JACC. Case reports最新文献_第6页

Dasatinib-Induced Pulmonary Arterial Hypertension 达沙替尼诱发肺动脉高压。

JACC. Case reports Pub Date : 2026-10-21 Epub Date: 2026-08-20 DOI: 10.1016/j.jaccas.2026.109931

Nimisha Musthafa Hafeesa MD, Gulbadin Mufti MD, DM, PDF, Harikrishnan Sivadasanpillai MD, DM, DNB

引用次数: 0

Endoarch Repair of Ruptured Extra-Anatomic Ascending to Descending Bypass Graft in Hypoplastic Arch With Coarctation 弓发育不全伴缩窄的解剖外升降搭桥破裂的弓内修复。

JACC. Case reports Pub Date : 2026-10-21 Epub Date: 2026-08-28 DOI: 10.1016/j.jaccas.2026.110034

Nikita Zadneulitca MD, Bryant Mclafferty MD, Brent Demanby PA-C, Nicholas C. Eglitis MD, Rhusheet P. Patel MD, MS, Castigliano M. Bhamidipati DO, PhD, MSc

{"title":"Endoarch Repair of Ruptured Extra-Anatomic Ascending to Descending Bypass Graft in Hypoplastic Arch With Coarctation","authors":"Nikita Zadneulitca MD, Bryant Mclafferty MD, Brent Demanby PA-C, Nicholas C. Eglitis MD, Rhusheet P. Patel MD, MS, Castigliano M. Bhamidipati DO, PhD, MSc","doi":"10.1016/j.jaccas.2026.110034","DOIUrl":"10.1016/j.jaccas.2026.110034","url":null,"abstract":"<div><h3>Background</h3><div>Hypoplastic arch and residual coarctation are treated with ascending to descending extra-anatomic bypasses and are challenging to manage.</div></div><div><h3>Case Summary</h3><div>A 36-year-old woman with several sternotomies had undergone ascending to descending extra-anatomic bypass as a neonate. She experienced blunt force trauma to her chest, and significant delay in diagnosis led to decompensation. A nondisplaced fracture lacerated the aortic graft and led to a contained rupture and bacteremia. She underwent left thoracotomy and complex thoracic endovascular aortic repair. Six weeks of antibiotics and careful conservative management led to a safe outcome.</div></div><div><h3>Discussion</h3><div>Management of a ruptured extra-anatomic bypass in the setting of bacteremia with thoracic endovascular aortic repair is controversial. Given multiple prior sternotomies, the degree of required tissue debridement, and anticipated lifelong antibiotic suppression, an initial endovascular approach seemed warranted. Unconventional approaches to complex adult congenital heart disease (ACHD) lesions are necessary to increase longevity and mitigate disease.</div></div><div><h3>Take-Home Messages</h3><div>Patients with ACHD require early recognition with a high index of suspicion. Endovascular repair in ACHD arch pathology should be considered.</div></div>","PeriodicalId":14792,"journal":{"name":"JACC. Case reports","volume":"31 42","pages":"Article 110034"},"PeriodicalIF":0.0,"publicationDate":"2026-10-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148840425","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

Hydroxychloroquine-Induced Cardiotoxicity in the Setting of a False Positive PYP Scan PYP扫描假阳性时羟基氯喹引起的心脏毒性。

JACC. Case reports Pub Date : 2026-10-21 Epub Date: 2026-08-29 DOI: 10.1016/j.jaccas.2026.109894

Leonardo Wagner Florencio dos Santos MD, Andrew Sephien MD, Silvio Litovsky MD, Jose A. Tallaj MD

{"title":"Hydroxychloroquine-Induced Cardiotoxicity in the Setting of a False Positive PYP Scan","authors":"Leonardo Wagner Florencio dos Santos MD, Andrew Sephien MD, Silvio Litovsky MD, Jose A. Tallaj MD","doi":"10.1016/j.jaccas.2026.109894","DOIUrl":"10.1016/j.jaccas.2026.109894","url":null,"abstract":"<div><h3>Background</h3><div>Hydroxychloroquine (HCQ)-induced cardiomyopathy may mimic transthyretin cardiac amyloidosis on technetium-99m pyrophosphate (PYP) scans, producing false positive results. This diagnostic challenge requires clinicians to maintain an accurate pretest probability before workup.</div></div><div><h3>Case Summary</h3><div>A 68-year-old woman with heart failure with reduced ejection fraction, complete heart block with cardiac resynchronization therapy with a defibrillator, and rheumatoid arthritis on HCQ 400 mg twice daily for 28 years presented with pre-syncope and recurrent ventricular tachycardia. Echocardiography was suggested of infiltrative disease. PYP scan was positive (grade 3, heart-to-contralateral lung ratio 1.64). Endomyocardial biopsy revealed diffuse vacuolization, negative Congo red, and myelin figures on electron microscopy, confirming HCQ cardiomyopathy.</div></div><div><h3>Discussion</h3><div>Differentiating HCQ cardiomyopathy from cardiac amyloidosis can be difficult because of overlapping clinical syndromes. This case highlights the importance of recognizing the potential for false positive PYP scans in HCQ cardiomyopathy.</div></div><div><h3>Take-Home Message</h3><div>Clinicians should recognize the potential for false positive PYP scans in patients with suspected HCQ cardiomyopathy and consider endomyocardial biopsy in cases of diagnostic uncertainty.</div></div>","PeriodicalId":14792,"journal":{"name":"JACC. Case reports","volume":"31 42","pages":"Article 109894"},"PeriodicalIF":0.0,"publicationDate":"2026-10-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148850752","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

Primary Cardiac Paraganglioma Management and Resection With Rare Recurrent Metastasis 原发性心脏副神经节瘤的治疗与切除及罕见的复发转移。

JACC. Case reports Pub Date : 2026-10-21 Epub Date: 2026-08-20 DOI: 10.1016/j.jaccas.2026.109928

Ashley B. Chuong BS, Marcell Szekely MD, Maria G. Lopez-Trevino MD, Dale Hamilton MD, Michael J. Reardon MD, Marvin D. Atkins Jr MD

{"title":"Primary Cardiac Paraganglioma Management and Resection With Rare Recurrent Metastasis","authors":"Ashley B. Chuong BS, Marcell Szekely MD, Maria G. Lopez-Trevino MD, Dale Hamilton MD, Michael J. Reardon MD, Marvin D. Atkins Jr MD","doi":"10.1016/j.jaccas.2026.109928","DOIUrl":"10.1016/j.jaccas.2026.109928","url":null,"abstract":"<div><h3>Background</h3><div>Primary cardiac paragangliomas are rare tumors that present with nonspecific sympathomimetic symptoms. Early recognition and multidisciplinary planning are essential.</div></div><div><h3>Case Summary</h3><div>A 55-year-old man presented with atrial fibrillation and pericarditis after weeks of dizziness, presyncope, and dyspnea. The patient underwent biopsy via thoracotomy, which was negative for malignancy. Workup revealed a 10 × 12 × 5 cm functional paraganglioma with left atrial involvement. He underwent cardiac autotransplantation with complete tumor resection and left atrial reconstruction. Postoperative recovery was complicated by extracorporeal membrane oxygenation requirement and stroke. One year later, surveillance identified a T9 vertebral metastasis, confirmed on biopsy, and later treated with Belzutifan, radiation, and kyphoplasty.</div></div><div><h3>Discussion</h3><div>Cardiac paragangliomas often require complex surgical approaches. This case highlights diagnostic difficulty, metastatic potential, and evolving systemic therapies of interest to cardiovascular and oncology specialists.</div></div><div><h3>Take-Home Messages</h3><div>Cardiac paragangliomas demand multidisciplinary management and long-term surveillance. Newer targeted therapies expand options for metastatic disease.</div></div>","PeriodicalId":14792,"journal":{"name":"JACC. Case reports","volume":"31 42","pages":"Article 109928"},"PeriodicalIF":0.0,"publicationDate":"2026-10-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148793520","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

Cardiopulmonary Exercise Testing Identifies Treatable ATTR Cardiac Amyloidosis 心肺运动试验识别可治疗的ATTR心脏淀粉样变性：超越利钠肽。

JACC. Case reports Pub Date : 2026-10-21 Epub Date: 2026-08-26 DOI: 10.1016/j.jaccas.2026.110006

Sara Rioja-Abad MD, Ramon Andion-Ogando MD, Maria Perez-Diaz MD, Cristina Barinaga-Martin MD, Jordi Candela-Ferre MD, Maria Jesus Rollan-Gomez MD, PhD, Ignacio Hernandez-Gonzalez MD, PhD, Maria del Mar de la Torre-Carpente MD, PhD, Hector Garcia-Pardo MD, Juan Carlos Muñoz-San Jose MD, PhD

{"title":"Cardiopulmonary Exercise Testing Identifies Treatable ATTR Cardiac Amyloidosis","authors":"Sara Rioja-Abad MD, Ramon Andion-Ogando MD, Maria Perez-Diaz MD, Cristina Barinaga-Martin MD, Jordi Candela-Ferre MD, Maria Jesus Rollan-Gomez MD, PhD, Ignacio Hernandez-Gonzalez MD, PhD, Maria del Mar de la Torre-Carpente MD, PhD, Hector Garcia-Pardo MD, Juan Carlos Muñoz-San Jose MD, PhD","doi":"10.1016/j.jaccas.2026.110006","DOIUrl":"10.1016/j.jaccas.2026.110006","url":null,"abstract":"<div><h3>Background</h3><div>Transthyretin cardiac amyloidosis (ATTR-CM) is a progressive infiltrative cardiomyopathy where early disease-modifying therapy improves outcomes. However, treatment access may be restricted by biomarker thresholds not reflecting true functional impairment.</div></div><div><h3>Case Summary</h3><div>A 73-year-old man with exertional dyspnea (NYHA functional class II) and confirmed wild-type ATTR-CM did not meet reimbursement criteria for tafamidis because N-terminal pro–B-type natriuretic peptide was below the required threshold (≥600 pg/mL), despite impaired functional capacity on cardiopulmonary exercise testing (CPET). Acoramidis was obtained through expanded access. At 6-month follow-up, the patient showed clinical stability and improved exercise capacity.</div></div><div><h3>Discussion</h3><div>Fixed N-terminal pro–B-type natriuretic peptide cutoffs may exclude patients with early-stage heart failure who would benefit from treatment. CPET helps identify therapy candidates below biomarker thresholds.</div></div><div><h3>Take-Home Messages</h3><div>CPET detects functional impairment in ATTR-CM even when natriuretic peptides remain low. Early transthyretin-stabilizer initiation in NYHA functional class I-II yields better outcomes; treatment eligibility should integrate functional assessment beyond biomarkers alone.</div></div>","PeriodicalId":14792,"journal":{"name":"JACC. Case reports","volume":"31 42","pages":"Article 110006"},"PeriodicalIF":0.0,"publicationDate":"2026-10-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148818515","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

Saphenous Vein Graft-to-Pulmonary Artery Fistula Presenting With Coronary Ischemia and Right Ventricular Dysfunction 隐静脉移植物肺动脉瘘表现为冠状动脉缺血和右心室功能障碍。

JACC. Case reports Pub Date : 2026-10-21 Epub Date: 2026-08-25 DOI: 10.1016/j.jaccas.2026.110009

Tugba Aktemur Özalp MD

{"title":"Saphenous Vein Graft-to-Pulmonary Artery Fistula Presenting With Coronary Ischemia and Right Ventricular Dysfunction","authors":"Tugba Aktemur Özalp MD","doi":"10.1016/j.jaccas.2026.110009","DOIUrl":"10.1016/j.jaccas.2026.110009","url":null,"abstract":"<div><h3>Background</h3><div>Acquired coronary and coronary-cameral fistulas are rare after coronary artery bypass grafting (CABG), and saphenous vein graft fistulas are exceptionally uncommon, especially without graft aneurysm.</div></div><div><h3>Case Summary</h3><div>A 61-year-old man with previous CABG presented with typical chest pain, elevated high-sensitivity troponin, and a continuous murmur. Echocardiography showed impaired right ventricular function. Coronary angiography revealed patent grafts, distal graft stenosis, and a sequential saphenous vein graft-to-left pulmonary artery fistula, confirmed by coronary computed tomography without graft aneurysm. The patient declined invasive treatment and remained asymptomatic on maximal medical therapy at 6 months.</div></div><div><h3>Discussion</h3><div>Most post-CABG fistulas to the pulmonary vasculature arise from the left internal mammary artery and may cause coronary steal syndrome. Saphenous vein graft fistulas are much rarer and are usually associated with graft aneurysm. This case is unique because the fistula occurred without aneurysmal degeneration.</div></div><div><h3>Take-Home Message</h3><div>A saphenous vein graft–to–pulmonary artery fistula is a rare post-CABG complication presenting with angina, continuous murmur, or right ventricular dysfunction, requiring multimodal diagnosis and individualized treatment.</div></div>","PeriodicalId":14792,"journal":{"name":"JACC. Case reports","volume":"31 42","pages":"Article 110009"},"PeriodicalIF":0.0,"publicationDate":"2026-10-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148813117","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

Selective Cardioneuroablation for Swallow-Induced Atrioventricular Block 选择性心血管消融术治疗吞咽引起的房室传导阻滞：消融术治疗慢速心律失常的机理。

JACC. Case reports Pub Date : 2026-10-21 Epub Date: 2026-08-25 DOI: 10.1016/j.jaccas.2026.109917

Katsuhide Hayashi MD, PhD, Ritsuko Kohno MD, PhD, Masashi Mitani MD, Takahiro Kobayashi MD, Nozomu Ishii MD, Yasunobu Yamagishi MD, PhD, Yasushi Oginosawa MD, PhD, Haruhiko Abe MD, PhD, Masaharu Kataoka MD, PhD

{"title":"Selective Cardioneuroablation for Swallow-Induced Atrioventricular Block","authors":"Katsuhide Hayashi MD, PhD, Ritsuko Kohno MD, PhD, Masashi Mitani MD, Takahiro Kobayashi MD, Nozomu Ishii MD, Yasunobu Yamagishi MD, PhD, Yasushi Oginosawa MD, PhD, Haruhiko Abe MD, PhD, Masaharu Kataoka MD, PhD","doi":"10.1016/j.jaccas.2026.109917","DOIUrl":"10.1016/j.jaccas.2026.109917","url":null,"abstract":"<div><h3>Background</h3><div>Swallow-induced atrioventricular (AV) block is a rare mechanism of paroxysmal AV block, and no established curative treatment currently exists.</div></div><div><h3>Case Summary</h3><div>A 75-year-old woman without known structural heart disease presented with symptomatic paroxysmal AV block during meals. Swallowing provocation test reproducibly induced AV block at the A-H level, which was suppressed following atropine administration, suggesting a vagally mediated reflex mechanism. Despite dietary counseling, her symptoms persisted; therefore, cardioneuroablation (CNA) was performed. Among the ganglionated plexi, sites demonstrating vagal responses during high-frequency stimulation, as well as anatomically defined ganglionated plexi regions, were selectively ablated. Following the procedure, no further swallow-induced paroxysmal AV block was observed.</div></div><div><h3>Discussion</h3><div>In this case, combined selective and anatomical CNA approach was used, targeting sites considered to provide parasympathetic input to the AV node.</div></div><div><h3>Take-Home Message</h3><div>Mechanism-based selective CNA may represent a promising therapeutic option for patients with swallow-induced AV block refractory to conservative management.</div></div>","PeriodicalId":14792,"journal":{"name":"JACC. Case reports","volume":"31 42","pages":"Article 109917"},"PeriodicalIF":0.0,"publicationDate":"2026-10-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148813158","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

Postoperative Pericardial Cyst Enlargement After Recurrent Breast Cancer 乳腺癌复发术后心包囊肿扩大：良、恶性病因的鉴别。

JACC. Case reports Pub Date : 2026-10-21 Epub Date: 2026-08-29 DOI: 10.1016/j.jaccas.2026.109932

Adrian A. Naoun MD, Arvind K. Pandey MD

{"title":"Postoperative Pericardial Cyst Enlargement After Recurrent Breast Cancer","authors":"Adrian A. Naoun MD, Arvind K. Pandey MD","doi":"10.1016/j.jaccas.2026.109932","DOIUrl":"10.1016/j.jaccas.2026.109932","url":null,"abstract":"<div><h3>Background</h3><div>Pericardial cysts (PCs) are benign congenital anomalies typically managed conservatively. Interval enlargement in patients with active malignancy may mimic metastatic pericardial involvement.</div></div><div><h3>Case Summary</h3><div>A 52-year-old woman with previously treated right-sided ductal carcinoma in situ presented with new ipsilateral breast lobular carcinoma. A right-sided pericardial lesion was incidentally identified during workup, and cardiac-gated computed tomography characterized this as a PC. Seven months after bilateral mastectomies and adjuvant chemoradiation, the patient underwent bilateral breast reconstruction. A postoperative computed tomography showed interval enlargement of the pericardial lesion, raising concern for possible residual malignant disease. Clinically, the patient remained asymptomatic, and multimodal imaging over the next month showed interval size regression, supporting a diagnosis of benign PC with inflammation-related size change.</div></div><div><h3>Discussion</h3><div>PC enlargement during recurrent malignancy may mimic metastatic pericardial disease; however, prevalent benign etiologies should be ruled out. Multimodal imaging and clinical evaluation are key in determining benign vs malignant pathology.</div></div>","PeriodicalId":14792,"journal":{"name":"JACC. Case reports","volume":"31 42","pages":"Article 109932"},"PeriodicalIF":0.0,"publicationDate":"2026-10-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148850679","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

Not All That Grows Is Malignant 并非所有生长的都是恶性的：良性心包囊肿的线索。

JACC. Case reports Pub Date : 2026-10-21 Epub Date: 2026-09-25 DOI: 10.1016/j.jaccas.2026.110278

Ellis Y. Kim MD, PhD, Mohammed Ruzieh MD, MSE

引用次数: 0

Transcatheter Salvage of the Ascending Aorta 经导管打捞升主动脉

JACC. Case reports Pub Date : 2026-10-21 DOI: 10.1016/j.jaccas.2026.110666

Edoardo Zancanaro MD, Thomas Modine MD, PhD, MBA, Tommaso Hinna Danesi MD

引用次数: 0