JACC. Case reports最新文献_第8页

Unusual-Appearing Calcified Left Atrial Myxoma 异常的左心房钙化黏液瘤

JACC. Case reports Pub Date : 2025-10-01 DOI: 10.1016/j.jaccas.2025.105282

Paige Holden MD , Akshat Banga MD , Paul VanderLaan MD, PhD , Kyle Pond MD , Louis Chu MD

{"title":"Unusual-Appearing Calcified Left Atrial Myxoma","authors":"Paige Holden MD , Akshat Banga MD , Paul VanderLaan MD, PhD , Kyle Pond MD , Louis Chu MD","doi":"10.1016/j.jaccas.2025.105282","DOIUrl":"10.1016/j.jaccas.2025.105282","url":null,"abstract":"<div><h3>Background</h3><div>Cardiac myxoma is a rare tumor with variability in clinical presentation, imaging, and histopathologic findings.</div></div><div><h3>Case summary</h3><div>An 82-year-old woman presented with fatigue, dizziness, and declining exercise tolerance. Work-up included echocardiogram notable for an atrial mass. Further imaging diagnosed left atrial myxoma for which she underwent open surgical resection.</div></div><div><h3>Discussion</h3><div>Cardiac myxomas with gross calcifications are uncommon and are usually seen in right rather than left atrial tumors. The pathogenesis of their formation is largely unknown. We present a rare case of a left atrial myxoma with large, dystrophic calcifications that affected both preoperative and intraoperative evaluation of the tumor.</div></div><div><h3>Take-Home Messages</h3><div>Cardiac myxoma tumor characteristics are quite variable, with gross calcifications generally uncommon and more frequently seen in the right rather than the left atrium. Supplemental imaging such as cardiac magnetic resonance may be necessary in preoperative evaluation of heavily calcified cardiac tumors owing to limitations in echocardiographic images regarding sufficient diagnostic detail.</div></div>","PeriodicalId":14792,"journal":{"name":"JACC. Case reports","volume":"30 30","pages":"Article 105282"},"PeriodicalIF":0.0,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145195903","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 Challenging Redo Mitral Clip Procedure in a Complex Clinical Scenario 在复杂的临床情况下，一个具有挑战性的重做二尖瓣夹手术

JACC. Case reports Pub Date : 2025-10-01 DOI: 10.1016/j.jaccas.2025.105240

Abed Qadan MD , Shemy Carasso MD , Mony Shuvy MD

{"title":"A Challenging Redo Mitral Clip Procedure in a Complex Clinical Scenario","authors":"Abed Qadan MD , Shemy Carasso MD , Mony Shuvy MD","doi":"10.1016/j.jaccas.2025.105240","DOIUrl":"10.1016/j.jaccas.2025.105240","url":null,"abstract":"<div><h3>Background</h3><div>Transcatheter edge-to-edge repair (TEER) is pivotal for high-risk, severe mitral regurgitation. Redo TEER remains challenging, particularly with prior structural interventions such as atrial septal defect (ASD) closure complicating access and maneuverability.</div></div><div><h3>Case Summary</h3><div>A 60-year-old man with severe functional mitral regurgitation and nonischemic dilated cardiomyopathy underwent redo TEER following clinical deterioration after a previous procedure. A previously implanted ASD occluder posed a significant anatomical challenge, however trans-septal puncture was successfully achieved adjacent to the ASD occluder without traversing or damaging it. The novel access approach allowed completion of the procedure without complications.</div></div><div><h3>Discussion</h3><div>This case highlights the feasibility of redo TEER in patients with prior ASD occluder and underscores the critical importance of careful preprocedural planning, precise trans-septal puncture, and meticulous device handling to optimize procedural success.</div></div><div><h3>Take-Home Message</h3><div>Redo TEER with prior ASD occluder is feasible with advanced imaging, planning, and multidisciplinary collaboration.</div></div>","PeriodicalId":14792,"journal":{"name":"JACC. Case reports","volume":"30 30","pages":"Article 105240"},"PeriodicalIF":0.0,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145195798","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

Transcatheter Mitral Valve Replacement With LAMPOON 经导管二尖瓣置换术

JACC. Case reports Pub Date : 2025-10-01 DOI: 10.1016/j.jaccas.2025.105284

Julien Feghaly MD, MPH , Naji Maaliki MD , Yixin Zhang MD , Mohamed Abdul Qader MD , Daniel Soffer MD , Ali Zgheib MD , Thomas Zeyl MD , Erol Belli MD , Valentin Suma MD , Calvin Choi MD, MHA

{"title":"Transcatheter Mitral Valve Replacement With LAMPOON","authors":"Julien Feghaly MD, MPH , Naji Maaliki MD , Yixin Zhang MD , Mohamed Abdul Qader MD , Daniel Soffer MD , Ali Zgheib MD , Thomas Zeyl MD , Erol Belli MD , Valentin Suma MD , Calvin Choi MD, MHA","doi":"10.1016/j.jaccas.2025.105284","DOIUrl":"10.1016/j.jaccas.2025.105284","url":null,"abstract":"<div><h3>Background</h3><div>Left ventricular outflow tract (LVOT) obstruction is a potentially fatal complication of transcatheter mitral valve replacement (TMVR), particularly in patients with anatomically high-risk features. LAMPOON (laceration of the anterior mitral leaflet to prevent outflow obstruction) is a transcatheter electrosurgical technique developed to mitigate this risk by modifying anterior mitral leaflet anatomy prior to valve deployment.</div></div><div><h3>Objective</h3><div>We describe our institutional experience with LAMPOON as a preventive strategy in TMVR cases with a high predicted risk for neo-LVOT obstruction.</div></div><div><h3>Methods</h3><div>This case series includes patients with high-risk anatomical features who underwent TMVR with LAMPOON. Variations of the LAMPOON technique, including antegrade and tip-to-base approaches using the “flying-V” electrosurgical wire configuration, were employed based on individual anatomy.</div></div><div><h3>Conclusions</h3><div>All patients underwent successful anterior mitral leaflet laceration, with no significant LVOT obstruction. Antegrade and tip-to-base LAMPOON techniques are safe and effective adjuncts to TMVR in patients at high risk of LVOT obstruction.</div></div>","PeriodicalId":14792,"journal":{"name":"JACC. Case reports","volume":"30 30","pages":"Article 105284"},"PeriodicalIF":0.0,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145195809","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

Chronic Large Pericardial Effusion Due to Rare Yellow Nail Syndrome 罕见黄指甲综合征所致慢性大量心包积液

JACC. Case reports Pub Date : 2025-10-01 DOI: 10.1016/j.jaccas.2025.105316

Tyler J. Canova MD , Milin Patel BHSc , Sushil Allen Luis MBBS, PhD , Jae K. Oh MD , James P. Utz MD , Tahir S. Kafil MD

{"title":"Chronic Large Pericardial Effusion Due to Rare Yellow Nail Syndrome","authors":"Tyler J. Canova MD , Milin Patel BHSc , Sushil Allen Luis MBBS, PhD , Jae K. Oh MD , James P. Utz MD , Tahir S. Kafil MD","doi":"10.1016/j.jaccas.2025.105316","DOIUrl":"10.1016/j.jaccas.2025.105316","url":null,"abstract":"<div><h3>Background</h3><div>Yellow nail syndrome (YNS) is a rare disorder characterized by the triad of yellow nails, lymphedema, and respiratory manifestations. Rarely, pericardial effusion can occur and guidance on management is limited.</div></div><div><h3>Case Summary</h3><div>A 71-year-old man presented with chronic large pericardial and pleural effusions, lower extremity lymphedema, and yellow nail discoloration. He was diagnosed with YNS, and several years later hypothyroidism was identified. Treatment with thyroid hormone led to improvement in his pericardial effusion and stabilization of pleural effusions.</div></div><div><h3>Discussion</h3><div>Pericardial involvement in YNS is rare, but can manifest as large effusions. In such cases, it is important to exclude concomitant reversible conditions such as hypothyroidism or autoimmune disease. This case suggests a common pathway between hypothyroidism and YNS pathophysiology with improvement after treatment, but not complete resolution. Chronic, large pericardial effusions in hemodynamically stable patients can safely be monitored with surveillance.</div></div>","PeriodicalId":14792,"journal":{"name":"JACC. Case reports","volume":"30 30","pages":"Article 105316"},"PeriodicalIF":0.0,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145195850","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

Brugada Phenocopy in a Child With Parvovirus B19 Myocarditis 小儿细小病毒B19心肌炎的Brugada表型分析

JACC. Case reports Pub Date : 2025-10-01 DOI: 10.1016/j.jaccas.2025.105283

Andrea Bueno-Gomez MD , Francisco José Castro MD , Ferran Gran MD, PhD , Marta Garrido-Pontnou MD , Paola Dolader MD , Ferran Rosés-Noguer MD, PhD

{"title":"Brugada Phenocopy in a Child With Parvovirus B19 Myocarditis","authors":"Andrea Bueno-Gomez MD , Francisco José Castro MD , Ferran Gran MD, PhD , Marta Garrido-Pontnou MD , Paola Dolader MD , Ferran Rosés-Noguer MD, PhD","doi":"10.1016/j.jaccas.2025.105283","DOIUrl":"10.1016/j.jaccas.2025.105283","url":null,"abstract":"<div><h3>Background</h3><div>Sodium channelopathies predispose to life-threatening arrhythmias. Brugada phenocopies (BrPs) are nongenetic conditions that mimic Brugada syndrome and may have a reversible cause.</div></div><div><h3>Case Presentation</h3><div>A 16-month-old child presented with a 12-day ventricular tachycardia storm and a spontaneous type 1 Brugada electrocardiogram pattern during sinus rhythm. The patient initially presented with no fever and normal ventricular function on admission that deteriorated severely within 6 days. Blood viral polymerase chain reaction was positive for parvovirus B19, and endomyocardial biopsy confirmed myocarditis. Targeted treatment led to full recovery.</div></div><div><h3>Discussion</h3><div>This is the first reported case to our knowledge of BrP caused by viral myocarditis. It highlights the diagnostic challenges and the importance of correct diagnosis and treatment.</div></div><div><h3>Take-Home Messages</h3><div>In pediatric refractory ventricular tachycardia, even with a Brugada pattern (possible BrP), myocarditis should be considered, as early diagnosis and treatment can be lifesaving. Blood viral polymerase chain reaction is a highly sensitive diagnostic tool for diagnosis of viral myocarditis in children.</div></div>","PeriodicalId":14792,"journal":{"name":"JACC. Case reports","volume":"30 30","pages":"Article 105283"},"PeriodicalIF":0.0,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145195852","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

Stent Infection Leading to Coronary Aneurysm and Coronary Cameral Fistula 支架感染导致冠状动脉瘤和冠状动脉瘤腔内瘘。

JACC. Case reports Pub Date : 2025-10-01 DOI: 10.1016/j.jaccas.2025.104125

Sathish Kumar Rentapalla MD , Barun Kumar MD, DM , Anirudh Mukherjee MD, DM , Pradeep Kumar MS, MCH

{"title":"Stent Infection Leading to Coronary Aneurysm and Coronary Cameral Fistula","authors":"Sathish Kumar Rentapalla MD , Barun Kumar MD, DM , Anirudh Mukherjee MD, DM , Pradeep Kumar MS, MCH","doi":"10.1016/j.jaccas.2025.104125","DOIUrl":"10.1016/j.jaccas.2025.104125","url":null,"abstract":"<div><h3>Background</h3><div>Coronary stent infection (SI) is a rare but catastrophic complication, occurring in 0.3% to 6% of cases post–percutaneous coronary intervention (PCI). Early diagnosis and surgical interventions are crucial for definitive diagnosis and management.</div></div><div><h3>Case Summary</h3><div>A 52-year-old man underwent PCI for an inferior wall myocardial infarction to the left circumflex artery (LCx) with a single sirolimus-eluting stent. He developed a fever 10 days later due to methicillin-sensitive <em>Staphylococcus aureus</em>. Imaging showed a coronary cameral fistula with a left atrial appendage (LAA) mycotic aneurysm. He was treated with antibiotics, stent explantation, abscess drainage, and fistula repair; however, he developed refractory vasoplegia and died 2 days post-surgery.</div></div><div><h3>Discussion</h3><div>Coronary SI requires a high index of suspicion. The use of multimodality imaging and multidisciplinary approaches to diagnose and manage infection is essential. Late and complicated stent infections have a high mortality rate.</div></div><div><h3>Take-Home Messages</h3><div>Coronary SI is an important differential diagnosis for fever post-PCI. Prompt diagnosis, multimodality imaging, and early intervention are needed.</div></div>","PeriodicalId":14792,"journal":{"name":"JACC. Case reports","volume":"30 30","pages":"Article 104125"},"PeriodicalIF":0.0,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144667690","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

Transcatheter Aortic Valve Implantation for Severe Bicuspid Aortic Stenosis With Concomitant Giant Cell Arteritis Aortitis 经导管主动脉瓣植入术治疗严重二尖瓣主动脉狭窄合并巨细胞动脉炎

JACC. Case reports Pub Date : 2025-10-01 DOI: 10.1016/j.jaccas.2025.105312

Issam Altnji MBBS, MD, James P. Curtain MB, BS, PhD, Stephen O'Connor MB, BCh, MD

{"title":"Transcatheter Aortic Valve Implantation for Severe Bicuspid Aortic Stenosis With Concomitant Giant Cell Arteritis Aortitis","authors":"Issam Altnji MBBS, MD, James P. Curtain MB, BS, PhD, Stephen O'Connor MB, BCh, MD","doi":"10.1016/j.jaccas.2025.105312","DOIUrl":"10.1016/j.jaccas.2025.105312","url":null,"abstract":"<div><h3>Background</h3><div>The use of transcatheter aortic valve implantation (TAVI) in patients with bicuspid aortic stenosis (AS) and aortitis has not been previously reported. Bicuspid AS creates significant challenges for TAVI due to complex anatomy. Furthermore, aortitis would make the case more challenging.</div></div><div><h3>Case Summary</h3><div>We report a case of a 71-year-old woman with a history of giant cell arteritis aortitis and severe bicuspid AS with low-flow, low-gradient who successfully underwent TAVI. The patient presented with acute heart failure with reduced ejection fraction. Following a thorough evaluation, a multidisciplinary team chose TAVI owing to the patient's high surgical risk and multiple comorbidities. Aortitis was managed with high-dose oral steroids for 2 weeks and subcutaneous tocilizumab. TAVI was performed successfully with a favorable short-term outcome.</div></div><div><h3>Conclusions</h3><div>This case demonstrates the feasibility of TAVI in severe bicuspid AS in patients with aortitis and emphasizes the need for careful patient selection.</div></div>","PeriodicalId":14792,"journal":{"name":"JACC. Case reports","volume":"30 30","pages":"Article 105312"},"PeriodicalIF":0.0,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145195800","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

Diagnostic Ambiguity in Apical Hypertrophic Cardiomyopathy 心尖肥厚性心肌病的诊断歧义

JACC. Case reports Pub Date : 2025-10-01 DOI: 10.1016/j.jaccas.2025.105310

May Li-Jedras DO , Yasser Hegazy MD , Ali Bin Abdul Jabbar MD , Ahmed El-Shaer MD , Muhammed Ghallab MD , Amjad Kabach MD

{"title":"Diagnostic Ambiguity in Apical Hypertrophic Cardiomyopathy","authors":"May Li-Jedras DO , Yasser Hegazy MD , Ali Bin Abdul Jabbar MD , Ahmed El-Shaer MD , Muhammed Ghallab MD , Amjad Kabach MD","doi":"10.1016/j.jaccas.2025.105310","DOIUrl":"10.1016/j.jaccas.2025.105310","url":null,"abstract":"<div><h3>Background</h3><div>Apical hypertrophic cardiomyopathy (HCM) is a unique subtype of HCM characterized by predominant hypertrophy of the left ventricular apex. Due to its unique morphology, apical HCM often manifests with nonspecific symptoms, leading to a challenging diagnosis. Apical measurements on transthoracic echocardiography may be altered depending on the quality and technique with which the images were obtained; thus advanced imaging, such as cardiac magnetic resonance (CMR), may be needed to establish the diagnosis.</div></div><div><h3>Case Summary</h3><div>We present 2 cases in which patients presented with nonspecific symptoms and initial transthoracic echocardiography was inconclusive for apical HCM, requiring CMR to better visualize structural changes and establish the diagnosis.</div></div><div><h3>Discussion</h3><div>Apical HCM remains an elusive subtype of HCM given its variable presentation and subtle structural changes. Our cases highlight the significant advantage of CMR to better characterize structural changes that may be overlooked on standard echocardiography to help diagnose apical HCM.</div></div>","PeriodicalId":14792,"journal":{"name":"JACC. Case reports","volume":"30 30","pages":"Article 105310"},"PeriodicalIF":0.0,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145195814","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

Empowering the Community to Understand Cardiovascular Disease Through a High School Lunch and Learn Series 通过高中午餐和学习系列增强社区对心血管疾病的了解

JACC. Case reports Pub Date : 2025-10-01 DOI: 10.1016/j.jaccas.2025.105294

Philip Schultheis , Daria Ilatovskaya PhD , Brittany B. Pinkerton PhD

{"title":"Empowering the Community to Understand Cardiovascular Disease Through a High School Lunch and Learn Series","authors":"Philip Schultheis , Daria Ilatovskaya PhD , Brittany B. Pinkerton PhD","doi":"10.1016/j.jaccas.2025.105294","DOIUrl":"10.1016/j.jaccas.2025.105294","url":null,"abstract":"<div><div>Cardiovascular disease (CVD) has been and remains the leading cause of death in the United States. Hypertension (HTN), or high blood pressure, is one of the most prevalent causes of CVD and its major modifiable risk factor. Where people live, such as rural versus urban areas, may also impact their HTN risk. Additionally, being obese and of low-income status increases risks associated with CVD and HTN. Augusta University researches and engages in a community outreach initiative focused on the “B” in the ABCDE's of heart health, blood pressure control. Specifically, the university focuses on increasing CVD and HTN literacy among people who are considered rural, obese, and at risk (ROAR). The ROAR campaign devotes resources to community outreach efforts. ROAR uses an interdisciplinary approach to foster wraparound community interaction points. One innovative part of this outreach was a pilot lunch and learn series at a local high school. The series were offered specifically in a Health Occupations Students of America–centered classroom. The pilot series demonstrates the promise and feasibility of embedding CVD and HTN awareness directly into local educational settings.</div></div>","PeriodicalId":14792,"journal":{"name":"JACC. Case reports","volume":"30 30","pages":"Article 105294"},"PeriodicalIF":0.0,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145195898","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

Multivessel Spontaneous Coronary Artery Dissection Linked to Antiphospholipid Syndrome. 多支自发性冠状动脉夹层与抗磷脂综合征相关。

JACC. Case reports Pub Date : 2025-10-01 DOI: 10.1016/j.jaccas.2025.105532

Brittni McClellan, Dhruva Govil, Keyur Patel, Nick Serafimovski, Ali Huda, Marcel Zughaib

{"title":"Multivessel Spontaneous Coronary Artery Dissection Linked to Antiphospholipid Syndrome.","authors":"Brittni McClellan, Dhruva Govil, Keyur Patel, Nick Serafimovski, Ali Huda, Marcel Zughaib","doi":"10.1016/j.jaccas.2025.105532","DOIUrl":"https://doi.org/10.1016/j.jaccas.2025.105532","url":null,"abstract":"<p><strong>Background: </strong>Spontaneous coronary artery dissection (SCAD) is a rare nonatherosclerotic cause of acute coronary syndrome, usually affecting young women without traditional risk factors. Currently, there is no definitive link between SCAD and autoimmune diseases such as antiphospholipid syndrome (APS).</p><p><strong>Case summary: </strong>A 51-year-old woman presented with anterior ST-segment elevation myocardial infarction due to multivessel SCAD of the mid left anterior descending artery and an intramural hematoma in a large obtuse marginal branch. Despite conservative management and Impella support, she developed an early extension of the obtuse marginal intramural hematoma 4 days later, complicated by a left ventricular thrombus. Subsequent evaluation confirmed APS.</p><p><strong>Discussion: </strong>This case illustrates multivessel SCAD with early extension in the setting of APS, highlighting critical challenges in the use of anticoagulation. Prolonged monitoring and autoimmune screening are crucial in atypical SCAD presentations. Mechanical circulatory support may assist in hemodynamic stability.</p><p><strong>Take-home message: </strong>APS should be considered for atypical SCAD presentations, with individualized multidisciplinary management to provide optimal outcomes.</p>","PeriodicalId":14792,"journal":{"name":"JACC. Case reports","volume":" ","pages":"105532"},"PeriodicalIF":0.0,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145206520","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