Case Reports in Cardiology最新文献

{"title":"Stentless Management of Cannabis-Associated STEMI in Young Adults: Two Case Reports.","authors":"Sofiene Haboubi, Alya Mrad, Mohamed Amine Soula, Elyes Lagha, Mariem Drissa, Rami Tlili, Youssef Ben Ameur","doi":"10.1155/cric/2378215","DOIUrl":"10.1155/cric/2378215","url":null,"abstract":"<p><strong>Background: </strong>ST-segment elevation myocardial infarction (STEMI) in young adults is uncommon and may occur in the absence of significant underlying atherosclerotic coronary artery disease. Recent cannabis consumption has been temporally associated with acute coronary syndromes through several proposed mechanisms, including coronary thrombosis, vasospasm, endothelial dysfunction, and platelet activation. We report two cases of STEMI occurring shortly after cannabis consumption that were managed using a stentless strategy.</p><p><strong>Case presentations: </strong>Case 1: A 36-year-old man with recently diagnosed Type 2 diabetes mellitus and a history of daily cannabis use presented with an inferior STEMI approximately 1 h after cannabis consumption. Coronary angiography demonstrated double culprit lesions with thrombotic occlusion of the distal right coronary artery and a large thrombus within the proximal left anterior descending artery without significant underlying angiographic atherosclerosis. A minimalist immediate mechanical intervention (MIMI) strategy consisting of manual thrombus aspiration, dual antiplatelet therapy, and therapeutic anticoagulation was performed, followed by deferred angiographic reassessment after 7 days, which demonstrated complete thrombus resolution and TIMI 3 flow without residual significant stenosis in both vessels. Case 2: A 29-year-old man with heavy tobacco use and regular cannabis and alcohol consumption presented with anterior STEMI complicated by acute heart failure. Coronary angiography revealed a high thrombus burden involving the distal left main coronary artery with thrombotic occlusion of the ostial left anterior descending artery. Revascularization was achieved using manual thrombus aspiration, intracoronary glycoprotein IIb/IIIa inhibitor administration, and balloon angioplasty without stent implantation, resulting in restoration of TIMI 3 flow. No significant residual angiographic coronary stenosis was identified.</p><p><strong>Conclusion: </strong>These cases illustrate the feasibility of a stentless strategy in carefully selected young patients presenting with a high coronary thrombus burden and no angiographic evidence of significant underlying coronary artery disease. Although a temporal association with cannabis consumption was observed, a causal relationship cannot be established. These observations are hypothesis-generating, and larger prospective studies are required to better define the mechanisms underlying cannabis-associated STEMI and the role of stentless management in this setting.</p>","PeriodicalId":51760,"journal":{"name":"Case Reports in Cardiology","volume":"2026 ","pages":"2378215"},"PeriodicalIF":0.5,"publicationDate":"2026-10-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13646709/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149139299","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}

{"title":"Lyme Carditis Beyond Atrioventricular Block: Cardiac Arrest and Transient Atrial Fibrillation With Preserved Atrioventricular Conduction.","authors":"Jamal A Anthony, Katherine Doktor","doi":"10.1155/cric/6360084","DOIUrl":"10.1155/cric/6360084","url":null,"abstract":"<p><p>Lyme disease may involve the heart during early dissemination and most commonly produces atrioventricular (AV) conduction abnormalities. PR interval prolongation, therefore, frequently guides clinical suspicion and management. We describe a previously healthy man who presented with seizure-like activity, aborted cardiac arrest, transient atrial fibrillation, and cardiac magnetic resonance findings consistent with acute myocarditis, although AV conduction remained normal. Serologic testing subsequently confirmed Lyme carditis. The patient recovered completely with oral doxycycline. This case illustrates that electrical instability may occur despite preserved PR intervals and reinforces the need for suspicion in patients with compatible systemic features.</p>","PeriodicalId":51760,"journal":{"name":"Case Reports in Cardiology","volume":"2026 ","pages":"6360084"},"PeriodicalIF":0.5,"publicationDate":"2026-10-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13643207/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149139195","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}

{"title":"When the Right and Left Coronary Arteries Join: A Case Report of Intercoronary Communication and Literature Review.","authors":"Yassine Ettagmouti, Amine Bejar, Asmaa Mounssif, Ayoub Huda, Nabil Poulos, Pierre Aubry","doi":"10.1155/cric/8331602","DOIUrl":"10.1155/cric/8331602","url":null,"abstract":"<p><p>An intercoronary communication is a very rare congenital anomaly characterized by a short connection between two main coronary arteries. A 41-year-old female presented with dyspnea and elevated D-dimer and N-terminal pro brain natriuretic peptide levels. Pulmonary CT angiography demonstrated a pulmonary embolism and significantly enlarged mediastinal lymph nodes. Echocardiography revealed apical akinesia and impaired left ventricular function (ejection fraction of 45%). Coronary angiography showed no evidence of obstructive coronary artery disease but identified an abnormal continuity between the distal right coronary artery and the distal left circumflex artery. Each coronary injection demonstrated retrograde filling of the contralateral artery. The short intercoronary connection did not have the characteristics of an acquired collateral circulation. Cardiac MRI revealed apical akinesia with multifocal areas of subepicardial late gadolinium enhancement raising suspicion for cardiac sarcoidosis. Fewer than 30 cases of intercoronary communication have been reported in the literature to date. This anomaly is often discovered incidentally, as in the present case, and may have a myocardial-protective effect in the presence of coronary artery disease. Conversely, it can also be associated with coronary steal phenomena. However, establishing proof for these mechanisms remains challenging.</p>","PeriodicalId":51760,"journal":{"name":"Case Reports in Cardiology","volume":"2026 ","pages":"8331602"},"PeriodicalIF":0.5,"publicationDate":"2026-10-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13643205/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149139312","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}

{"title":"A Clinical Exploration of One of the Longest Documented Ventricular Pauses in an Ambulatory Patient.","authors":"Alyaa Saleh, Lanah Almatroud, Jibran Ajaz Sheikh, Vipin Khetarpal","doi":"10.1155/cric/9163647","DOIUrl":"10.1155/cric/9163647","url":null,"abstract":"<p><p>Cardiac conduction system abnormalities, such as sinus nodal dysfunction and AV block, can lead to significant bradyarrhythmias and pauses, potentially causing symptoms like dizziness and loss of consciousness. Monitoring these rhythm disturbances is crucial, as they may evolve and indicate underlying structural heart disease or lead to more serious arrhythmias. We present the case of a 76-year-old man with an exceptionally prolonged 62-second ventricular pause, followed by a single ventricular beat and an additional 24-second pause before normal rhythm resumes. He presented recurrent, intermittent, and unpredictable episodes of dizziness that were not associated with postural changes. A resting electrocardiogram (ECG) showing a normal sinus rhythm with first-degree heart block prompting placement of the event monitor and that detected the ventricular pauses. To our knowledge, our case represents one of the longest documented ventricular pauses in an ambulatory patient, emphasizing the need for ongoing evaluation in similar cases and the potential benefits of earlier intervention to prevent serious complications and death.</p>","PeriodicalId":51760,"journal":{"name":"Case Reports in Cardiology","volume":"2026 ","pages":"9163647"},"PeriodicalIF":0.5,"publicationDate":"2026-10-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13639232/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149118283","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}

{"title":"Unexpected Cardiogenic Shock in a Young Woman: A Case Report.","authors":"Benjamin A Johnson, Luis A Ortiz, Xavier E Prida","doi":"10.1155/cric/7627691","DOIUrl":"https://doi.org/10.1155/cric/7627691","url":null,"abstract":"<p><p>Recent cardiogenic shock (CS) literature emphasizes early recognition, staging, and treatment to improve survival, highlighting the need for system-wide detection pathways and prompt shock team activation to enable timely intervention. We present a 26-year-old woman initially diagnosed with septic shock who deteriorated despite therapy. Ongoing reassessment led to reclassification as CS, prompting shock team activation and initiation of mechanical circulatory support, ultimately resulting in full recovery. CS is uncommon in young adults and may be misdiagnosed as distributive shock. Repeated evaluations with focused examinations, laboratory testing, and echocardiography are critical for early detection and proper diagnosis and management.</p>","PeriodicalId":51760,"journal":{"name":"Case Reports in Cardiology","volume":"2026 ","pages":"7627691"},"PeriodicalIF":0.5,"publicationDate":"2026-10-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13633448/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149118305","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}

{"title":"Elevated NT-proBNP in the Setting of Ongoing Chest Infection Leading to Incidental Diagnosis of Infective Endocarditis-A Case Report.","authors":"Jaiden Townsend, Tiago Correia da Silva, Salman Nishtar, Ibrahim Antoun","doi":"10.1155/cric/8004408","DOIUrl":"10.1155/cric/8004408","url":null,"abstract":"<p><p>Infective endocarditis (IE) poses a known diagnostic challenge due to its variable clinical presentation. High suspicion for IE is generally driven by fever and positive blood cultures in the absence of an alternative focus of infection. We report an adult woman with a permanent pacemaker who presented with persistent fever, pleuritic chest pain and productive cough, diagnosed with right-sided community-acquired pneumonia. Blood cultures were negative; blood tests showed elevated inflammatory markers and an elevated white blood cell count, consistent with ongoing infection; and the NT-proBNP (obtained due to shortness of breath and evidence of pleural effusion on chest X-ray [CXR]) was markedly elevated, prompting transthoracic echocardiography (TTE). TTE demonstrated a large, irregular, independently mobile mass adherent to the pacemaker lead within the right atrium, prolapsing across the tricuspid valve into the right ventricle during diastole (≈2.3 × 1.0 cm), mild tricuspid regurgitation and normal biventricular systolic function. Transoesophageal echocardiography (TOE) confirmed a similar lead-adherent structure (≈2.5 × 1.0 cm), supporting a diagnosis of pacemaker-related IE in the appropriate clinical context. The patient was referred for complete device extraction at a specialist centre. This case highlights the diagnostic and management challenges of blood culture-negative endocarditis, the central role of echocardiography in the diagnosis of IE and the importance of integrating and interpreting imaging findings in the wider clinical context.</p>","PeriodicalId":51760,"journal":{"name":"Case Reports in Cardiology","volume":"2026 ","pages":"8004408"},"PeriodicalIF":0.5,"publicationDate":"2026-09-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13618809/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149076601","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}

{"title":"Pregnancy-Associated Spontaneous Coronary Artery Dissection in the Third Trimester Requiring Multistent Percutaneous Coronary Intervention: A Case Report.","authors":"Steven Liu, Austin Layton, Hollace Chastain","doi":"10.1155/cric/5560692","DOIUrl":"10.1155/cric/5560692","url":null,"abstract":"<p><strong>Background: </strong>Pregnancy-associated spontaneous coronary artery dissection (P-SCAD) is an uncommon cause of acute coronary syndrome (ACS) in young women. Although SCAD accounts for less than 1% of ACS cases, it causes up to 40%-50% of myocardial infarctions during pregnancy and the postpartum period. Third-trimester cases requiring complex percutaneous coronary intervention (PCI) are particularly rare.</p><p><strong>Case presentation: </strong>A 33-year-old gravida 5, para 3 woman at 27 weeks' gestation presented with sudden severe substernal chest pain. Electrocardiographic findings and elevated cardiac biomarkers confirmed an anterior ST-segment elevation myocardial infarction (STEMI). Coronary angiography demonstrated spontaneous coronary artery dissection involving the mid-to-distal left anterior descending artery. Owing to ongoing ischemia and extensive dissection, she underwent intravascular ultrasound-guided PCI with four overlapping drug-eluting stents, restoring TIMI III flow. Following revascularization, she remained hospitalized for maternal and fetal monitoring because of concerns for preeclampsia and severe fetal growth restriction. Although expectant management was initially pursued, worsening fetal heart-rate concerns necessitated cesarean delivery at 29 weeks' gestation without maternal cardiac complications. Although left ventricular function initially improved with guideline-directed medical therapy (GDMT), discontinuation of several medications because she felt symptomatically better contributed to progressive left ventricular dysfunction and NYHA class III heart failure, ultimately requiring cardiac rehabilitation and prophylactic implantable cardioverter-defibrillator placement.</p><p><strong>Discussion: </strong>This case highlights the complexity of managing extensive third-trimester P-SCAD requiring multistent PCI while balancing maternal cardiovascular stabilization with ongoing obstetric complications. It further emphasizes the importance of longitudinal imaging, sustained GDMT, medication adherence, and coordinated multidisciplinary follow-up after significant myocardial injury.</p><p><strong>Conclusion: </strong>Third-trimester P-SCAD requiring complex PCI is rare. Early recognition, individualized revascularization strategies, multidisciplinary obstetric and cardiovascular management, and close long-term follow-up are essential to optimize maternal and fetal outcomes while reducing the risk of adverse ventricular remodeling and heart failure progression.</p>","PeriodicalId":51760,"journal":{"name":"Case Reports in Cardiology","volume":"2026 ","pages":"5560692"},"PeriodicalIF":0.5,"publicationDate":"2026-09-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13602165/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149042122","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}

{"title":"Resolution of Right Atrial Pacemaker Lead Thrombosis After Rivaroxaban Failure: A Case Report.","authors":"Bowen Wang, Zhan Zhang, Qi Guo, Yanling Li, Ping Xie","doi":"10.1155/cric/6121153","DOIUrl":"10.1155/cric/6121153","url":null,"abstract":"<p><strong>Background: </strong>Pacemaker lead thrombosis is a rare but serious complication of cardiac implantable electronic devices (CIEDs) that often mimics infection; its management, given the lack of standardized treatment strategies, requires individualized anticoagulation and dynamic imaging.</p><p><strong>Case presentation: </strong>A 65-year-old woman with heart failure and diabetes mellitus had previously undergone dual-chamber pacemaker implantation following radiofrequency catheter ablation. After the subsequent occurrence of ventricular tachycardia, the device was upgraded to a cardiac resynchronization therapy defibrillator (CRT-D). She later experienced recurrent atrial flutter accompanied by worsening heart failure. The timing of atrial flutter recurrence was uncertain, and the patient had not received anticoagulation therapy. Preoperative transesophageal echocardiography (TEE) revealed a mobile mass measuring 10 × 3.5 mm attached to the right atrial lead. Comprehensive clinical and laboratory evaluation showed no evidence of infection. Anticoagulation with rivaroxaban at 20 mg once daily was initiated; however, no reduction in thrombus size was observed after 1 month. The treatment regimen was therefore switched to warfarin, with an initial target international normalized ratio (INR) of 2.0-3.0. Follow-up TEE performed 3 months later demonstrated enlargement of the thrombus to 18 × 3.8 mm. The target INR was subsequently intensified to 2.5-3.0, after which the thrombus gradually regressed. Serial TEE examinations confirmed complete thrombus resolution by 6 months. No embolic or bleeding complications occurred during the treatment course.</p><p><strong>Conclusion: </strong>This case underscores the inadequacy of NOAC monotherapy in selected high-risk patients with lead-associated thrombus, and demonstrates that INR-guided warfarin therapy with individualized adjustment was effective in achieving thrombus resolution.</p>","PeriodicalId":51760,"journal":{"name":"Case Reports in Cardiology","volume":"2026 ","pages":"6121153"},"PeriodicalIF":0.5,"publicationDate":"2026-09-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13594381/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149026632","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}

{"title":"The STEMI Mimic: Cocaine-Associated Pulmonary Embolism With ST-Segment Elevation.","authors":"Kishan Reddy, Dhairya Nanavaty, Sohrab Singh, Parasuram Krishnamoorthy, Pedro Moreno","doi":"10.1155/cric/9651125","DOIUrl":"10.1155/cric/9651125","url":null,"abstract":"<p><p>Cocaine has been linked to both myocardial infarction (MI) and pulmonary embolism (PE), with the latter occasionally mimicking acute coronary syndrome. We report a 54-year-old man with polysubstance abuse who was found unresponsive and revived with naloxone. He developed chest pain with electrocardiogram showing ST-segment elevation in V2-V3 and elevated troponin, suggestive of anteroseptal ST-elevation MI (STEMI). Bedside echocardiography revealed right ventricular dilation and dysfunction without left ventricular abnormalities, prompting computed tomography angiography (CTA), which demonstrated large bilateral pulmonary emboli with right heart strain. He was anticoagulated and later discharged on a direct oral anticoagulant; coronary angiography revealed only mild nonobstructive disease. This case underscores the diagnostic challenge of distinguishing PE from STEMI in patients with cocaine use and highlights the utility of point-of-care echocardiography in avoiding unnecessary invasive procedures. Clinicians should consider PE in the differential diagnosis of chest pain with ST elevation.</p>","PeriodicalId":51760,"journal":{"name":"Case Reports in Cardiology","volume":"2026 ","pages":"9651125"},"PeriodicalIF":0.5,"publicationDate":"2026-09-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13591124/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149018596","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}

{"title":"5-Fluorouracil (5-FU) Cardiotoxicity: A Stressful Event.","authors":"Yash Desai, Rohan Singh, Kush Desai, Samuel Bennett, Rohan Desai, Manu Mysore","doi":"10.1155/cric/2215209","DOIUrl":"10.1155/cric/2215209","url":null,"abstract":"<p><p>5-Fluorouracil (5-FU), a chemotherapeutic agent, is routinely used for solid tumors. Known cardiotoxic effects of 5-FU include fatal arrhythmias, myocardial infarctions, and coronary vasospasms. This case report describes a 56-year-old man who had acute heart failure with cardiogenic shock suspected to be related to 5-FU exposure; notably, cardiac dysfunction resolved following cessation of therapy.</p>","PeriodicalId":51760,"journal":{"name":"Case Reports in Cardiology","volume":"2026 ","pages":"2215209"},"PeriodicalIF":0.5,"publicationDate":"2026-09-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13583453/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148992537","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}