JACC. Case reports最新文献_第5页

Recurrent Cardiac Sarcoidosis After Heart Transplantation. 心脏移植后复发性心脏结节病。

JACC. Case reports Pub Date : 2025-10-07 DOI: 10.1016/j.jaccas.2025.105601

Molly A Cole, Nandakumar Menon, Elise Strycharske, David Pham, Jefree J Schulte, Carmen Campbell, Veli K Topkara

{"title":"Recurrent Cardiac Sarcoidosis After Heart Transplantation.","authors":"Molly A Cole, Nandakumar Menon, Elise Strycharske, David Pham, Jefree J Schulte, Carmen Campbell, Veli K Topkara","doi":"10.1016/j.jaccas.2025.105601","DOIUrl":"https://doi.org/10.1016/j.jaccas.2025.105601","url":null,"abstract":"<p><strong>Background: </strong>Cardiac sarcoidosis (CS) is a rare but clinically significant condition in heart transplant recipients.</p><p><strong>Case summary: </strong>A 64-year-old woman with nonischemic cardiomyopathy and heart transplant presented with exertional dyspnea and new reduction in left ventricular ejection fraction. Endomyocardial biopsy, donor-specific antibodies, and imaging were concerning for antibody-mediated rejection versus CS. Empiric treatment for antibody-mediated rejection was initiated, but her left ventricular ejection fraction remained unchanged. Native heart explant was reviewed and was consistent with CS. Methotrexate was started, with clinical and radiographic improvement.</p><p><strong>Discussion: </strong>Owing to its patchy nature, CS can be difficult to diagnose on biopsy, but cardiac imaging can assist. Heart transplant recipients with known CS have similar outcomes to transplant recipients without CS if they take low-dose steroids indefinitely.</p><p><strong>Take-home message: </strong>The explanted heart should be extensively examined for CS in transplant recipients; if found, clinicians should prescribe CS-effective therapy indefinitely to prevent recurrence.</p>","PeriodicalId":14792,"journal":{"name":"JACC. Case reports","volume":" ","pages":"105601"},"PeriodicalIF":0.0,"publicationDate":"2025-10-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145238578","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 of Papillary Muscle-Origin Left Ventricular Myxoma. 乳头状肌源性左心室黏液瘤的多模态成像。

JACC. Case reports Pub Date : 2025-10-07 DOI: 10.1016/j.jaccas.2025.105602

Lei Liu, Ling Chen, Hui Chen, Lei Tao, Yanfei Mo, Jing Yao, Xuelin Yang, Aijuan Fang

{"title":"Multimodal Imaging of Papillary Muscle-Origin Left Ventricular Myxoma.","authors":"Lei Liu, Ling Chen, Hui Chen, Lei Tao, Yanfei Mo, Jing Yao, Xuelin Yang, Aijuan Fang","doi":"10.1016/j.jaccas.2025.105602","DOIUrl":"https://doi.org/10.1016/j.jaccas.2025.105602","url":null,"abstract":"<p><strong>Background: </strong>Cardiac myxomas most commonly originate in the left atrium, whereas occurrences in the ventricles are rare, accounting for only 3% to 4% of cases. Their pseudoinvasive growth, which can mimic malignancy, poses significant diagnostic challenges.</p><p><strong>Case summary: </strong>A 49-year-old asymptomatic man underwent transthoracic echocardiography, revealing a 27.5 × 16.5 mm moderately echogenic mass in the midlateral left ventricle, adjacent to the anterior papillary muscle. Further examination showed the mass with low-density margins merging with the chordae tendineae on computed tomography (54 HU), homogeneous T2 hyperintensity with delayed \"cloud-like\" enhancement on cardiac magnetic resonance imaging, and moderate metabolic activity (SUV<sub>max</sub> = 7.8) on positron emission tomography/computed tomography. Histopathological examination confirmed the mass as a benign myxoma with pseudoinvasive entrapment of the papillary muscle. Subtotal resection was performed, successfully maintaining mitral valve integrity.</p><p><strong>Discussion: </strong>This case demonstrates the value of integrated imaging techniques in differentiating pseudoinvasive cardiac myxomas from malignant tumors, thereby enhancing diagnostic approaches for ventricular masses.</p><p><strong>Take-home messages: </strong>Multimodal imaging is crucial for diagnosing cardiac tumors located in atypical regions. Recognizing benign pseudoinvasive patterns is key to avoiding unnecessary radical surgery.</p>","PeriodicalId":14792,"journal":{"name":"JACC. Case reports","volume":" ","pages":"105602"},"PeriodicalIF":0.0,"publicationDate":"2025-10-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145238354","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

Isolated Left Ventricular Apical Hypoplasia Presenting as Vasovagal Syncope in a Middle-Aged Male Patient. 孤立的左心室顶端发育不全表现为血管迷走神经性晕厥一例中年男性患者。

JACC. Case reports Pub Date : 2025-10-07 DOI: 10.1016/j.jaccas.2025.105600

Lakshmi Siddhi Kolaparthi, Rajesh Thachathodiyl, Ramiah Rajesh Kannan

{"title":"Isolated Left Ventricular Apical Hypoplasia Presenting as Vasovagal Syncope in a Middle-Aged Male Patient.","authors":"Lakshmi Siddhi Kolaparthi, Rajesh Thachathodiyl, Ramiah Rajesh Kannan","doi":"10.1016/j.jaccas.2025.105600","DOIUrl":"https://doi.org/10.1016/j.jaccas.2025.105600","url":null,"abstract":"<p><strong>Background: </strong>Isolated left ventricular apical hypoplasia (ILVAH) is a rare congenital cardiomyopathy characterized by a truncated and spherical left ventricle with compensatory right ventricle elongation. Clinical presentation is variable and often delayed.</p><p><strong>Case summary: </strong>We report a 40-year-old man with no comorbidities who presented with a vasovagal episode. Electrocardiogram showed sinus rhythm with incomplete left bundle branch block. Echocardiography suggested dilated cardiomyopathy; however, cardiac magnetic resonance imaging (CMR) revealed the classic features of isolated left ventricular apical hypoplasia, including a truncated, spherical left ventricle with fatty apical infiltration, elongated right ventricle encasing the apex, and papillary muscle abnormalities. Despite preserved ejection fraction (53%), we initiated medical therapy with angiotensin receptor neprilysin inhibitor, beta-blockers, SGLT2i, spironolactone, and aspirin. The patient declined coronary angiography and is under follow-up.</p><p><strong>Discussion: </strong>ILVAH can mimic dilated cardiomyopathy on echocardiography. CMR is key to accurate diagnosis and management.</p><p><strong>Take home messages: </strong>Suspect ILVAH in a globular left ventricle with apical truncation. It may mimic dilated cardiomyopathy and requires CMR for confirmation.</p>","PeriodicalId":14792,"journal":{"name":"JACC. Case reports","volume":" ","pages":"105600"},"PeriodicalIF":0.0,"publicationDate":"2025-10-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145238348","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

Unexpected Diagnosis of Arrhythmogenic Right Ventricular Cardiomyopathy After Routine Preoperative Evaluation Leads to Life-Saving Intervention 常规术前评估后意外诊断为致心律失常的右室心肌病导致挽救生命的干预

JACC. Case reports Pub Date : 2025-10-01 DOI: 10.1016/j.jaccas.2025.105306

Parth Desai MD , Alexandra Maloof MD , Linda Vong DO , Savitri Fedson MD , Dhaval Parekh MD , Wilson W. Lam MD

{"title":"Unexpected Diagnosis of Arrhythmogenic Right Ventricular Cardiomyopathy After Routine Preoperative Evaluation Leads to Life-Saving Intervention","authors":"Parth Desai MD , Alexandra Maloof MD , Linda Vong DO , Savitri Fedson MD , Dhaval Parekh MD , Wilson W. Lam MD","doi":"10.1016/j.jaccas.2025.105306","DOIUrl":"10.1016/j.jaccas.2025.105306","url":null,"abstract":"<div><h3>Background</h3><div>A healthy 44-year-old woman presented for preoperative evaluation of planned bunionectomy. Electrocardiogram showed T-wave inversions in leads V<sub>1</sub> to V<sub>5</sub> and epsilon waves in precordium prompting further evaluation.</div></div><div><h3>Case Summary</h3><div>Imaging studies and genetic testing revealed diagnosis of arrhythmogenic right ventricular cardiomyopathy. Patient met Class IIb indication for primary prevention with implantable cardioverter-defibrillator (ICD). Despite weak guideline indication, shared decision-making with the patient led to ICD implantation. Six months later, she had a ventricular tachycardia arrest resulting in ICD shock and return to sinus rhythm.</div></div><div><h3>Discussion</h3><div>Routine preoperative evaluation led to the diagnosis of a rare pathology. Prompt evaluation and intervention using shared decision-making led to a life-saving intervention.</div></div><div><h3>Take-Home Messages</h3><div>Utilization of guidelines in conjunction with patient-centered therapy is the best approach to provide optimal care and prevent mortality in rare instances like this case for ICD placement after arrhythmogenic right ventricular cardiomyopathy diagnosis.</div></div>","PeriodicalId":14792,"journal":{"name":"JACC. Case reports","volume":"30 30","pages":"Article 105306"},"PeriodicalIF":0.0,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145195843","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

Percutaneous Patent Foramen Ovale Closure Device Endocarditis 经皮卵圆孔未闭器心内膜炎

JACC. Case reports Pub Date : 2025-10-01 DOI: 10.1016/j.jaccas.2025.105314

Stefan Milutinovic MD , Berniece Johnson MD , Claudiu Ciuciureanu MD , David C. Cervantes MD, PhD , Kamaldeep Singh MD

引用次数: 0

Nifekalant for Atrial Tachycardia–Induced Cardiogenic Shock in a Patient With Severe Left Ventricular Systolic Dysfunction 尼非卡兰治疗严重左心室收缩功能不全患者心房性心动过速心源性休克

JACC. Case reports Pub Date : 2025-10-01 DOI: 10.1016/j.jaccas.2025.105329

Hiroyuki Mizukami MD , Takafumi Oka MD, PhD , Ryohei Sakai MD, PhD , Takayuki Sekihara MD , Yasuhiro Akazawa MD, PhD , Daisuke Nakamura MD , Fusako Sera MD, PhD , Isamu Mizote MD, PhD , Tomohito Ohtani MD, PhD , Yasushi Sakata MD, PhD

{"title":"Nifekalant for Atrial Tachycardia–Induced Cardiogenic Shock in a Patient With Severe Left Ventricular Systolic Dysfunction","authors":"Hiroyuki Mizukami MD , Takafumi Oka MD, PhD , Ryohei Sakai MD, PhD , Takayuki Sekihara MD , Yasuhiro Akazawa MD, PhD , Daisuke Nakamura MD , Fusako Sera MD, PhD , Isamu Mizote MD, PhD , Tomohito Ohtani MD, PhD , Yasushi Sakata MD, PhD","doi":"10.1016/j.jaccas.2025.105329","DOIUrl":"10.1016/j.jaccas.2025.105329","url":null,"abstract":"<div><h3>Background</h3><div>Atrial tachycardia (AT) during acute heart failure with reduced left ventricular ejection fraction (LVEF) can worsen hemodynamics. Antiarrhythmic drugs are limited by negative inotropic effects.</div></div><div><h3>Case Summary</h3><div>A 55-year-old man with idiopathic dilated cardiomyopathy was admitted with worsening heart failure under sustained AT. His LVEF had declined to 12%. Multiple ATs caused resistance to inotropes and diuretics. Repeated electrical cardioversion with intravenous amiodarone failed owing to recurrent ATs triggered by premature atrial contractions, leading to cardiogenic shock. Intravenous nifekalant and digoxin were administered for rhythm and rate control. After electrical cardioversion, premature atrial contractions no longer induced AT. Continuous nifekalant maintained sinus rhythm, allowing recovery from shock without mechanical support. Catheter ablation, cardiac resynchronization therapy, and oral sotalol achieved long-term rhythm control. The patient was discharged on day 96.</div></div><div><h3>Discussion</h3><div>Nifekalant, a selective delayed rectifier potassium current blocker, prolongs refractoriness with minimal inotropic effect, stabilizing rhythm and bridging to definitive therapy.</div></div><div><h3>Take-Home Message</h3><div>Nifekalant may be effective for refractory AT in patients with severely reduced LVEF and hemodynamic instability.</div></div>","PeriodicalId":14792,"journal":{"name":"JACC. Case reports","volume":"30 30","pages":"Article 105329"},"PeriodicalIF":0.0,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145195853","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

Calcified Pulmonary Artery Conduit With Distal Embolism 钙化肺动脉导管远端栓塞：成人先天性心脏病后rastelli的挑战。

JACC. Case reports Pub Date : 2025-10-01 DOI: 10.1016/j.jaccas.2025.105241

Maethas Panyawongkhanti MD, MSc , Sopida Thammongkolchai MD, MSc , Niracha Atanavanich MD , Monravee Tumkosit MD , Sarawut Siwamogsatham MD, MSc

{"title":"Calcified Pulmonary Artery Conduit With Distal Embolism","authors":"Maethas Panyawongkhanti MD, MSc , Sopida Thammongkolchai MD, MSc , Niracha Atanavanich MD , Monravee Tumkosit MD , Sarawut Siwamogsatham MD, MSc","doi":"10.1016/j.jaccas.2025.105241","DOIUrl":"10.1016/j.jaccas.2025.105241","url":null,"abstract":"<div><h3>Background</h3><div>The Rastelli procedure is a standard surgical repair for congenital heart disease (CHD). Improved long-term survival has revealed rare complications previously unrecognized.</div></div><div><h3>Case Summary</h3><div>We report a unique case of a patient with a history of Rastelli repair who presented with left-sided heart failure. Diagnostic workup revealed a calcified pulmonary artery conduit and multiple sites of pulmonary embolism (PE) presumed to originate from fragments of the conduit. The PE was initially masked by nonspecific heart failure symptoms. Multimodality cardiovascular imaging was essential for diagnosis.</div></div><div><h3>Discussion</h3><div>This is the first reported case of calcified PE from a degenerated pulmonary artery conduit in a Rastelli patient. While right ventricular outflow tract complications are known, calcium-related embolic phenomena are underrecognized. This case highlights a rare but significant complication that may increase as CHD survival improves.</div></div><div><h3>Take-Home Messages</h3><div>Surveillance imaging in CHD patients is vital to detect late structural complications. Individualized treatment is essential for rare PE etiologies.</div></div>","PeriodicalId":14792,"journal":{"name":"JACC. Case reports","volume":"30 30","pages":"Article 105241"},"PeriodicalIF":0.0,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144954980","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

Right-Sided Septal Pouch Thrombus 右侧隔袋血栓

JACC. Case reports Pub Date : 2025-10-01 DOI: 10.1016/j.jaccas.2025.105285

Ivy Ziqian Liu DO , Mohammad Alsheikh-Kassim MD , Jennifer K. Lang MD

引用次数: 0

Patent Foramen Ovale Closure in Neuroendocrine Prostate Cancer–Induced Hepatopulmonary Syndrome 卵圆孔未闭在神经内分泌前列腺癌诱导的肝肺综合征中的作用

JACC. Case reports Pub Date : 2025-10-01 DOI: 10.1016/j.jaccas.2025.105217

Zoee U. D'Costa MD , Nida Qadir MD , Rushi V. Parikh MD , Jamil A. Aboulhosn MD , Angela Li MD , John Shen MD , Irene Riahi MD , Alison Xiaotang Du MD, MSc , Eric H. Yang MD

引用次数: 0

Coronary Embolism From a Sinus Venosus ASD With PAPVD 静脉窦ASD合并PAPVD的冠状动脉栓塞

JACC. Case reports Pub Date : 2025-10-01 DOI: 10.1016/j.jaccas.2025.105220

Jasper Lin MD , Bradley Hefford BSc , Jeremy Hefford BSc , Eric Jacombs BSc , Rowena Solayar MD , Simon Kang MD , Sylvio Carvalho Junior Provenzano MD , Maria Gabriela Matta MD

{"title":"Coronary Embolism From a Sinus Venosus ASD With PAPVD","authors":"Jasper Lin MD , Bradley Hefford BSc , Jeremy Hefford BSc , Eric Jacombs BSc , Rowena Solayar MD , Simon Kang MD , Sylvio Carvalho Junior Provenzano MD , Maria Gabriela Matta MD","doi":"10.1016/j.jaccas.2025.105220","DOIUrl":"10.1016/j.jaccas.2025.105220","url":null,"abstract":"<div><h3>Background</h3><div>Paradoxical embolism (PDE) is a rare, underrecognized cause of acute coronary syndrome, occurring when a thrombus crosses an intracardiac defect into systemic circulation. Sinus venosus atrial septal defects (ASDs), often associated with partial anomalous pulmonary venous drainage, may manifest in adulthood with complications such as PDE.</div></div><div><h3>Case Summary</h3><div>We describe a 52-year-old man presenting with non-ST elevation myocardial infarction. Coronary angiography showed a distal right coronary occlusion suggestive of embolic infarction. Transthoracic echocardiography with bubbles revealed a right-to-left shunt. Transesophageal echocardiography confirmed a sinus venosus ASD with partial anomalous pulmonary venous drainage. Surgical correction with intra-atrial baffle and ASD closure was successful.</div></div><div><h3>Discussion</h3><div>This case highlights the importance of considering PDE in myocardial infarction in the absence of risk factors. Multimodality imaging was key to diagnosis and guiding treatment.</div></div><div><h3>Take-Home Messages</h3><div>PDE is an underrecognized cause of acute coronary syndrome mechanism. Structural heart defects must be ruled out in coronary embolism or cryptogenic myocardial infarction.</div></div>","PeriodicalId":14792,"journal":{"name":"JACC. Case reports","volume":"30 30","pages":"Article 105220"},"PeriodicalIF":0.0,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145195902","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