Journal of Cardiology Cases最新文献

{"title":"Intraprocedural left atrial appendage thrombus formation during percutaneous left atrial appendage closure: A case report","authors":"Aiko Takami MD, PhD,&nbsp;Kensuke Nakamura MD, PhD,&nbsp;Fumiyasu Hirano MD,&nbsp;Yasuhito Kotake MD, PhD,&nbsp;Masaru Kato MD, PhD","doi":"10.1016/j.jccase.2026.05.005","DOIUrl":"10.1016/j.jccase.2026.05.005","url":null,"abstract":"<div><div>Percutaneous left atrial appendage closure (LAAC) is an established strategy for stroke prevention in patients with atrial fibrillation (AF). Although device-related thrombus after LAAC has been reported, intraprocedural thrombus formation within the left atrial appendage (LAA) during the procedure is rare. A 78-year-old male with persistent AF underwent LAAC under ongoing warfarin and clopidogrel therapy. Intraprocedural transesophageal echocardiography (TEE) demonstrated markedly reduced LAA flow with spontaneous echo contrast and sludge, which transiently resolved after isoproterenol administration. Device deployment required multiple recaptures and repeated repositioning due to difficulty in achieving stable anchoring. During these manipulations, a 14-mm mobile thrombus developed within the LAA, despite the activated clotting time being maintained above 300 s, which prompted immediate termination of the procedure. The patient experienced no post-procedural neurological deficits, and follow-up TEE on day 4 confirmed complete thrombus resolution. Contributing factors to intraprocedural LAA thrombus formation were considered to include severely reduced LAA flow, repeated device manipulation, and transient procedural bradycardia. Early recognition through continuous TEE monitoring was critical for preventing embolic complications.</div></div><div><h3>Learning objective</h3><div>Intraprocedural thrombus formation within the left atrial appendage (LAA) during LAA closure can occur even under adequate anticoagulation.</div><div>Potential contributing factors include reduced LAA flow, repeated device manipulation, and transient bradycardia, which may synergistically promote acute thrombus formation.</div><div>Continuous intraprocedural transesophageal echocardiographic surveillance is essential for early detection and timely termination of the procedure to prevent embolic complications.</div></div>","PeriodicalId":52092,"journal":{"name":"Journal of Cardiology Cases","volume":"34 3","pages":"Pages 93-97"},"PeriodicalIF":0.0,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148859383","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}

{"title":"Tricuspid accessory valve–induced hemodynamic deterioration in a Noonan syndrome neonate with myocardial hypertrophy","authors":"Asuka Miyamae MD,&nbsp;Keijiro Ibuki MD, PhD,&nbsp;Shinya Takarada MD, PhD,&nbsp;Mako Okabe MD, PhD,&nbsp;Hideyuki Nakaoka MD, PhD,&nbsp;Masaya Aoki MD, PhD,&nbsp;Sayaka Ozawa MD, PhD,&nbsp;Naoki Yoshimura MD, PhD,&nbsp;Keiichi Hirono MD, PhD","doi":"10.1016/j.jccase.2026.05.012","DOIUrl":"10.1016/j.jccase.2026.05.012","url":null,"abstract":"<div><div>While accessory mitral valves have been reported in association with ventricular outflow obstruction of Noonan syndrome, accessory tricuspid valves remain extremely rare. To the best of our knowledge, this is the first well-documented case report of this unique combination. We report a 2-month-old male infant with myocardial hypertrophy, who presented with progressive right ventricular outflow tract obstruction (RVOTO) caused by accessory tricuspid valve tissue. At referral, echocardiography revealed severe RVOTO due to the prolapse of accessory tricuspid valve tissue during systole. Cardiac catheterization revealed suprasystemic right ventricular pressure. Surgical resection of the accessory tissue led to immediate resolution of the RVOTO. Postoperatively, the patient was successfully managed with beta-blockers and discharged in stable condition. Although the combination of myocardial hypertrophy and accessory tricuspid valve tissue is rare, clinicians should be aware that it may lead to dynamic and potentially life-threatening hemodynamic deterioration due to RVOTO.</div></div><div><h3>Learning objective</h3><div>In neonates with Noonan syndrome, an accessory tricuspid valve leaflet can cause right ventricular outflow tract obstruction, and early surgical resection can prevent fatal hemodynamic deterioration.</div></div>","PeriodicalId":52092,"journal":{"name":"Journal of Cardiology Cases","volume":"34 3","pages":"Pages 114-116"},"PeriodicalIF":0.0,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148859549","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":"Pacing cessation just before generator replacement - A life-threatening consequence of pacemaker battery depletion: A case report","authors":"Ryoto Mitsumizo MD,&nbsp;Yusuke Takahara MD, PhD,&nbsp;Hiroshi Ikuta MD,&nbsp;Ryota Komoto CE,&nbsp;Ryuichi Matsukawa MD, PhD, FJCC,&nbsp;Keita Inanaga MD, PhD,&nbsp;Jun-ichiro Nishi MD, PhD","doi":"10.1016/j.jccase.2026.04.005","DOIUrl":"10.1016/j.jccase.2026.04.005","url":null,"abstract":"<div><div>We report the case of a 77-year-old man who underwent single-chamber pacemaker implantation 16 years prior. The patient, who did not utilize remote monitoring, was lost to follow-up 14 years after the implantation, leading to profound battery depletion. This lack of surveillance resulted in a critical reduction of the pacing rate to 14 ppm, culminating in the complete cessation of pacing immediately before generator replacement. Despite the Abbott device's specified End-of-Life (EOL) safety mechanism, pacing function failed entirely—a rare but life-threatening complication. Uniquely, this case provides serial electrocardiographic documentation capturing the full progression of severe battery depletion. These findings underscore that continuous follow-up and remote monitoring, as emphasized in recent guidelines, are pivotal for preventing such critical outcomes.</div></div><div><h3>Learning objective</h3><div>This case highlights the potential for profound pacemaker rate reduction and complete pacing cessation beyond manufacturer-defined End-of-Life settings in the setting of extreme battery depletion. It emphasizes the importance of regular device follow-up, timely generator replacement, and the use of remote monitoring to detect critical battery status changes and prevent life-threatening complications during pacemaker management.</div></div>","PeriodicalId":52092,"journal":{"name":"Journal of Cardiology Cases","volume":"34 2","pages":"Pages 67-70"},"PeriodicalIF":0.0,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148660721","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":"Early device-related thrombosis after WATCHMAN™ FLX Pro implantation requiring surgical excision in essential thrombocythemia","authors":"Kota Nakatsuji MD,&nbsp;Kenzaburo Nakajima MD, PhD,&nbsp;Akinori Wakamiya MD, PhD,&nbsp;Ryoma Inui MD,&nbsp;Masayuki Shiozawa MD,&nbsp;Takashi Kakuta MD, PhD,&nbsp;Kisaki Amemiya MD, PhD,&nbsp;Hideaki Kanzaki MD, PhD, FJCC,&nbsp;Yoshihiko Ikeda MD, PhD,&nbsp;Masatoshi Koga MD, PhD,&nbsp;Satsuki Fukushima MD, PhD,&nbsp;Kengo Kusano MD, PhD, FJCC","doi":"10.1016/j.jccase.2026.05.007","DOIUrl":"10.1016/j.jccase.2026.05.007","url":null,"abstract":"<div><div>Left atrial appendage occlusion is an alternative therapy to oral anticoagulation for patients with non-valvular atrial fibrillation. Despite design refinements, device-related thrombus (DRT) remains a clinical concern, even with the latest WATCHMAN FLX Pro device (Boston Scientific, Marlborough, MA, USA). We report a case of surgical removal of the WATCHMAN FLX Pro device due to DRT. Despite appropriate antithrombotic therapy, a 77-year-old patient developed DRT leading to cardioembolic cerebral infarction. The thrombus was initially small and nonmobile but rapidly progressed over 45 days to a large, pedunculated, highly mobile thrombus with minimum attachment to the device, necessitating urgent surgical intervention. Subsequent hematologic evaluation revealed previously unrecognized essential thrombocythemia as the underlying prothrombotic condition. This case demonstrates that DRT can occur in patients with unrecognized prothrombotic conditions. Preprocedural thrombophilia screening should be considered in patients with suggestive clinical or laboratory findings, such as unexplained thrombocytosis, along with careful post implantation monitoring.</div></div><div><h3>Learning objectives</h3><div><ul><li><span>•</span><span><div>Preprocedural evaluation for underlying prothrombotic disorders, including essential thrombocythemia, should be considered in patients with suggestive clinical or laboratory findings, such as ischemic stroke despite adequate anticoagulation or unexplained thrombocytosis.</div></span></li><li><span>•</span><span><div>Careful post-procedural monitoring is essential, as initially low-risk device-related thrombus may progress rapidly to high-risk forms requiring surgical intervention.</div></span></li></ul></div></div>","PeriodicalId":52092,"journal":{"name":"Journal of Cardiology Cases","volume":"34 2","pages":"Pages 71-75"},"PeriodicalIF":0.0,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148660479","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":"Titanium hypersensitivity as a partial cause of arm swelling after pacemaker implantation","authors":"Naoshi Ito MD,&nbsp;Shusuke Yagi MD, PhD, FJCC","doi":"10.1016/j.jccase.2026.05.003","DOIUrl":"10.1016/j.jccase.2026.05.003","url":null,"abstract":"","PeriodicalId":52092,"journal":{"name":"Journal of Cardiology Cases","volume":"34 2","pages":"Page 91"},"PeriodicalIF":0.0,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148660859","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}

{"title":"Repeated epicardial lead dislodgement in a child with trisomy 21 and complete atrioventricular block: A case report","authors":"Tatsunori Itabashi MD,&nbsp;Ayako Chida-Nagai MD, PhD,&nbsp;Yuto Suzuki MD,&nbsp;Daisuke Sasaki MD, PhD,&nbsp;Jiro Abe MD, PhD,&nbsp;Nobuyasu Kato MD, PhD,&nbsp;Taro Temma MD, PhD,&nbsp;Hirokuni Yamazawa MD, PhD,&nbsp;Atsuhito Takeda MD, PhD","doi":"10.1016/j.jccase.2026.04.002","DOIUrl":"10.1016/j.jccase.2026.04.002","url":null,"abstract":"<div><div>Lead dislodgement is a rare complication of epicardial leads, which are generally chosen for pacemaker implantation in pediatric patients. Here, we report the case of a 12-year-old girl with trisomy 21 and a complete atrioventricular septal defect. The patient required epicardial pacemaker implantation; however, the epicardial left ventricular lead unexpectedly dislodged twice. This report discusses the potential causes and outlines our management strategy.</div></div><div><h3>Learning objective</h3><div>Age, body size, growth-related changes, lifestyle, and durability complicate pacemaker implantation in children. Therefore, epicardial leads are commonly used for pacemaker implantation. Epicardial leads are not limited by body size or disease, and venous obstruction is not an issue; however, they are more invasive. Pacemaker implantation in pediatric patients with congenital heart disease requires meticulous consideration of patient-specific anatomical and physiological factors. Careful preoperative discussions among pediatric and adult cardiology teams, as well as cardiovascular surgery teams, are essential to optimize patient outcomes.</div></div>","PeriodicalId":52092,"journal":{"name":"Journal of Cardiology Cases","volume":"34 2","pages":"Pages 46-48"},"PeriodicalIF":0.0,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148660860","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}

{"title":"Effects of Impella support level on coronary blood flow velocity measured by transthoracic Doppler echocardiography","authors":"Nobutaka Wakasa MSc,&nbsp;Shiho Ono,&nbsp;Kyoko Sakae,&nbsp;Mariko Isezawa,&nbsp;Yoshihisa Kanaji MD, PhD,&nbsp;Eisuke Usui MD, PhD,&nbsp;Hiroki Ueno MD,&nbsp;Tsunekazu Kakuta MD, PhD","doi":"10.1016/j.jccase.2026.04.009","DOIUrl":"10.1016/j.jccase.2026.04.009","url":null,"abstract":"<div><div>Previous invasive studies on the Impella device (Abiomed, Danvers, MA, USA) have reported that its effect increases coronary artery perfusion. However, non-invasive evaluation using transthoracic Doppler echocardiography (TTDE) remains limited. We assessed the effects of different Impella support levels on coronary blood flow velocity using TTDE in four patients: two with ST-elevation myocardial infarction (STEMI), one with acute myocarditis, and one with myocardial infarction with non-obstructive coronary arteries (MINOCA) due to coronary spasm. The peak diastolic flow velocity (DPV) at the distal left anterior descending artery was measured for a surrogate of coronary blood flow at various Impella flow settings. In STEMI patients, DPV decreased in parallel with stepwise reductions in Impella support levels. In contrast, patients with acute myocarditis and MINOCA exhibited no significant DPV changes despite adjustments in support levels. These findings suggest that the impact of Impella on coronary flow velocity varies according to underlying disease pathology. In STEMI patients post-percutaneous coronary intervention, Impella-induced left ventricular unloading appears to enhance coronary perfusion, while in cases of myocarditis and MINOCA, microvascular dysfunction and other pathophysiological factors may limit this effect.</div></div><div><h3>Learning objectives</h3><div>This non-invasive evaluation used transthoracic Doppler echocardiography to assess the effect of Impella on coronary flow, revealing disease-specific differences. Patients with extensive anterior ST-elevation myocardial infarction showed a support-level-dependent increase in left anterior descending artery flow velocity. In contrast, those with acute myocarditis and myocardial infarction with non-obstructive coronary arteries showed no consistent changes. This suggests the beneficial effect may be dependent on the underlying pathology.</div></div>","PeriodicalId":52092,"journal":{"name":"Journal of Cardiology Cases","volume":"34 2","pages":"Pages 54-57"},"PeriodicalIF":0.0,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148660476","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}

{"title":"Usefulness and safety of trans-radial endovascular therapy for puncture-site bleeding in a patient with acute coronary syndrome requiring mechanical circulatory support","authors":"Yutaro Nakano MD,&nbsp;Yusuke Sato MD, PhD,&nbsp;Tatsuhiro Kataoka MD, PhD,&nbsp;Hiroyuki Ikeda MD, PhD,&nbsp;Hiroshi Tada MD, PhD, FJCC","doi":"10.1016/j.jccase.2026.05.008","DOIUrl":"10.1016/j.jccase.2026.05.008","url":null,"abstract":"<div><div>A 66-year-old man with acute coronary syndrome underwent emergency percutaneous coronary intervention (PCI) using Impella CP (Abiomed, Danvers, MA, USA) via the left common femoral artery (CFA). After PCI, he experienced shock and severe anemia. A computed tomography scan revealed a large retroperitoneal hematoma caused by femoral puncture-site bleeding. He was in hemorrhage and cardiogenic shock, so we needed to achieve hemostasis without removing Impella CP. We performed endovascular therapy (EVT) through the radial artery system. Angiography showed ongoing bleeding in the left CFA. Initially, we attempted balloon tamponade with an 8-mm semi-compliant balloon, but this was unsuccessful. We then performed percutaneous thrombin injections combined with balloon tamponade. Ultimately, we achieved hemostasis at the puncture site. Our case suggests that trans-radial EVT combined with percutaneous thrombin injection is a useful and safe method for controlling femoral puncture-site bleeding.</div></div><div><h3>Learning objective</h3><div>Trans-radial endovascular therapy combined with percutaneous thrombin injection is a useful and safe method for controlling femoral puncture-site bleeding, even in patients requiring mechanical circulatory support.</div></div>","PeriodicalId":52092,"journal":{"name":"Journal of Cardiology Cases","volume":"34 2","pages":"Pages 76-78"},"PeriodicalIF":0.0,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148660857","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":"Septic embolization without visible vegetations: The challenges of image-negative endocarditis or severe disseminated bacteremia","authors":"Bárbara Lage Garcia MD,&nbsp;Emídio Mata MD,&nbsp;André Pereira MD,&nbsp;Flávia Santos MD,&nbsp;Carlos Fernandes MD","doi":"10.1016/j.jccase.2026.04.008","DOIUrl":"10.1016/j.jccase.2026.04.008","url":null,"abstract":"<div><div>Infective endocarditis remains a life-threatening condition with high morbidity and mortality, particularly when caused by methicillin-sensitive <em>Staphylococcus aureus.</em> Early diagnosis is essential yet often challenging, especially when typical valvular vegetations are absent.</div><div>We present the case of a 41-year-old man with methicillin-sensitive <em>S. aureus</em> bacteremia, complicated by retropharyngeal abscess, pyomyositis, empyema, and septic lung embolization. Multiple peripheral stigmata, including Osler nodes, Janeway lesions, and splinter hemorrhages fulfilled the modified Duke criteria for definite endocarditis, despite no imaging evidence of vegetations, in repeated echocardiograms, as well as fluorine-18 fluorodeoxyglucose positron emission tomography/computed tomography scan. Early antibiotic therapy and drainage of empyema and leg abscess led to a full recovery. This case illustrates the diagnostic limitations of imaging in native valve endocarditis, where small or mural vegetations may be overlooked. It underscores the critical role of clinical judgment in managing bacteremia with systemic involvement, ensuring timely and appropriate treatment despite negative imaging.</div></div><div><h3>Learning objective</h3><div>Infective endocarditis may be present despite the absence of vegetations on echocardiography or positron emission tomography imaging. The diagnosis must integrate microbiological results and clinical findings, such as peripheral stigmata such as Osler nodes and Janeway lesions. This case emphasizes the limitations of imaging, the continued value of bedside examination, and the importance of applying the modified Duke criteria to ensure timely recognition and treatment of endocarditis.</div></div>","PeriodicalId":52092,"journal":{"name":"Journal of Cardiology Cases","volume":"34 2","pages":"Pages 49-53"},"PeriodicalIF":0.0,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148660475","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}

{"title":"Primary cardiac lymphoma in internal septum to left atrium with progressive heart failure in which cardiac magnetic resonance imaging led to the diagnosis: case report","authors":"Motohiro Shingu MD,&nbsp;Tatsuya Nishikawa MD, PhD,&nbsp;Masahiro Yamada MD,&nbsp;Yuya Ohga MD,&nbsp;Hibiki Kadohara MD,&nbsp;Yuto Osumi MD, PhD,&nbsp;Kenta Ishibashi MD,&nbsp;Mana Hiraishi MD,&nbsp;Mitsuo Kinugasa MD, PhD,&nbsp;Yasutaka Hirayama MD,&nbsp;Kinta Hatakeyama MD, PhD,&nbsp;Koichi Tamita MD, PhD, FJCC","doi":"10.1016/j.jccase.2026.04.007","DOIUrl":"10.1016/j.jccase.2026.04.007","url":null,"abstract":"<div><div>Primary cardiac lymphoma is an uncommon malignancy that usually affects the right atrium. We report a rare case of diffuse large B-cell lymphoma involving the interatrial septum and posterior wall of the left atrium in a 74-year-old woman who presented with chest pain and complete atrioventricular block accompanied by therapy-resistant heart failure. Results using conventional diagnostic tools including echocardiography and computed tomography were unclear, but there was moderate pericardial effusion. Despite standard heart failure therapy, symptoms progressed, so we performed cardiac magnetic resonance imaging (CMR) to exclude myocarditis. Unexpectedly, CMR showed a mass that was infiltrating the interatrial septum and the adjacent left ventricular wall, but the coronary artery structure was basically unaffected. Gallium-67 scintigraphy confirmed cardiac localization, and surgical biopsy established the diagnosis of diffuse large B-cell lymphoma. The clinical course was complicated by progressive heart failure and sepsis, and the patient was transferred for hematologic treatment. This case highlights the diagnostic value of CMR in detecting atypical primary cardiac lymphoma and delineating myocardial infiltration. In patients with unexplained heart failure and conduction abnormalities, CMR should be promptly considered to guide appropriate management and to improve outcomes.</div></div><div><h3>Learning objective</h3><div>Primary cardiac lymphoma may present with atypical localization, including the interatrial septum, the posterior wall of the left atrium, and the basal left ventricular septum, which could cause progressive heart failure and atrioventricular block. We found cardiac magnetic resonance imaging to be especially helpful in this case for detecting cardiac tumors and myocardial infiltration. Early consideration of cardiac malignancy in unexplained conduction disturbance and refractory heart failure was helpful in diagnosis and management of our patient.</div></div>","PeriodicalId":52092,"journal":{"name":"Journal of Cardiology Cases","volume":"34 2","pages":"Pages 58-62"},"PeriodicalIF":0.0,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148660477","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}