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Heart on Fire: Unmasking RyR2 Mutation in Stress-Induced Ventricular Arrhythmias.
Methodist DeBakey cardiovascular journal Pub Date : 2025-03-12 eCollection Date: 2025-01-01 DOI: 10.14797/mdcvj.1560
Vaibhav Sharma, Vishakha Maheshwari, Thirugnanasambandam Thayumanavan, Akshat Sahai, Surender Singh, Biswajit Kar
{"title":"Heart on Fire: Unmasking <i>RyR2</i> Mutation in Stress-Induced Ventricular Arrhythmias.","authors":"Vaibhav Sharma, Vishakha Maheshwari, Thirugnanasambandam Thayumanavan, Akshat Sahai, Surender Singh, Biswajit Kar","doi":"10.14797/mdcvj.1560","DOIUrl":"https://doi.org/10.14797/mdcvj.1560","url":null,"abstract":"<p><p>Catecholaminergic polymorphic ventricular tachycardia (CPVT) is a rare inherited arrhythmogenic disorder that can lead to sudden cardiac death (SCD) in young individuals with structurally normal hearts. This case report presents a novel instance of CPVT caused by a Ryanodine receptor channel-2 (<i>RyR2</i>) gene mutation in a young adult. A 24-year-old male presented with recurrent syncope and pre-syncopal episodes. Initial cardiac evaluations, including electrocardiography and echocardiography, were unremarkable. The patient experienced multiple syncopal events, including an episode of aborted SCD. Implantation of a loop recorder and subsequent implantable cardioverter-defibrillator (ICD) revealed recurrent ventricular tachycardia (VT). Comprehensive genetic testing identified a pathogenic mutation in the <i>RyR2</i> gene, confirming the diagnosis of CPVT. The patient was initiated on beta-blocker therapy (propranolol) for primary prevention of VT episodes and to reduce ICD interventions. The ICD was maintained for secondary prevention. This case underscores the importance of considering genetic arrhythmia syndromes in the differential diagnosis of unexplained syncope in young adults, even when initial cardiac assessments appear normal. It also highlights the critical role of genetic testing in the diagnosis and management of inherited cardiac conditions and emphasizes the need for family screening due to the autosomal dominant inheritance pattern of <i>RyR2</i> mutations.</p>","PeriodicalId":39207,"journal":{"name":"Methodist DeBakey cardiovascular journal","volume":"21 1","pages":"25-29"},"PeriodicalIF":0.0,"publicationDate":"2025-03-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11908418/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143651108","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
TAV-in-TAV Explant Through Surgical Resection of Prosthetic Valve Leaflets Under Direct Vision: SURPLUS.
Methodist DeBakey cardiovascular journal Pub Date : 2025-03-10 eCollection Date: 2025-01-01 DOI: 10.14797/mdcvj.1521
George Bcharah, Joyce Zhuang, Juan M Farina, J Asher Jenkins, Kristen A Sell-Dottin
{"title":"TAV-in-TAV Explant Through Surgical Resection of Prosthetic Valve Leaflets Under Direct Vision: SURPLUS.","authors":"George Bcharah, Joyce Zhuang, Juan M Farina, J Asher Jenkins, Kristen A Sell-Dottin","doi":"10.14797/mdcvj.1521","DOIUrl":"https://doi.org/10.14797/mdcvj.1521","url":null,"abstract":"<p><p>Transcatheter aortic valve replacement (TAVR) has become a widely utilized procedure for treating aortic stenosis (AS). However, TAVR-related complications are rising, with TAVR explants becoming the fastest growing cardiac surgery procedure. We report a case of an 80-year-old female with severe AS status post TAVR and subsequent TAV-in-TAV a few years later. She was found to have severe stenosis of her more recent TAV and was scheduled for surgical TAVR explant. The inner, most recent TAV was completely removed, and only the leaflets of the outer, older TAV were resected, sparing the stent frame. This was followed by deployment of a new TAV within the preserved frame under direct visualization. The patient's postoperative recovery was uncomplicated, and 1-month follow-up was reassuring. We highlight the advantages of this approach in minimizing aortic manipulation, reducing the risk of aortic wall damage, and potentially optimizing overall outcomes in a high-risk procedure.</p>","PeriodicalId":39207,"journal":{"name":"Methodist DeBakey cardiovascular journal","volume":"21 1","pages":"20-24"},"PeriodicalIF":0.0,"publicationDate":"2025-03-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11908415/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143651112","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
Left Atrium Compression by Iatrogenic Hematoma Due to Left Atrial Appendage Clipping in Open Coronary Artery Bypass Grafting Surgery.
Methodist DeBakey cardiovascular journal Pub Date : 2025-03-07 eCollection Date: 2025-01-01 DOI: 10.14797/mdcvj.1534
Ahmad Tabatabaeishoorijeh, Albert Oh, Ziyab K Sarfaraz, Mahesh Ramchandani
{"title":"Left Atrium Compression by Iatrogenic Hematoma Due to Left Atrial Appendage Clipping in Open Coronary Artery Bypass Grafting Surgery.","authors":"Ahmad Tabatabaeishoorijeh, Albert Oh, Ziyab K Sarfaraz, Mahesh Ramchandani","doi":"10.14797/mdcvj.1534","DOIUrl":"10.14797/mdcvj.1534","url":null,"abstract":"<p><p>Left atrial appendage (LAA) clipping during open cardiac surgery is widely used for stroke and embolization prevention in atrial fibrillation. Various devices are available for this purpose, including the AtriCure AtriClip and the recently introduced Medtronic Penditure clip. We present a case of a 59-year-old male with multiple comorbidities, including chronic kidney disease and coronary artery disease, who underwent coronary artery bypass grafting with prophylactic LAA clipping using the Medtronic Penditure atrial clip. The procedure was complicated by an iatrogenic hematoma due to clip erosion into the atrioventricular groove, leading to left atrial tamponade and necessitating chest re-exploration. This case underscores the importance of understanding the structural interactions between different LAA occlusion devices and surrounding cardiac anatomy. Further evaluation is warranted to assess the safety profile of newer LAA occlusion devices and their impact on postoperative outcomes.</p>","PeriodicalId":39207,"journal":{"name":"Methodist DeBakey cardiovascular journal","volume":"21 1","pages":"16-19"},"PeriodicalIF":0.0,"publicationDate":"2025-03-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11887459/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143587539","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
Incidental Detection of Adult Polysplenia Syndrome With Situs Inversus Totalis, Interrupted Inferior Vena Cava, and Bronchiectasis.
Methodist DeBakey cardiovascular journal Pub Date : 2025-03-06 eCollection Date: 2025-01-01 DOI: 10.14797/mdcvj.1537
Kanupriya Arora, Mansi Verma, Sushma Makhaik
{"title":"Incidental Detection of Adult Polysplenia Syndrome With Situs Inversus Totalis, Interrupted Inferior Vena Cava, and Bronchiectasis.","authors":"Kanupriya Arora, Mansi Verma, Sushma Makhaik","doi":"10.14797/mdcvj.1537","DOIUrl":"10.14797/mdcvj.1537","url":null,"abstract":"<p><p>Incidental detection of polysplenia associated with situs inversus totalis in an adult is rarely reported in literature.12 \"Heterotaxy\" refers to a wide spectrum of anomalies involving dysmorphism of thoracoabdominal organs across the right-left axis of the body. Polysplenia is observed in left isomerism along with bilateral bilobed bronchi and bilateral morphologic left atria. However, in this case, polysplenia was present without isomerism.</p>","PeriodicalId":39207,"journal":{"name":"Methodist DeBakey cardiovascular journal","volume":"21 1","pages":"6-9"},"PeriodicalIF":0.0,"publicationDate":"2025-03-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11887460/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143587536","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
Cinematic Rendered Computed Tomography Imaging Enhances 3D Visualization of Upper Extremity Arteriovenous Malformation.
Methodist DeBakey cardiovascular journal Pub Date : 2025-03-06 eCollection Date: 2025-01-01 DOI: 10.14797/mdcvj.1569
Balazs C Lengyel, Alan B Lumsden, Ponraj Chinnadurai
{"title":"Cinematic Rendered Computed Tomography Imaging Enhances 3D Visualization of Upper Extremity Arteriovenous Malformation.","authors":"Balazs C Lengyel, Alan B Lumsden, Ponraj Chinnadurai","doi":"10.14797/mdcvj.1569","DOIUrl":"10.14797/mdcvj.1569","url":null,"abstract":"<p><p>Inspired by the quality of computer-rendered images in the animated movie industry, cinematic rendering (CR) is a novel image visualization technique using proprietary rendering algorithms that simulate the propagation and interaction of light rays passing through 3-dimensional (3D) volumetric data, resulting in a photorealistic representation of bodily organs and vasculature.<sup>1,2</sup> Due to its more realistic representative and intuitive format, it has become part of medical education, especially 3D anatomy teaching, patient education, and communication.<sup>3,4</sup> It also plays an important role in the diagnostics and treatment planning for complex vascular pathologies, especially malformations.<sup>5</sup> This short report highlights the additional diagnostic and clinical value of this image visualization technique by showing its value in treatment planning in a case of arteriovenous malformation (Figure 1).</p>","PeriodicalId":39207,"journal":{"name":"Methodist DeBakey cardiovascular journal","volume":"21 1","pages":"13-15"},"PeriodicalIF":0.0,"publicationDate":"2025-03-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11887464/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143587535","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
Intra-atrial Course of Right Coronary Artery: A Rare Anomaly Detected on Computed Tomography.
Methodist DeBakey cardiovascular journal Pub Date : 2025-03-06 eCollection Date: 2025-01-01 DOI: 10.14797/mdcvj.1538
Archita Mahajan, Mansi Verma, Sumala Kapila
{"title":"Intra-atrial Course of Right Coronary Artery: A Rare Anomaly Detected on Computed Tomography.","authors":"Archita Mahajan, Mansi Verma, Sumala Kapila","doi":"10.14797/mdcvj.1538","DOIUrl":"10.14797/mdcvj.1538","url":null,"abstract":"<p><p>We describe a case of a 59-year-old male who presented with intermittent episodes of atypical chest pain where computed tomography revealed intracavitary course of right coronary artery.The recognition of intra-atrial course of RCA is important as it can predispose patients to inadvertent iatrogenic injuries during surgical or endovascular procedures that can prove catastrophic, even fatal.</p>","PeriodicalId":39207,"journal":{"name":"Methodist DeBakey cardiovascular journal","volume":"21 1","pages":"10-12"},"PeriodicalIF":0.0,"publicationDate":"2025-03-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11887463/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143587538","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
Best Friends.
Methodist DeBakey cardiovascular journal Pub Date : 2025-02-18 eCollection Date: 2025-01-01 DOI: 10.14797/mdcvj.1566
Philip Alexander
{"title":"Best Friends.","authors":"Philip Alexander","doi":"10.14797/mdcvj.1566","DOIUrl":"https://doi.org/10.14797/mdcvj.1566","url":null,"abstract":"<p><p>Philip Alexander, MD, is a native Texan, retired physician, and accomplished musician and artist. After 41 years as an internal medicine physician, Dr. Phil retired from his practice in College Station in 2016. A lifelong musician and former music professor, he often performs as an oboe soloist for the Brazos Valley Symphony Orchestra. He began exploring visual art in 1980, evolving from pencil sketches-including an official White House portrait of President Ronald Reagan-to the computer-generated drawings featured in this journal. His images, which first appeared in this journal in the spring of 2012, are his own original creations. If you would like to see your art published in the <i>Methodist DeBakey Cardiovascular Journal</i>, submit your creation online at journal.houstonmethodist.org as a \"Humanities\" entry.</p>","PeriodicalId":39207,"journal":{"name":"Methodist DeBakey cardiovascular journal","volume":"21 2","pages":"104-106"},"PeriodicalIF":0.0,"publicationDate":"2025-02-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11843990/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143484289","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
Beyond BMI: A Patient-Centered Approach to Discussing Obesity.
Methodist DeBakey cardiovascular journal Pub Date : 2025-02-18 eCollection Date: 2025-01-01 DOI: 10.14797/mdcvj.1531
Sharon Anderson, Enjoli Benitez, Edith Gonzalez-Godinez, Yatri Desai, Nickveer Heer, Jordan White
{"title":"Beyond BMI: A Patient-Centered Approach to Discussing Obesity.","authors":"Sharon Anderson, Enjoli Benitez, Edith Gonzalez-Godinez, Yatri Desai, Nickveer Heer, Jordan White","doi":"10.14797/mdcvj.1531","DOIUrl":"10.14797/mdcvj.1531","url":null,"abstract":"<p><p>This Points to Remember column outlines an approach to initiating the discussion of obesity with a patient in the clinical setting. Written by faculty and residents of the Houston Methodist Family Medicine Residency Program, these points can help physicians develop a patient-centered approach to broaching the discussion of weight management that fosters an open dialogue and works to reduce weight stigma and biases surrounding obesity.</p>","PeriodicalId":39207,"journal":{"name":"Methodist DeBakey cardiovascular journal","volume":"21 2","pages":"94-96"},"PeriodicalIF":0.0,"publicationDate":"2025-02-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11843918/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143484293","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
The Impact of Obesity on Cardiovascular Diseases: Heart Failure.
Methodist DeBakey cardiovascular journal Pub Date : 2025-02-18 eCollection Date: 2025-01-01 DOI: 10.14797/mdcvj.1511
Hatem Alansari, Gina Lazzara, Mohamad B Taha, Janardhana R Gorthi
{"title":"The Impact of Obesity on Cardiovascular Diseases: Heart Failure.","authors":"Hatem Alansari, Gina Lazzara, Mohamad B Taha, Janardhana R Gorthi","doi":"10.14797/mdcvj.1511","DOIUrl":"10.14797/mdcvj.1511","url":null,"abstract":"<p><p>Obesity and heart failure (HF) are two intersecting public health challenges, each with rising prevalence worldwide. Obesity alters cardiac structure and function, leading to ventricular systolic and diastolic dysfunction. However, weight loss interventions, whether through lifestyle changes, pharmacological agents, or bariatric surgery, can improve cardiac function, reduce symptoms, and lower hospitalization rates. Interestingly, the \"obesity paradox\" suggests that HF patients with obesity may experience better survival outcomes than HF patients with normal weight despite the adverse cardiac effects of obesity. Most importantly, focusing on strategies that aim to prevent HF in patients with obesity can potentially curb the burden of this chronic condition. This review explores the complex relationship between obesity and HF, emphasizing pathophysiological mechanisms, the paradoxical survival benefit, and the impact of weight loss strategies. A deeper understanding of this relationship is critical for optimizing care and outcomes in HF patients with obesity.</p>","PeriodicalId":39207,"journal":{"name":"Methodist DeBakey cardiovascular journal","volume":"21 2","pages":"44-52"},"PeriodicalIF":0.0,"publicationDate":"2025-02-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11844025/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143484359","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
Medical Management of Obesity: Current Trends and Future Perspectives.
Methodist DeBakey cardiovascular journal Pub Date : 2025-02-18 eCollection Date: 2025-01-01 DOI: 10.14797/mdcvj.1503
Andres Calderon Valladares, Maria Aguilera Astudillo, Alexsandra Rojas Drinnon, Samaneh Dowlatshahi, Abhishek Kansara, Jawairia Shakil, Bhargavi Patham
{"title":"Medical Management of Obesity: Current Trends and Future Perspectives.","authors":"Andres Calderon Valladares, Maria Aguilera Astudillo, Alexsandra Rojas Drinnon, Samaneh Dowlatshahi, Abhishek Kansara, Jawairia Shakil, Bhargavi Patham","doi":"10.14797/mdcvj.1503","DOIUrl":"10.14797/mdcvj.1503","url":null,"abstract":"<p><p>Obesity and overweight have become increasingly significant conditions, affecting more than 70% of the adult population in the United States. These conditions are caused by a combination of factors, including genetic, behavioral, environmental, and medical influences. Obesity is a major risk factor for cardiovascular and metabolic diseases. A comprehensive treatment plan for individuals with obesity must recognize the chronic nature of the condition and offer strategies for weight reduction and long-term cardiometabolic benefits. Over the past several decades, multiple therapeutic options have been implemented to address weight loss, appetite regulation, and caloric expenditure, with the goal of reducing the burden of obesity and improving cardiovascular outcomes. Pharmacological treatment of obesity has focused primarily on the central regulation of appetite and food intake behavior. The introduction of incretin agonists for obesity treatment has ushered in a new era of cardiometabolic health, with a multitargeted mechanism that achieves weight loss, glycemic control, decreased cardiovascular mortality, and other metabolic benefits. This review explores the current pharmacological options and the future of obesity treatment.</p>","PeriodicalId":39207,"journal":{"name":"Methodist DeBakey cardiovascular journal","volume":"21 2","pages":"62-73"},"PeriodicalIF":0.0,"publicationDate":"2025-02-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11844017/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143484243","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
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