Case Reports in Cardiology最新文献

{"title":"Combined Minimally Invasive Surgical and Percutaneous Approaches for a Patient on Hemodialysis With Severe Aortic Stenosis and Complex Coronary Artery Disease.","authors":"Teruaki Wada, Kentaro Honda, Hironori Kitabata, Yoshiharu Nishimura, Atsushi Tanaka","doi":"10.1155/cric/9229849","DOIUrl":"10.1155/cric/9229849","url":null,"abstract":"<p><p>Patients on hemodialysis with concomitant severe aortic stenosis (AS) and multivessel coronary artery disease (CAD) are at high risk for surgical aortic valve replacement (SAVR) and coronary artery bypass grafting (CABG). Transsubclavian-transcatheter aortic valve implantation (TSc-TAVI) is a well-established alternative approach to transfemoral TAVI for patients with unfavorable femoral access. Herein, we report a case in which minimally invasive surgical treatment and TSc-TAVI were performed simultaneously in a patient with severe AS and multivessel CAD undergoing hemodialysis. An 85-year-old man undergoing hemodialysis for end-stage renal disease owing to severe AS (mean pressure gradient, 46 mmHg; aortic valve area, 0.75 cm²; and left ventricular ejection fraction, 59%) presented to our hospital with chest pain on exertion. Preoperative coronary angiography revealed significant stenosis of the left anterior descending (LAD) coronary artery and right coronary artery (RCA), requiring revascularization. However, the patient was not a good candidate for transfemoral TAVI because of a porcelain ascending aorta and a shaggy descending aorta observed on computed tomography. He was scheduled for concomitant right TSc-TAVI and minimally invasive cardiac surgery (MICS)-CABG after percutaneous coronary intervention (PCI) for the RCA. The treatment was successful. Simultaneous TSc-TAVI and MICS-CABG with PCI may be applied as a minimally invasive surgical treatment modality for patients with AS and CAD undergoing hemodialysis.</p>","PeriodicalId":51760,"journal":{"name":"Case Reports in Cardiology","volume":"2025 ","pages":"9229849"},"PeriodicalIF":0.6,"publicationDate":"2025-03-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11952915/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143755844","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":"Fulminant Cardiac Sarcoidosis Successfully Treated With Aggressive Immunosuppressive Therapy.","authors":"Kaori Yasumura, Fusako Sera, Yasuhiro Akazawa, Kei Nakamoto, Makiko Kawai, Masako Kurashige, Daisuke Nakamura, Takafumi Oka, Isamu Mizote, Eiichi Morii, Tomohito Ohtani, Yasushi Sakata","doi":"10.1155/cric/1350557","DOIUrl":"https://doi.org/10.1155/cric/1350557","url":null,"abstract":"<p><p><b>Background:</b> The clinical course of cardiac sarcoidosis is typically subacute, and fulminant cases requiring mechanical circulatory support are rare. Here, we report the case of a patient with pathologically diagnosed cardiac sarcoidosis who presented with fulminant myocarditis and whose cardiac function was improved by aggressive immunosuppressive therapy based on the treatment of giant cell myocarditis. <b>Case Presentation:</b> A 55-year-old woman presented with progressive dyspnoea and nausea that persisted for 1 month and was eventually diagnosed with acute heart failure. Echocardiography showed a reduced left ventricular ejection fraction with thinning of the basal septal wall. During hospitalisation, she experienced ventricular tachycardia and fibrillation attacks, and bradycardia due to a complete atrioventricular block and sinus dysfunction was observed after starting amiodarone. Subsequently, she underwent intra-aortic balloon pump insertion in addition to inotropic agent administration; however, venoarterial extracorporeal membrane oxygenation and Impella 5.0 were needed because biventricular dysfunction progressed. We diagnosed our patient with cardiac sarcoidosis based on the pathological findings revealing inflammatory cell infiltration, including giant cells with extensive fibrosis and granulomas. However, the possibility of giant cell myocarditis could not be ruled out because of the fulminant clinical course; therefore, aggressive immunosuppressive therapy with corticosteroids and cyclosporine was started. Her cardiac function improved, and all mechanical circulatory support and inotropic agents were discontinued. <b>Conclusion:</b> Cardiac sarcoidosis is difficult to differentiate from giant cell myocarditis because they have many similarities in terms of myocardial histopathology and clinical manifestations. While whether the two diagnoses are parts of a single-disease continuum remains debatable, aggressive combination immunosuppressive therapy may contribute to favourable outcomes.</p>","PeriodicalId":51760,"journal":{"name":"Case Reports in Cardiology","volume":"2025 ","pages":"1350557"},"PeriodicalIF":0.6,"publicationDate":"2025-03-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11986919/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144042757","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":"Hydralazine-Induced ANCA Vasculitis Presenting With Pericarditis: A Novel Case and Literature Review.","authors":"Ahmed Sami Hammami, Osejie Oriaifo, Sinda Hidri, Sukhvir Singh, Husam El Sharu, Joshua Peltz, Soroush Nomigolzar, Kunjan Udani","doi":"10.1155/cric/9932632","DOIUrl":"https://doi.org/10.1155/cric/9932632","url":null,"abstract":"<p><p>Hydralazine, a commonly used arterial vasodilator for managing congestive heart failure and hypertension, is known to be associated with drug-induced lupus and, less frequently, antineutrophil cytoplasmic antibody (ANCA)-associated vasculitis (AAV). Drug-induced AAV typically carries a favorable long-term prognosis and is not commonly linked to cardiovascular or ocular involvement. Pericarditis cases associated with hydralazine have not been previously reported. We present a rare case involving an 85-year-old woman on long-term hydralazine therapy, initially presenting with acute lobar pneumonia. During her hospitalization, she developed pericarditis, chemosis, and conjunctivitis in her eyes, along with cutaneous lesions described as a maculopapular rash on her face, tender bullae on her digits, and a petechial rash on her back. Laboratory findings were consistent with drug-induced AAV, showing positive myeloperoxidase and proteinase 3 antibodies. An attempted diagnostic pericardiocentesis was unsuccessful. Hydralazine was discontinued, and she was successfully treated with corticosteroids and tolerated immunosuppression well. Subsequently, she recovered and was discharged from the hospital.</p>","PeriodicalId":51760,"journal":{"name":"Case Reports in Cardiology","volume":"2025 ","pages":"9932632"},"PeriodicalIF":0.6,"publicationDate":"2025-02-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11986942/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144048506","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":"Ivabradine for Incessant Atrial Tachycardia in a 1-Year-Old Child After Tetralogy of Fallot Repair.","authors":"Haikal Balweel, Rubiana Sukardi, Eva Miranda Marwali, Rifqi Rizkani Eri, Novaro Adeneur Tafriend, Agus Harsoyo","doi":"10.1155/cric/2601345","DOIUrl":"10.1155/cric/2601345","url":null,"abstract":"<p><p><b>Background</b>: Ivabradine is a novel drug with the ability to reduce heart rate without compromising myocardial contractility or blood pressure. Studies on this drug exist mainly for heart failure and coronary artery disease; for arrhythmia, the studies are limited to small sample trials and case series, mostly unrandomized. Additionally, its evidence for arrhythmia in pediatric patients is limited. Here, we present a case of successful ivabradine administration for incessant atrial tachycardia in a 1-year-old child following tetralogy of Fallot (TOF) repair. <b>Case</b>: A 1-year-old child experienced incessant tachyarrhythmia episodes after TOF repair. Multiple standard therapies, including adenosine, amiodarone, multiple cardioversions, beta-blockers, and digoxin, failed to convert the rhythm. Considering the limited therapy options and existing case reports, ivabradine was administered at a dose of 0.1 mg/kg. Subsequently, sinus rhythm was restored 8 h after its administration, with the heart rate significantly decreased, and the patient returned to a stable hemodynamic status. <b>Discussion</b>: Ivabradine may be an option for incessant atrial tachycardia in pediatric patients. Although most tachyarrhythmias following TOF repair occur due to a reentry mechanism, focal mechanisms can also occur, suggested by timing, gradual acceleration after cardioversion and its response to ivabradine. Future studies are needed to further understand the safety and efficacy of ivabradine for atrial tachycardia in pediatric patients.</p>","PeriodicalId":51760,"journal":{"name":"Case Reports in Cardiology","volume":"2025 ","pages":"2601345"},"PeriodicalIF":0.6,"publicationDate":"2025-02-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11832250/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143442523","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":"Novel Endovascular Technique for Thrombus Removal: The \"Super Grab a Clot and Hold ON (Super GACHON)\" Technique.","authors":"Takahiro Tokuda, Hideyuki Takimura, Yasuhiro Oba, Keisuke Hirano","doi":"10.1155/cric/5525113","DOIUrl":"https://doi.org/10.1155/cric/5525113","url":null,"abstract":"<p><p>We present a case of a 60-year-old man with claudication in his right foot; the patient had received stent-graft implantation for the right superficial femoral artery (SFA) 1 year ago. Computed tomography angiography suggested stent occlusion of the right SFA, and a thrombus was considered to cause occlusion. To avoid distal embolization, we performed lesion recanalization via a trans-ankle intervention. First, we performed aspiration for the lesion; however, the thrombus persisted. Second, we performed the \"Super Grab a Clot and Hold ON\" technique and removed several thrombi. Finally, we used drug-coated balloons as a final device for the lesion. Two years later, the right SFA was found open upon an ultrasonography.</p>","PeriodicalId":51760,"journal":{"name":"Case Reports in Cardiology","volume":"2025 ","pages":"5525113"},"PeriodicalIF":0.6,"publicationDate":"2025-01-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11737903/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143016183","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":"Anomalous Right Coronary Artery: Culprit or Innocent Bystander?","authors":"Cooper B Kersey, Shakirat Oyetunji, Creighton W Don","doi":"10.1155/cric/1450803","DOIUrl":"10.1155/cric/1450803","url":null,"abstract":"<p><p>Anomalous aortic origin of a coronary artery is a rare congenital heart defect. The detection of anomalous coronary arteries is likely to increase with increased availability and application of cardiac computed tomography and magnetic resonance imaging. Once detected, the recommendation for surgical intervention on anomalous coronary arteries depends upon patient symptoms, the presence or absence of inducible ischemia on stress imaging, and high-risk anatomic features. A 77-year-old man with a history of hypertension, hyperlipidemia, chronic kidney disease Stage III, and moderate aortic stenosis presented with a non-ST-elevation myocardial infarction and was found to have an anomalous aortic origin of the right coronary artery on cross-sectional imaging. His aortic stenosis had also progressed from moderate to severe, and it was not clear whether his myocardial infarction could be exclusively attributed to a supply-demand disparity within the context of profound aortic stenosis or if his aberrant coronary anatomy could be implicated as the culprit for his presentation. A multidisciplinary heart team decided to proceed with a transcatheter aortic valve replacement and then readdress surgical intervention on his anomalous right coronary artery if his anginal symptoms persisted following valve replacement.</p>","PeriodicalId":51760,"journal":{"name":"Case Reports in Cardiology","volume":"2025 ","pages":"1450803"},"PeriodicalIF":0.6,"publicationDate":"2025-01-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11724727/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142973225","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":"Type A Aortic Dissection in a Previously Healthy Pregnant Patient: A Challenging Dilemma, Case Report, and Literature Review.","authors":"Elham Bateni, Maryam Dehghan, Zeinab Ahmadikia","doi":"10.1155/cric/6971509","DOIUrl":"10.1155/cric/6971509","url":null,"abstract":"<p><p>Aortic dissection (AoD) is a rare fatal condition in which tearing in the intima causes a false channel in the aorta and can lead to rupture. AoD is classified as the DeBakey classification (Types I, II, III) and Stanford classification (Types A and B). Women with underlying risk factors such as hypertension, smoking, bicuspid aortic valve, and connective tissue disorders are at risk for pregnancy-related AoD. These risk factors may not be recognized until the AoD occurs during pregnancy. We describe an acute incidence of type A AoD in the second trimester of pregnancy. A multiparous woman with no previously known risk factor presented with nonspecific chest pain. She was found to have AoD and underwent successful surgical intervention. This case demonstrates the importance of vigilance in the evaluation of pregnant women with new cardiopulmonary symptoms. A multidisciplinary approach can save the mother and the fetus.</p>","PeriodicalId":51760,"journal":{"name":"Case Reports in Cardiology","volume":"2024 ","pages":"6971509"},"PeriodicalIF":0.6,"publicationDate":"2024-12-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11695080/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142924110","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":"Triple-Vessel Spontaneous Coronary Artery Dissection Managed Conservatively.","authors":"Garen S Kroshian, Matthew J Cozzolino, Edeliz Flores, Sheilah A Bernard","doi":"10.1155/cric/7144164","DOIUrl":"10.1155/cric/7144164","url":null,"abstract":"<p><p>The management of spontaneous coronary artery dissection (SCAD) presents challenges and uncertainties. We present a case of a 54-year-old woman who developed SCAD in the three primary coronary artery territories including the distal left anterior descending artery (LAD), a diagonal branch, the first and second obtuse marginals (OMs), and the midright coronary artery (RCA). She was managed conservatively without procedural intervention, and follow-up coronary angiography demonstrated complete recovery.</p>","PeriodicalId":51760,"journal":{"name":"Case Reports in Cardiology","volume":"2024 ","pages":"7144164"},"PeriodicalIF":0.6,"publicationDate":"2024-12-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11671644/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142903996","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":"Intraoperative Hemodynamic Instability in a Patient With Ebstein's Anomaly Complicated With Eisenmenger Syndrome.","authors":"Leonardo A Marquez Roa, Jorge Araujo-Duran, Richard Hofstra, Jibran Ikram, Sabry Ayad","doi":"10.1155/cric/8283566","DOIUrl":"10.1155/cric/8283566","url":null,"abstract":"<p><p>Ebstein's anomaly is a rare congenital displacement of the tricuspid valve resulting in atrialization of the right ventricle. About half of the patients with Ebstein's anomaly also have atrial septal defects, which may lead to chronic shunting and development of Eisenmenger syndrome. We describe a case of a sexagenarian male patient with a history of Ebstein's anomaly complicated with Eisenmenger syndrome undergoing robotic laparoscopic adrenalectomy who presented hemodynamic instability, hypoxemia, and likely right-to-left shunting intraoperatively, as well as the actions taken to correct it and have a successful outcome. Perioperative management of adult patients with congenital heart defects is complex and requires careful monitoring. When available, intraoperative transesophageal echocardiography is strongly recommended. To prevent right-to-left shunting, maintaining elevated systemic vascular resistance with the use of vasopressors and low positive end-expiratory pressure (PEEP) ventilation is critical.</p>","PeriodicalId":51760,"journal":{"name":"Case Reports in Cardiology","volume":"2024 ","pages":"8283566"},"PeriodicalIF":0.6,"publicationDate":"2024-12-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11668542/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142886478","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":"Successful Bailout of Catheter-Induced Dissection in Acute Myocardial Infarction Resulting From a Nondominant Right Coronary Artery Occlusion.","authors":"Hiroshi Abe, Tadao Aikawa, Ken Yokoyama, Tohru Minamino","doi":"10.1155/cric/1091601","DOIUrl":"10.1155/cric/1091601","url":null,"abstract":"<p><p>A 48-year-old male with a history of hyperlipidemia presented to the emergency department with chest pain. Electrocardiographic abnormalities indicated an acute coronary syndrome. Urgent coronary angiography revealed nondominant right coronary artery (RCA) occlusion. During primary percutaneous coronary intervention (PCI), a 0.014-inch floppy guidewire could not be easily advanced into the middle RCA due to poor backup support from the guiding catheter and the patient's breathing. The pressure was monitored several times after reinserting the guiding catheter. Nevertheless, the guidewire was inadvertently inserted into the false lumen from the ostium, leading to subsequent dissection during contrast injection. Intravascular ultrasound (IVUS) imaging confirmed dissection from the ostium to the middle RCA and passage of the guidewire into the false lumen. An additional guidewire was successfully inserted into the true lumen of the RCA using real-time IVUS-guided wiring. We demonstrated successful bailout stenting for catheter-induced dissection of the nondominant small RCA. Our case highlights the risk of coronary artery dissection associated with guiding catheter use, especially in a nondominant small RCA, and the importance of optimal guiding catheter selection for primary PCI. The real-time IVUS-guided wiring technique can be applied to a single 6-Fr guiding catheter and is useful for quickly inserting a guidewire into the true lumen.</p>","PeriodicalId":51760,"journal":{"name":"Case Reports in Cardiology","volume":"2024 ","pages":"1091601"},"PeriodicalIF":0.6,"publicationDate":"2024-12-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11666313/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142883353","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}