, dizziness, and worsening dyspnea on exertion for 1 month. She was hypoxic, requiring high-flow oxygen. Initial work-up, including imaging and right heart catheterization, revealed an aneurysmal interatrial septum with a right-to-left shunt through a patent foramen ovale (PFO). The patient underwent successful percutaneous closure of the PFO, resulting in resolution of hypoxia and dyspnea.</p><p><strong>Discussion: </strong>POS should be suspected in cases of positional hypoxia. The pathophysiology involves anatomical and hemodynamic factors that promote right-to-left shunting in specific positions. PFO closure is the definitive treatment, leading to symptom resolution.</p><p><strong>Take-home messages: </strong>POS should be considered in patients with unexplained positional hypoxia. PFO closure can significantly improve symptoms and quality of life in affected patients.</p>","PeriodicalId":14792,"journal":{"name":"JACC. Case reports","volume":" ","pages":"104433"},"PeriodicalIF":0.0,"publicationDate":"2025-06-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144505713","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Multimodal Cardiac Imaging of a Sudden Cardiac Death Survivor From Central America 中美洲一例心源性猝死幸存者的多模态心脏成像

JACC. Case reports Pub Date : 2025-06-25 DOI: 10.1016/j.jaccas.2025.104203

D. Douglas Miller MD, Gyanendra K. Sharma MD, Sam Natla MD, Sean P. Javaheri MD, Vishal Arora MD

{"title":"Multimodal Cardiac Imaging of a Sudden Cardiac Death Survivor From Central America","authors":"D. Douglas Miller MD, Gyanendra K. Sharma MD, Sam Natla MD, Sean P. Javaheri MD, Vishal Arora MD","doi":"10.1016/j.jaccas.2025.104203","DOIUrl":"10.1016/j.jaccas.2025.104203","url":null,"abstract":"<div><h3>Background</h3><div>Sudden cardiac death (SCD) in a nonimmunosuppressed individual from El Salvador who had visited 2 <em>Trypanosoma cruzi</em> seropositive siblings raised clinical suspicion for Chagas disease.</div></div><div><h3>Case Summary</h3><div>A 61-year-old male SCD survivor presented with electrocardiogram conduction abnormalities, cardiomegaly, myocardial necrosis with basal inferolateral aneurysm formation (echocardiography, left ventriculography), and sluggish contrast flow in the absence of coronary obstruction. Cardiac magnetic resonance defined the extent of myocardial fibrosis (delayed enhancement) from microvascular disease and guided endomyocardial biopsy. <em>T. cruzi</em> serology studies and circulating inflammatory markers supported late-stage Chagas cardiomyopathy.</div></div><div><h3>Discussion</h3><div>Patients in <em>T. cruzi</em>-endemic regions are at an increased risk of developing Chagas cardiomyopathy, predisposing to SCD. Multimodal imaging provided indications for antiparasitic therapy to reduce disease progression and for dual-chamber implantable cardioverter defibrillator for secondary prevention in high-risk patients (Rassi score = 13).</div></div><div><h3>Take-Home Message</h3><div>In SCD survivors with Chagas cardiomyopathy, multimodal cardiac imaging: 1) improves early management; 2) guides antiparasitic therapy; and 3) adds prognostic value.</div></div>","PeriodicalId":14792,"journal":{"name":"JACC. Case reports","volume":"30 16","pages":"Article 104203"},"PeriodicalIF":0.0,"publicationDate":"2025-06-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144481329","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

A Rare Case of Left Internal Mammary Artery Transection During Pericardiocentesis 心包穿刺时左乳内动脉横断1例

JACC. Case reports Pub Date : 2025-06-25 DOI: 10.1016/j.jaccas.2025.104041

Shaun Abid MD , Anton Stolear MD , Lila Kaminsky MD , Samdish Sethi MD , David Narotsky MD , Chirag Shah MD , Matthew Seigerman MD

{"title":"A Rare Case of Left Internal Mammary Artery Transection During Pericardiocentesis","authors":"Shaun Abid MD , Anton Stolear MD , Lila Kaminsky MD , Samdish Sethi MD , David Narotsky MD , Chirag Shah MD , Matthew Seigerman MD","doi":"10.1016/j.jaccas.2025.104041","DOIUrl":"10.1016/j.jaccas.2025.104041","url":null,"abstract":"<div><h3>Background</h3><div>Pericardiocentesis is a common procedure for managing pericardial effusions, but it carries risks for vascular injury, particularly in patients with coagulopathies.</div></div><div><h3>Case Summary</h3><div>A 72-year-old man with factor V Leiden mutation and sick sinus syndrome (status post pacemaker placement), presented with dizziness, dyspnea, and chest pain. Echocardiography revealed a large pericardial effusion with tamponade physiology, necessitating pericardiocentesis. After drain removal, the patient developed hypotension and bradycardia. Imaging identified active bleeding from a distal branch of the left internal mammary artery (LIMA). Hemostasis was achieved via embolization and microcoil placement. The patient recovered with no reaccumulation of effusion or hematoma.</div></div><div><h3>Discussion</h3><div>This rare case of LIMA injury following pericardiocentesis highlights an underrecognized complication, particularly in patients with coagulation disorders. It underscores the need for vigilant postprocedural monitoring and the role of advanced imaging in diagnosing vascular injuries.</div></div><div><h3>Take-Home Message</h3><div>LIMA injury is a rare but serious complication of pericardiocentesis, requiring prompt-recognition and intervention.</div></div>","PeriodicalId":14792,"journal":{"name":"JACC. Case reports","volume":"30 16","pages":"Article 104041"},"PeriodicalIF":0.0,"publicationDate":"2025-06-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144480123","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Multimodality Cardiac Imaging 多模态心脏成像

JACC. Case reports Pub Date : 2025-06-25 DOI: 10.1016/j.jaccas.2025.104447

Maurice Enriquez-Sarano MD (Associate Editor, JACC: Case Reports)

引用次数: 0

Primary Cardiac Lymphoma Masquerading as a Pericardial Mass 伪装成心包肿块的原发性心脏淋巴瘤

JACC. Case reports Pub Date : 2025-06-25 DOI: 10.1016/j.jaccas.2025.103690

Joseph Hajj MD , Serge C. Harb MD , Ryan S. Klatte BSBME , Sarah L. Ondrejka DO , Jason Valent MD , Bradley Rosinski MD , Eric E. Roselli MD , Michael Z.Y. Tong MD, MBA

引用次数: 0

Right Ventricular Outflow Conduit Stenosis After Childhood Ross-Konno Procedure 儿童Ross-Konno手术后右心室流出管狭窄

JACC. Case reports Pub Date : 2025-06-25 DOI: 10.1016/j.jaccas.2025.104341

Lakshmi Kattamuri MD , Kunal Sharma MD , Kahtan Fadah DO , Chanwit Roongsritong MD

{"title":"Right Ventricular Outflow Conduit Stenosis After Childhood Ross-Konno Procedure","authors":"Lakshmi Kattamuri MD , Kunal Sharma MD , Kahtan Fadah DO , Chanwit Roongsritong MD","doi":"10.1016/j.jaccas.2025.104341","DOIUrl":"10.1016/j.jaccas.2025.104341","url":null,"abstract":"<div><h3>Background</h3><div>Right ventricle–pulmonary artery (RV-PA) conduit stenosis is a relatively uncommon complication after a childhood Ross-Konno procedure.</div></div><div><h3>Case Summary</h3><div>A man in his 20s presented with progressive dyspnea for 1 year. He had previously undergone modified Konno and Ross-Konno procedures for congenital subaortic stenosis followed by pulmonic balloon valvuloplasty for RV-PA stenosis. Echocardiography demonstrated reduced left ventricular ejection fraction, severe pulmonary hypertension, and right ventricular outflow tract obstruction. Cardiac computed tomography revealed right ventricular outflow/conduit stenosis with calcification. Right heart catheterization showed elevated right ventricular outflow/conduit pressure gradient, confirming severe conduit stenosis. He was referred for surgical pulmonic valve and conduit repair.</div></div><div><h3>Discussion</h3><div>Surgical conduit replacement remains the most definitive treatment strategy in small, calcified conduits. Multimodal imaging strategies aid in comprehensive assessment of anatomy and function of RV-PA conduit and valves to guide intervention strategies in adults with complex congenital heart disease.</div></div>","PeriodicalId":14792,"journal":{"name":"JACC. Case reports","volume":"30 16","pages":"Article 104341"},"PeriodicalIF":0.0,"publicationDate":"2025-06-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144481330","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Multimodality Imaging in Anomalous Aortic Origin of the Coronary Arteries 冠状动脉异常主动脉起源的多模态成像

JACC. Case reports Pub Date : 2025-06-25 DOI: 10.1016/j.jaccas.2025.104250

Joelle J.N. Daems MD , Maarten A. van Diepen MD , Splinter R.E. de Mooij BSc , Manou Speleman MD, PhD , Sebastiaan Velthuis MD, PhD , Peter Damman MD, PhD , Marcel Beijk MD, PhD , Mark Hinderks MD , Robin Nijveldt MD, PhD , Harald T. Jorstad MD, PhD

{"title":"Multimodality Imaging in Anomalous Aortic Origin of the Coronary Arteries","authors":"Joelle J.N. Daems MD , Maarten A. van Diepen MD , Splinter R.E. de Mooij BSc , Manou Speleman MD, PhD , Sebastiaan Velthuis MD, PhD , Peter Damman MD, PhD , Marcel Beijk MD, PhD , Mark Hinderks MD , Robin Nijveldt MD, PhD , Harald T. Jorstad MD, PhD","doi":"10.1016/j.jaccas.2025.104250","DOIUrl":"10.1016/j.jaccas.2025.104250","url":null,"abstract":"<div><h3>Background</h3><div>Anomalous aortic origin of a coronary artery (AAOCA) is a rare congenital anomaly linked to increased risk of myocardial ischemia and sudden cardiac death, especially among athletes subjected to extreme physiological stress. The diagnostic and therapeutic strategies in highly active individuals remain challenging and represent important knowledge gaps.</div></div><div><h3>Case Summary</h3><div>We present 4 cases of elite athletes with AAOCA with a variety of characteristics and detail their clinical evaluation, imaging and functional assessment, risk stratification, treatment decisions, and longitudinal follow-up.</div></div><div><h3>Discussion</h3><div>There are limited prospective data regarding the management of AAOCA in athletes. Autopsy studies have identified young age (<35 years), high exercise levels, and myocardial fibrosis as risk factors for sudden cardiac death. Moreover, the European Society of Cardiology on adult congenital heart disease recommends including age, level of exercise, and presence of high-risk anomaly features in risk assessment. This series highlights the complexities of managing AAOCA in athletes, and emphasizes the necessity for multimodality imaging in a context of multidisciplinary, individualized decision-making.</div></div><div><h3>Take-Home Messages</h3><div>A multimodality imaging approach is essential for early recognition, risk stratification, and clinical decision-making in AAOCA. Treatment decisions should be based on symptoms, presence of high-risk features, and inducible ischemia using complementary imaging modalities, with personalized recommendations supported by a multidisciplinary sports cardiology team.</div></div>","PeriodicalId":14792,"journal":{"name":"JACC. Case reports","volume":"30 16","pages":"Article 104250"},"PeriodicalIF":0.0,"publicationDate":"2025-06-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144481334","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Posterior Mediastinal Mass With Intracardiac Protrusion 后纵隔肿块伴心内突出

JACC. Case reports Pub Date : 2025-06-25 DOI: 10.1016/j.jaccas.2025.103902

Anuja Gadre MD, DM , Manphool Singhal MD, DNB , Manojkumar Rohit MD, DM , Harkant Singh MS, MCh , Suvradeep Mitra MD , Arun Sharma MD, DM , Meenakshi Mandal MS, MCh

{"title":"Posterior Mediastinal Mass With Intracardiac Protrusion","authors":"Anuja Gadre MD, DM , Manphool Singhal MD, DNB , Manojkumar Rohit MD, DM , Harkant Singh MS, MCh , Suvradeep Mitra MD , Arun Sharma MD, DM , Meenakshi Mandal MS, MCh","doi":"10.1016/j.jaccas.2025.103902","DOIUrl":"10.1016/j.jaccas.2025.103902","url":null,"abstract":"<div><h3>Background</h3><div>Posterior mediastinal masses are rare and remain asymptomatic until they enlarge enough to compress vital vascular structures, the tracheobronchial tree, the spine, or cardiac chambers. Computed tomography (CT) and cardiac magnetic resonance (CMR) provide precise locations and characterization of lesions.</div></div><div><h3>Case Summary</h3><div>A young woman was found to have a cystic mass in the posterior mediastinum extending into the interatrial septum and left atrium (LA) on echocardiography. Cardiac CT and CMR showed it protruding into the interatrial septum and LA. The diagnosis was confirmed as hydatid cyst on imaging and histopathologic examination.</div></div><div><h3>Discussion</h3><div>Mediastinal hydatid cysts are usually asymptomatic but may rarely cause pressure effects on vital organs or rupture, leading to life-threatening complications mandating precise diagnosis and management.</div></div><div><h3>Take-Home Messages</h3><div>Primary posterior mediastinal hydatid cysts are uncommon and can protrude into cardiac chambers, simulating a cardiac mass on echocardiography. They can be accurately diagnosed using multimodality imaging to guide appropriate treatment.</div></div>","PeriodicalId":14792,"journal":{"name":"JACC. Case reports","volume":"30 16","pages":"Article 103902"},"PeriodicalIF":0.0,"publicationDate":"2025-06-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144481339","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Multimodal Imaging to Guide Stent Placement in a Patient After Fontan Palliation With Restrictive Interatrial Communication 多模态成像指导限制性心房间沟通方坦姑息患者支架置入

JACC. Case reports Pub Date : 2025-06-25 DOI: 10.1016/j.jaccas.2025.104115

Daniel S. Schwab MD, Patcharapong Suntharos MD, Nicholas A. Szugye MD, MSc

{"title":"Multimodal Imaging to Guide Stent Placement in a Patient After Fontan Palliation With Restrictive Interatrial Communication","authors":"Daniel S. Schwab MD, Patcharapong Suntharos MD, Nicholas A. Szugye MD, MSc","doi":"10.1016/j.jaccas.2025.104115","DOIUrl":"10.1016/j.jaccas.2025.104115","url":null,"abstract":"<div><h3>Objective</h3><div>Late interatrial communication restriction is a rare complication in patients with single-ventricle physiology, obstructing pulmonary venous flow to the systemic ventricle. It is commonly treated percutaneously with balloon atrial septoplasty or atrial septum stenting, a technically challenging task.</div></div><div><h3>Key Steps</h3><div>Preprocedural specialized postprocessing of multiphase acquisition cardiac computed tomography and intraprocedure transesophageal echocardiography allowed for planning and successful stent placement, reducing left atrial pressure and relieving pulmonary venous outflow obstruction.</div></div><div><h3>Potential Pitfalls</h3><div>Aside from the increased preprocedural time and possible need for additional anesthesia, there are no pitfalls anticipated with this procedure.</div></div><div><h3>Take-Home Message</h3><div>Multimodality preprocedural imaging and advanced three-dimensional reconstruction can provide a procedural design when planning percutaneous intervention in patients with complex congenital heart disease.</div></div>","PeriodicalId":14792,"journal":{"name":"JACC. Case reports","volume":"30 16","pages":"Article 104115"},"PeriodicalIF":0.0,"publicationDate":"2025-06-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144481345","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Using Multimodality Imaging and 3-Dimensional Printed Models to Guide Decision-Making for Complex Congenital Biventricular Repair 利用多模态成像和三维打印模型指导复杂先天性双心室修复的决策

JACC. Case reports Pub Date : 2025-06-25 DOI: 10.1016/j.jaccas.2025.103884

Sukran Erdem MD , Munes Fares MD , Felipe Murguia MD , Jay Moore RDCS , Gregory Sturgeon RDCS , Catherine M. Ikemba MD , Gerald Greil MD, PhD , Tarique Hussain MD, PhD , Nicholas D. Andersen MD , Qing Zou PhD

{"title":"Using Multimodality Imaging and 3-Dimensional Printed Models to Guide Decision-Making for Complex Congenital Biventricular Repair","authors":"Sukran Erdem MD , Munes Fares MD , Felipe Murguia MD , Jay Moore RDCS , Gregory Sturgeon RDCS , Catherine M. Ikemba MD , Gerald Greil MD, PhD , Tarique Hussain MD, PhD , Nicholas D. Andersen MD , Qing Zou PhD","doi":"10.1016/j.jaccas.2025.103884","DOIUrl":"10.1016/j.jaccas.2025.103884","url":null,"abstract":"<div><h3>Background</h3><div>Determining the optimal surgical approach for complex congenital heart disease (CHD) can be challenging using conventional 2-dimensional transthoracic echocardiography (TTE) and cross-sectional imaging, including cardiac magnetic resonance (CMR) and computed tomography.</div></div><div><h3>Case Summary</h3><div>An 11-month-old female patient presented with heterotaxy syndrome, dextrocardia, double-outlet right ventricle, and complex pulmonary valve stenosis. Fetal echocardiography and postnatal TTE established the complexity of the cardiac anatomy and led to a multidisciplinary discussion to plan a complex staged cardiac repair.</div></div><div><h3>Discussion</h3><div>Three-dimensional (3D) printed and virtual heart models, along with CMR angiography, provided detailed anatomical visualization and spatial conceptualization, which aided in assessing the feasibility of a staged biventricular repair. Postoperative CMR guided subsequent surgical procedures, evaluated newly created structures such as baffles, and identified complications.</div></div><div><h3>Take-Home Message</h3><div>This case highlights the critical role of multimodality imaging, including advanced imaging with virtual and 3D printed modeling, in surgical planning in a patient with complex CHD.</div></div>","PeriodicalId":14792,"journal":{"name":"JACC. Case reports","volume":"30 16","pages":"Article 103884"},"PeriodicalIF":0.0,"publicationDate":"2025-06-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144481340","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0