{"title":"Achalasia as an Unusual Cause of Acute Cellular Rejection of a Transplanted Heart.","authors":"Amanda Fernandes, Crystal Lihong Yan, Phillip Ruiz, Nina Thakkar Rivera","doi":"10.1155/2022/2054727","DOIUrl":"https://doi.org/10.1155/2022/2054727","url":null,"abstract":"<p><p>A 68-year-old female with end-stage heart failure presented to the hospital for heart transplant. She was diagnosed with achalasia 14 months prior and treated with frequent botulinum toxin injections. She underwent orthotopic heart transplant on the day of admission and was extubated a few days later. She developed intractable nausea and vomiting. Her first endomyocardial biopsy revealed moderate, approaching severe rejection. She was treated with high-dose intravenous pulse steroids. Fluoroscopy at the time of follow-up biopsy showed undigested pills in her esophagus with narrowing at the distal end and thus failure to deliver immunosuppressive therapy. This case highlights achalasia as an etiology for acute rejection and its potential management.</p>","PeriodicalId":51760,"journal":{"name":"Case Reports in Cardiology","volume":" ","pages":"2054727"},"PeriodicalIF":0.6,"publicationDate":"2022-09-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9569230/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40322001","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}
KaChon Lei, Wilbur Ji, Bhavana Bhaya, Chowdhury Ahsan
{"title":"A Rare Case of Cardiac Recovery after Acute Myocarditis from West Nile Virus Infection: A Review of the Current Literature.","authors":"KaChon Lei, Wilbur Ji, Bhavana Bhaya, Chowdhury Ahsan","doi":"10.1155/2022/8517728","DOIUrl":"https://doi.org/10.1155/2022/8517728","url":null,"abstract":"<p><p>West Nile Virus (WNV) myocarditis is nearly fatal, according to the current medical literature. We report a previously healthy 37-year-old Caucasian male who presented to our facility with two days of progressive lower extremity weakness, fever, edema, and shortness of breath found to have left ventricular global hypokinesis with an ejection fraction of less than 25%, consistent with acute viral myocarditis. He also has concomitant WNV meningoencephalitis due to his altered mentation. He was found to have a positive serum WNV IgM suggestive of a diagnosis of WNV myocarditis. He was intubated and was placed on vasoactive pressors for supportive care due to evidence of mixed cardiogenic and septic shock. After two weeks of hemodynamic support, we discovered a near-complete cardiac recovery, as shown on a repeat transthoracic echocardiography (TTE) and a normalized mean arterial blood pressure. This is a unique case report because near fatality is often associated with WNV myocarditis secondary to tachyarrhythmia, and there are currently no documented cases that are suggestive of cardiac recovery from the current literature.</p>","PeriodicalId":51760,"journal":{"name":"Case Reports in Cardiology","volume":" ","pages":"8517728"},"PeriodicalIF":0.6,"publicationDate":"2022-09-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9534694/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"33497370","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}
Mohamed Laimoud, Patricia Machado, Andrea Rossi Zadra, Mary Maghirang, Ali Alenazy
{"title":"Emergency Veno-Arterial Extracorporeal Membrane Oxygenation for Pericardial Decompression Syndrome.","authors":"Mohamed Laimoud, Patricia Machado, Andrea Rossi Zadra, Mary Maghirang, Ali Alenazy","doi":"10.1155/2022/5440635","DOIUrl":"https://doi.org/10.1155/2022/5440635","url":null,"abstract":"<p><strong>Background: </strong>Pericardiocentesis is a therapeutic lifesaving intervention for patients presenting with cardiogenic shock due to pericardial effusion with signs of tamponade. Pericardial decompression syndrome (PDS) is a rare fatal complication that may occur after pericardiocentesis. <i>Case Presentation</i>. We report a case of a patient with idiopathic primary pulmonary hypertension who presented with massive pericardial effusion complicated with rapid hemodynamic and respiratory deterioration. Gradual therapeutic pericardiocentesis was done but progressive circulatory collapse occurred. Emergent veno-arterial extracorporeal membrane oxygenation (VA-ECMO) was applied. Echocardiography revealed severe right ventricle failure. Unfortunately, the patient developed acute progressive thrombocytopenia and bilaterally diffuse subarachnoid hemorrhage after 4 days of ECMO support.</p><p><strong>Conclusions: </strong>Therapeutic pericardiocentesis can be occasionally fatal in cases of significant pulmonary hypertension with massive pericardial effusion when complicated by pericardial decompression syndrome. Acute significant thrombocytopenia may occur with VA-ECMO support resulting in fatal bleeding.</p>","PeriodicalId":51760,"journal":{"name":"Case Reports in Cardiology","volume":" ","pages":"5440635"},"PeriodicalIF":0.6,"publicationDate":"2022-09-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9553751/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"33513943","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}
Christian Birner, Matthias Gasche, Rainer Voisard, Christian Neumann
{"title":"Pericardial Tamponade following Asymptomatic SARS-CoV-2 Infection: A Diagnostic Journey.","authors":"Christian Birner, Matthias Gasche, Rainer Voisard, Christian Neumann","doi":"10.1155/2022/1332844","DOIUrl":"https://doi.org/10.1155/2022/1332844","url":null,"abstract":"<p><p><i>Background</i>. Pericardial tamponade is a known life-threatening condition rarely reported in COVID-19 but has not been reported following asymptomatic SARS-CoV-2 infection. Its pathomechanism is still elusive. <i>Case Summary</i>. We report the case of a 66-year-old man with progressive shortness of breath and leg swelling due to new-onset heart failure and pericardial tamponade following asymptomatic SARS-CoV-2 infection. Ultrasound-guided placement of a pericardial drainage led to significant improvement of symptoms and revealed an exudative effusion. Throughout the diagnostic process, we were confronted with a systemic inflammatory syndrome suspicion of an induced autoimmune condition. After steroid pulse therapy and oral anticoagulation for subclavian vein thrombosis, the patient was discharged and followed in our outpatient clinic. <i>Discussion</i>. Patients with asymptomatic SARS-CoV-2 infection are at risk for developing life-threatening complications. Induced autoimmune conditions could be a potential explanation for late-onset pericardial tamponade in this population. A multimodal imaging approach is crucial in the diagnosis and characterization of cardiac inflammation. An interdisciplinary approach is essential. Awareness of uncommon cardiac complications following a SARS-CoV-2 infection is crucial for the initial assessment and the appropriate treatment of these patients.</p>","PeriodicalId":51760,"journal":{"name":"Case Reports in Cardiology","volume":" ","pages":"1332844"},"PeriodicalIF":0.6,"publicationDate":"2022-09-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9553720/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"33513944","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 Treatment of Whole Coronary Artery Spasm after Off-Pump Coronary Artery Bypass Grafting.","authors":"Akihiro Kobayashi, Yoshimori Araki, Takafumi Terada, Osamu Kawaguchi","doi":"10.1155/2022/9003921","DOIUrl":"https://doi.org/10.1155/2022/9003921","url":null,"abstract":"<p><p>Coronary artery spasm after coronary artery bypass grafting is a rare but life-threatening condition. Herein, we report the case of a 77-year-old man who received off-pump coronary artery bypass grafting. An hour after surgery, there was a sudden hemodynamic compromise due to coronary artery spasm, prompting emergent coronary angiography with extracorporeal membrane oxygenation support. Because the angiography results showed diffuse severe spasm of the entire native coronary artery, the patient was treated with an intracoronary injection of vasodilators. The patient recovered in 7 days with mechanical support, catecholamines, and vasodilators, and he was discharged on postoperative day 30. Although coronary artery spasm after off-pump coronary artery bypass surgery is a rare condition, it must be suspected when sudden circulatory collapse occurs.</p>","PeriodicalId":51760,"journal":{"name":"Case Reports in Cardiology","volume":" ","pages":"9003921"},"PeriodicalIF":0.6,"publicationDate":"2022-09-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9481397/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40367847","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}
Franz Haertel, P Christian Schulze, Anett Große, Dirk Prochnau, Ralf Surber
{"title":"Ordinary AV Nodal Reentry Tachycardia-Unusual Ablation: A Case Report and Review of the Literature.","authors":"Franz Haertel, P Christian Schulze, Anett Große, Dirk Prochnau, Ralf Surber","doi":"10.1155/2022/9383016","DOIUrl":"https://doi.org/10.1155/2022/9383016","url":null,"abstract":"<p><p>A 72-year-old woman was referred to us with typical symptoms of paroxysmal supraventricular tachycardia for electrophysiological diagnostics and catheter ablation. During the first session of catheter ablation, a probing of the right ventricle was not successful. Therefore, an angiography of the central veins was performed. A rare anatomical variation with atresia of the inferior vena cava below the hepatic veins with azygos persistence was detected. The blood of the lower half of the body was drained via the dilated azygos into the superior vena cava; the blood of the liver veins enters into the right atrium directly. By atypical catheter placement over the azygos vein in the right ventricle and coronary sinus, an AV nodal reentry tachycardia (AVNRT) could be confirmed as the mechanism of tachycardia. However, a stable position of the ablation catheter could not be achieved by the femoral approach, so the successful AV node modulation with ablation of the slow pathway was performed via jugular access.</p>","PeriodicalId":51760,"journal":{"name":"Case Reports in Cardiology","volume":" ","pages":"9383016"},"PeriodicalIF":0.6,"publicationDate":"2022-08-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9427300/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40342884","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}
Muhammad H Khan, Obadah Aqtash, David M Harris, Alexandru I Costea, Myron C Gerson
{"title":"Ventricular Tachycardia or Fibrillation Storm in Coronavirus Disease.","authors":"Muhammad H Khan, Obadah Aqtash, David M Harris, Alexandru I Costea, Myron C Gerson","doi":"10.1155/2022/1157728","DOIUrl":"https://doi.org/10.1155/2022/1157728","url":null,"abstract":"<p><p>Ventricular tachycardia (VT) or ventricular fibrillation (VF) storm associated with severe acute respiratory syndrome coronavirus 2 infection is a potentially fatal complication; the correlation of these 2 disorders, however, has not been well studied. This retrospective case series examined outcomes of 2 patients who were admitted for repeated implantable cardioverter-defibrillator shocks with or without syncope and observed to have VT/VF storms with COVID-19. Mechanisms of VT/VF storms in COVID-19 are multifactorial including myocarditis, systemic inflammation, hyperadrenergic state, hemodynamic instability, hypoxia, acidosis, and proarrhythmic drugs. A higher incidence of VT/VF storm is observed in patients with comorbidities and those requiring critical care, with some studies reporting increased mortality. In our cohort, 1 of the 2 patients succumbed to the complications from COVID-19, and the other patient was discharged to home in stable condition. Monitoring of life-threatening arrhythmias in the setting of COVID-19 may need to be adopted to prevent morbidity and mortality.</p>","PeriodicalId":51760,"journal":{"name":"Case Reports in Cardiology","volume":" ","pages":"1157728"},"PeriodicalIF":0.6,"publicationDate":"2022-08-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9410984/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"33441955","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}
Elyssa Cohen, Conor P O'Halloran, Philip T Thrush, T Marsha Ma, Paul Tannous
{"title":"A Volume Challenge Reveals the Diagnosis of Pediatric Restrictive Cardiomyopathy.","authors":"Elyssa Cohen, Conor P O'Halloran, Philip T Thrush, T Marsha Ma, Paul Tannous","doi":"10.1155/2022/4707309","DOIUrl":"https://doi.org/10.1155/2022/4707309","url":null,"abstract":"<p><p>A healthy 11-year-old girl presented with exercise intolerance of unclear etiology, and her physical exam was notable for a 3/6 systolic ejection murmur at the left upper sternal border with radiation to the back. Extensive noninvasive workup consisted of ECG, transthoracic echocardiogram, and cardiac MRI/MRA, which were all nondiagnostic. She was ultimately referred for cardiac catheterization. Baseline invasive hemodynamics demonstrated a normal cardiac index and pulmonary vascular resistance but was notable for mildly elevated right and left end-diastolic pressures. A diagnosis remained elusive, so a 500 mL volume challenge was performed, which unmasked right and left ventricular waveform transformations to reveal the pathognomonic \"square root sign\" of restrictive cardiomyopathy with concordant RV/LV respirophasic variation. These findings and her clinical history allowed for the rare pediatric diagnosis of restrictive cardiomyopathy early in her clinical course, prior to the development of overt signs of pathologic myocardial remodeling, such as pulmonary hypertension and biatrial enlargement.</p>","PeriodicalId":51760,"journal":{"name":"Case Reports in Cardiology","volume":" ","pages":"4707309"},"PeriodicalIF":0.6,"publicationDate":"2022-08-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9402386/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"33441956","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}
Chris Pantsios, Zacharias-Alexandros Anyfantakis, Andrew Xanthopoulos, Ioannis Leventis, Spyridon Skoularigkis, Apostolos Dimos, Angeliki Bourazana, Michail Papamichalis, Grigorios Giamouzis, Filippos Triposkiadis, John Skoularigis
{"title":"Acute Myopericarditis after the Second Dose of mRNA COVID-19 Vaccine Mimicking Acute Coronary Syndrome.","authors":"Chris Pantsios, Zacharias-Alexandros Anyfantakis, Andrew Xanthopoulos, Ioannis Leventis, Spyridon Skoularigkis, Apostolos Dimos, Angeliki Bourazana, Michail Papamichalis, Grigorios Giamouzis, Filippos Triposkiadis, John Skoularigis","doi":"10.1155/2022/1600734","DOIUrl":"https://doi.org/10.1155/2022/1600734","url":null,"abstract":"<p><p>Myocarditis is a rare adverse event of vaccination. Recently, mRNA vaccines for COVID-19 have been reported to correlate with myocarditis, specifically in adolescents and young men. We report a rare case of a 50-year-old man who presented with symptoms of myocardial infarction 3 days after the second dose of vaccination for COVID-19. Cardiac magnetic resonance (CMR) imaging revealed acute myopericarditis. Clinicians should be aware of that rare side effect of mRNA vaccines for COVID-19 that can affect not only younger recipients but also middle-aged patients presenting with symptoms mimicking acute coronary syndrome.</p>","PeriodicalId":51760,"journal":{"name":"Case Reports in Cardiology","volume":" ","pages":"1600734"},"PeriodicalIF":0.6,"publicationDate":"2022-08-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9381285/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40721544","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 Case of Postpartum Takotsubo (Stress) Cardiomyopathy.","authors":"Fadi Kandah, Tanya Deol, Pooja Dhruva, Zachary Chandler, Thaer Musa, Gladys Velarde","doi":"10.1155/2022/4739742","DOIUrl":"https://doi.org/10.1155/2022/4739742","url":null,"abstract":"<p><p>Takotsubo (stress) cardiomyopathy (TCM) is usually triggered by psychological and/or physical stress. Most often, it is seen in postmenopausal women. Cases of TCM related to pregnancy are rare. We present a unique case of a 35-year-old, two-day postpartum female who was diagnosed with TCM.</p>","PeriodicalId":51760,"journal":{"name":"Case Reports in Cardiology","volume":" ","pages":"4739742"},"PeriodicalIF":0.6,"publicationDate":"2022-08-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9371808/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40614701","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}