Journal of Cardiology Cases最新文献

{"title":"Hemorrhaged left atrial myxoma presenting with acute heart failure: A case report","authors":"Hitoshi Nakanowatari MD,&nbsp;Keiichi Ishida MD,&nbsp;Ikuko Shibasaki MD, PhD,&nbsp;Shigeyuki Asano MD, PhD,&nbsp;Yoshihito Irie MD, PhD","doi":"10.1016/j.jccase.2026.04.006","DOIUrl":"10.1016/j.jccase.2026.04.006","url":null,"abstract":"<div><div>Left atrial myxoma is the most common primary cardiac tumor, although intratumoral hemorrhage remains exceedingly rare. We recently treated a 55-year-old man with a 37-year smoking history who presented with progressive dyspnea and leg edema caused by acute heart failure. Echocardiography revealed a large, pedunculated left atrial mass (54 × 27 mm) protruding into the left ventricle during diastole, causing functional mitral stenosis, as well as moderate mitral and tricuspid regurgitation. Contrast-enhanced computed tomography revealed a 30 × 46 mm intracardiac mass without definite feeding vessels or signs of hemorrhage. The patient underwent semi-urgent surgery 1 week after diagnosis, with complete tumor excision and concomitant mitral and tricuspid annuloplasty. Histopathological examination revealed a 5.5 cm myxoid tumor containing multiple intratumoral hemorrhagic foci with hemosiderin deposition, consistent with hemorrhagic myxoma. The postoperative course was uneventful. Intratumoral bleeding within a myxoma may result from rupture of fragile neovessels, potentially leading to sudden enlargement and mitral inflow obstruction. Awareness of this rare condition is essential for timely clinical recognition and appropriate surgical decision-making in patients with deteriorating left atrial myxoma.</div></div><div><h3>Learning objective</h3><div>To highlight that intratumoral hemorrhage in left atrial myxoma, although rare, can cause rapid tumor enlargement and acute mitral inflow obstruction. Recognition of early symptoms, such as unexplained cough and dyspnea, may facilitate timely diagnosis and prompt surgical intervention.</div></div>","PeriodicalId":52092,"journal":{"name":"Journal of Cardiology Cases","volume":"34 2","pages":"Pages 63-66"},"PeriodicalIF":0.0,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148660478","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":"A successful case of revascularization with a hybrid intervention for Leriche syndrome combined with bilateral femoropopliteal occlusive disease","authors":"Nobuo Ishiguro MD,&nbsp;Akimitsu Tanaka MD,&nbsp;Kazuo Kato MD, PhD,&nbsp;Takeki Ohashi MD","doi":"10.1016/j.jccase.2026.05.001","DOIUrl":"10.1016/j.jccase.2026.05.001","url":null,"abstract":"<div><div>Leriche syndrome (LS) is an aortoiliac occlusive disease (AIOD) characterized by claudication, decreased femoral pulses, and erectile dysfunction. We present an LS case with bilateral femoropopliteal occlusive disease (FPOD) considered untreatable with surgery or endovascular therapy alone but successfully revascularized via hybrid intervention (HI). An 84-year-old woman with a history of LS was admitted to our hospital with rest pain in the right leg, and coldness and numbness in the left leg. The ankle–brachial index (ABI) indicated severe bilateral amplitude reduction and pulse elongation. Computed tomography angiography revealed occlusion of the terminal aorta, bilateral common iliac artery to external iliac artery, common femoral artery to superficial femoral artery, and right popliteal artery with poor run-off. We initially decided to perform HI only on the right lower extremity. Easy guidewire passage through the occluded lesion suggested a primarily thrombotic nature. HI using Fogarty arterial thrombectomy was eventually performed for the bilateral lower extremities. Complete revascularization was achieved using covered and self-expanding stents for aortoiliac lesions, and drug-eluting stent deployment and drug-coated balloon angioplasty for FPOD. The post-operative ABI was elevated, and symptoms improved bilaterally. This HI is highly effective for treating AIOD combined with bilateral FPOD involving thrombotic lesions.</div></div><div><h3>Learning objective</h3><div>Aortoiliac occlusive disease (AIOD) with bilateral femoropopliteal occlusive disease was considered difficult to treat with surgery or endovascular therapy (EVT) alone. Hybrid interventions are ideal for patients with AIOD with extension to the common femoral artery or superficial femoral artery, especially involving thrombotic lesions. This procedure achieves good results that cannot be obtained by surgery or EVT alone.</div></div>","PeriodicalId":52092,"journal":{"name":"Journal of Cardiology Cases","volume":"34 2","pages":"Pages 79-82"},"PeriodicalIF":0.0,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148660862","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":"Transcatheter bi-caval valve implantation in a post-pacemaker patient with severe tricuspid regurgitation: A case report","authors":"Rajesh Vijayvergiya DM,&nbsp;Arghadip Bose DM,&nbsp;Basant Kumar DM,&nbsp;Anirudh Mukherjee DM","doi":"10.1016/j.jccase.2026.05.010","DOIUrl":"10.1016/j.jccase.2026.05.010","url":null,"abstract":"<div><div>Severe tricuspid regurgitation (TR) presents a significant clinical challenge in patients deemed unsuitable for conventional surgical intervention. This case describes a 60-year-old woman with torrential TR and intractable ascites with a dual-chamber pacemaker in situ who presented with refractory right heart failure unresponsive to maximal medical therapy. Transcatheter bicaval valve implantation was performed with computed tomography guidance, deploying 29-mm and 35-mm self-expanding nitinol-pericardial valves in the superior and inferior vena cavae. At six-month follow-up, the patient demonstrated marked clinical improvement with substantial reduction in ascites and resolution of venous congestion, establishing bicaval valve implantation as an effective palliative strategy for alleviating systemic venous hypertension in high-risk patients with end-stage TR and prohibitive surgical risk, despite limited right ventricular structural recovery.</div></div><div><h3>Learning objective</h3><div><ul><li><span>1)</span><span><div>To recognize the clinical presentation, hemodynamic findings, and diagnostic features of severe, symptomatic tricuspid regurgitation.</div></span></li><li><span>2)</span><span><div>To understand the anatomic and hemodynamic principles underlying transcatheter heterotopic bicaval valve implantation (CAVI) as a palliative strategy in patients with advanced right heart remodeling and prohibitive surgical risk.</div></span></li><li><span>3)</span><span><div>To understand the short- and medium-term symptomatic and hemodynamic outcomes of CAVI.</div></span></li></ul></div></div>","PeriodicalId":52092,"journal":{"name":"Journal of Cardiology Cases","volume":"34 2","pages":"Pages 87-90"},"PeriodicalIF":0.0,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148660858","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":"Bilateral coronary-pulmonary artery fistulas presenting with new-onset heart failure and pulmonary hypertension","authors":"Daniel Duque-Restrepo MD,&nbsp;Paula Eliana Ramírez-Arboleda MD,&nbsp;José Julián Escobar-Matallana,&nbsp;Clara Saldarriaga-Giraldo","doi":"10.1016/j.jccase.2026.04.001","DOIUrl":"10.1016/j.jccase.2026.04.001","url":null,"abstract":"<div><div>Coronary artery fistulas are rare abnormalities that may lead to significant hemodynamic consequences, including heart failure and pulmonary hypertension. A healthy 58-year-old male presented with one month of moderate dyspnea, chest pain, and palpitations. Echocardiography showed severe eccentric left ventricular hypertrophy and reduced ejection fraction of 22%. Left and right heart catheterization revealed large tortuous vessels arising from the left anterior descending and right coronary arteries, both draining into the pulmonary artery, as well as elevated pulmonary capillary wedge pressure. Coronary computed tomography confirmed bilateral coronary-to-pulmonary artery fistulas. The patient underwent successful surgical closure of the fistulas and pulmonary artery reconstruction. At four-month follow-up, left ventricular ejection fraction had improved to 33%, and pulmonary hypertension probability was low. In conclusion, bilateral coronary-to-pulmonary artery fistulas are rare and can present with heart failure symptoms in adulthood. Surgical management remains a definitive treatment when percutaneous options are high risk.</div></div><div><h3>Learning objective</h3><div>To recognize bilateral coronary–pulmonary artery fistulas as a rare cause of heart failure with variable presentation. To understand the importance of multimodality imaging (echocardiography, coronary angiography, and computed coronary tomography) in defining anatomy and hemodynamic significance. To discuss management strategies, emphasizing surgical closure as a safe option in complex anatomies. To highlight the need for early diagnosis and timely intervention to prevent ventricular remodeling, preserve cardiac function, and improve long-term outcomes.</div></div>","PeriodicalId":52092,"journal":{"name":"Journal of Cardiology Cases","volume":"34 2","pages":"Pages 43-45"},"PeriodicalIF":0.0,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148660861","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–associated coronary vasospasm with takotsubo-like myocardial dysfunction: A case report","authors":"Keisho Kurokawa MD,&nbsp;Toru Miyoshi MD,&nbsp;Yasuhisa Nakao MD, PhD,&nbsp;Shigehiro Miyazaki MD,&nbsp;Tomoki Fujisawa MD,&nbsp;Yusuke Akazawa MD,&nbsp;Akinori Higaki MD, PhD,&nbsp;Hiroshi Kawakami MD, PhD, FJCC,&nbsp;Haruhiko Higashi MD, PhD,&nbsp;Shunsuke Tamaki MD, PhD, FJCC,&nbsp;Kazuhisa Nishimura MD, PhD,&nbsp;Katsuji Inoue MD, PhD, FJCC,&nbsp;Shuntaro Ikeda MD, PhD, FJCC,&nbsp;Osamu Yamaguchi MD, PhD, FJCC","doi":"10.1016/j.jccase.2026.05.004","DOIUrl":"10.1016/j.jccase.2026.05.004","url":null,"abstract":"<div><div>Fluorouracil (5-FU) is frequently used in chemotherapy for several cancers, but adverse effects such as electrocardiography (ECG) ST-T changes and vascular spasms have been reported. Here, we present a case in which 5-FU triggered coronary vasospastic angina and takotsubo syndrome. A 65-year-old woman was admitted to our hospital for treatment of esophageal adenocarcinoma and initiated on 5-FU, leucovorin, and oxaliplatin. Three days after administration, she experienced chest pain that resolved spontaneously. On the fifth day, she was referred to our department. ECG showed ST-segment elevation in leads II, III, and aV_F, with T-wave inversion in leads I, aV_L, and V_1–6. Echocardiography revealed wall motion abnormalities predominantly at the apex. Cardiac computed tomography showed no significant coronary artery stenosis. An acetylcholine provocation test was performed, revealing multi-vessel spasm, leading to a diagnosis of coronary vasospastic angina. Coronary vasodilators were initiated, and the chemotherapy regimen was changed to discontinue 5-FU. The patient experienced no recurrence of chest pain, and improvements were observed in both echocardiographic and ECG findings. Reports of takotsubo syndrome caused by 5-FU are rare, and its mechanism remains unclear. In this case, the presence of coronary vasospastic angina suggests that it may have contributed to the development of takotsubo syndrome.</div></div><div><h3>Learning objective</h3><div>5-Fluorouracil (5-FU) is commonly used for various cancers. 5-FU has been reported to cause side effects such as chest pain, changes in the electrocardiogram, and coronary spastic angina. We experienced vasospastic coronary angina and takotsubo syndrome induced by 5-FU. The mechanism of takotsubo syndrome may be related to ischemia caused by coronary spasm.</div></div>","PeriodicalId":52092,"journal":{"name":"Journal of Cardiology Cases","volume":"34 2","pages":"Pages 83-86"},"PeriodicalIF":0.0,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148660863","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":"Acute ischemic stroke during TAVI promptly managed with mechanical thrombectomy: the importance of peripheral interventional skills and multidisciplinary collaboration","authors":"Marcello Marchetta MD,&nbsp;Giulio Russo MD, PhD,&nbsp;Gianluca Massaro MD, PhD,&nbsp;Maria Crapanzano MD,&nbsp;Daniela Benedetto MD, PhD,&nbsp;Giuseppe Massimo Sangiorgi MD, PhD","doi":"10.1016/j.jccase.2026.03.012","DOIUrl":"10.1016/j.jccase.2026.03.012","url":null,"abstract":"<div><div>Transcatheter aortic valve implantation (TAVI) carries a small but serious risk of periprocedural stroke. Prompt recognition and rapid management are essential to prevent permanent neurological injury. We describe an acute ischemic stroke occurring during TAVI for bicuspid aortic stenosis, immediately identified by the interventional cardiologist through carotid angiography. The patient developed sudden left hemibody weakness and aphasia after balloon predilatation, and angiography revealed an occlusion of the right middle cerebral artery (M1). While maintaining hemodynamic stability with valve implantation, the operator restored partial flow in the ophthalmic artery and activated the stroke team. Mechanical thrombectomy was rapidly performed using an aspiration catheter, achieving complete recanalization, with a modified Thrombolysis in Cerebral Infarction grade 3 within 30 min of symptom onset. Post-procedural imaging confirmed the absence of hemorrhage, and neurological deficits improved markedly. This case highlights how immediate in-laboratory carotid angiography performed by the structural interventional cardiologist can significantly shorten the diagnostic-to-reperfusion interval and facilitate ultra-rapid multidisciplinary rescue in periprocedural stroke.</div></div><div><h3>Learning objective</h3><div>Immediate in-laboratory carotid angiography by the structural operator may significantly shorten time-to-reperfusion in periprocedural stroke. Peripheral interventional skills are essential for structural cardiologists, enabling them to promptly recognize and address extracardiac complications. Multidisciplinary collaboration between interventional cardiologists, neurologists, and interventional radiologists is vital to achieve optimal outcomes in life-threatening complications. The absence of cerebral embolic protection did not compromise the outcome, consistent with recent randomized evidence showing no significant reduction in clinical stroke with routine use of protection devices.</div></div>","PeriodicalId":52092,"journal":{"name":"Journal of Cardiology Cases","volume":"34 1","pages":"Pages 25-27"},"PeriodicalIF":0.0,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13326234/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148377847","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":"Cardiac resynchronization therapy and transvenous lead extraction via an isolated subaortic left brachiocephalic vein","authors":"Yasushi Wakabayashi MD,&nbsp;Morio Shoda MD, PhD,&nbsp;Masanori Kobayashi MD,&nbsp;Tomohide Ichikawa MD, PhD,&nbsp;Takashi Koyama MD, PhD, FJCC,&nbsp;Hidetoshi Abe MD, PhD","doi":"10.1016/j.jccase.2026.03.008","DOIUrl":"10.1016/j.jccase.2026.03.008","url":null,"abstract":"<div><div>The subaortic left brachiocephalic vein is a rare and lesser-known systemic venous anomaly. The vein crosses the subaortic space and joins the lower part of the right brachiocephalic vein to form the superior vena cava. Cardiac or aortic arch anomalies are frequently observed in patients with subaortic left brachiocephalic veins, whereas the incidence of isolated subaortic left brachiocephalic vein was reported to be much lower. We present the case of a 74-year-old man with an isolated subaortic left brachiocephalic vein, who underwent cardiac resynchronization therapy with defibrillator (CRT<img>D) implantation. Subsequently, a transvenous lead extraction was performed 5 years after the implantation because a device infection was observed. These procedures were successful despite the aberrant course of the subaortic left brachiocephalic vein.</div><div>To the best of our knowledge, this is the first report to demonstrate successful CRT-D implantation and transvenous lead extraction in a patient with a subaortic left brachiocephalic vein. This anomaly should be recognized before invasive transvenous procedures because the aberrant course of the left brachiocephalic vein may pose technical difficulties.</div></div><div><h3>Learning objective</h3><div>Left brachiocephalic vein aberrations detected during cardiac implantable electronic device (CIED) implantation or transvenous lead extraction have rarely been described. Such aberrations may result in procedural complexity. If a characteristic venogram of the subaortic left brachiocephalic vein is observed before CIED implantation or transvenous lead extraction, the anomaly should be considered and the procedures should be performed carefully.</div></div>","PeriodicalId":52092,"journal":{"name":"Journal of Cardiology Cases","volume":"34 1","pages":"Pages 1-4"},"PeriodicalIF":0.0,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148377895","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":"High-resolution 8-spline mapping and radiofrequency catheter ablation for middle cardiac vein diverticulum epicardial accessory pathways: Efficacy and safety","authors":"Shuhei Fujita MD, PhD,&nbsp;Yoshikatsu Takeda MD,&nbsp;Akio Chikata MD, PhD,&nbsp;Kazuo Usuda MD, PhD, FJCC","doi":"10.1016/j.jccase.2026.03.010","DOIUrl":"10.1016/j.jccase.2026.03.010","url":null,"abstract":"<div><div>Posteroseptal accessory pathways (APs) often involve epicardial connections, making radiofrequency catheter ablation (RFA) particularly challenging. We present the case of a 14-year-old boy in whom a heart murmur was detected after birth. Echocardiography revealed an isolated ductus arteriosus aneurysm with tricuspid regurgitation, while electrocardiogram (ECG) showed pre-excitation due to an AP. The aneurysm spontaneously closed during infancy. At age 13 years, the patient experienced brief monthly palpitations but did not seek medical treatment. By age 14 years, echocardiography showed reduced cardiac function, and a 12‑lead ECG revealed a posteroseptal AP. Contrast-enhanced computed tomography revealed a small middle cardiac vein (MCV) diverticulum located &gt;5 mm from the right coronary artery. Electrophysiological study (EPS) and RFA were performed to improve cardiac function. Although EPS did not induce atrioventricular reciprocating tachycardia, intracardiac echocardiography and multipolar electrode mapping demonstrated continuous atrioventricular potentials with an AP potential at the MCV diverticulum neck. Low-power radiofrequency energy delivered with a QDOT MICRO™ catheter eliminated AP conduction within 2 s. Follow-up echocardiography confirmed resolution of left ventricular dyssynchrony and improved function. High-resolution electroanatomical mapping enabled precise localization of the AP, and low-power irrigation catheter use provided effective and safe ablation in pediatric posteroseptal AP.</div></div><div><h3>Learning objective</h3><div>The posteroseptal accessory pathway (AP) is a possible epicardial pathway often associated with anatomical abnormalities, such as the coronary sinus diverticula, and radiofrequency catheter ablation (RFA) is technically more challenging in such cases than in other APs. The combined use of a multispline high-resolution electroanatomical mapping catheter and a low-power irrigation catheter enables accurate and safe RFA, even in pediatric patients with an epicardial posteroseptal AP in the middle cardiac vein diverticulum.</div></div>","PeriodicalId":52092,"journal":{"name":"Journal of Cardiology Cases","volume":"34 1","pages":"Pages 19-24"},"PeriodicalIF":0.0,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148377872","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":"High-grade left atrial intimal sarcoma mimicking myxoma: The diagnostic and therapeutic relevance of tumor topography","authors":"Pedro Iturralde-Torres MD,&nbsp;José Antonio Arias-Godínez MD,&nbsp;Mauricio Soulé-Egea MD,&nbsp;Alejandra Iturralde-Chávez MD,&nbsp;Alberto Aranda-Fraustro MD,&nbsp;Santiago Obregón-Rosas MD","doi":"10.1016/j.jccase.2026.03.004","DOIUrl":"10.1016/j.jccase.2026.03.004","url":null,"abstract":"<div><div>Primary cardiac tumors are rare; among them, sarcomas represent an aggressive minority with complex diagnosis and poor prognosis. We report the case of a 45-year-old woman with a history of dysautonomia who presented with progressive dyspnea (New York Heart Association class II–III) and exertional angina. Transthoracic echocardiography revealed a 38 × 27 mm mobile mass in the left atrium, attached to the posterior wall, partially obstructing the mitral inflow tract. A presumptive diagnosis of myxoma was made.</div><div>Intraoperatively, a 5 × 5 cm fibrolipomatous mass infiltrating the posterior atrial wall and pulmonary veins was resected, and structural reconstruction was performed with autologous and bovine pericardial patches. Histopathology showed a high-grade intimal sarcoma, MDM2 and vimentin positive, with a Ki-67 index of 50%.</div><div>Postoperatively, the patient developed persistent sinus node dysfunction requiring permanent pacemaker implantation, and refractory bilateral pleural effusion managed with thoracic drainage. Positron emission tomography-computed tomography showed no metastatic disease but revealed bilateral jugular thrombosis and hepatic congestion. She began chemotherapy (doxorubicin/ifosfamide), but experienced rapid local recurrence and new hepatic metastases. She began second-line therapy with progressive disease.</div><div>This case emphasizes the importance of tumor origin. A posterior infiltrative mass suggests malignancy, and preoperative recognition of this pattern may guide surgical planning and oncologic intervention.</div></div><div><h3>Learning objective</h3><div>This case underscores the importance of correctly identifying intimal sarcomas, often misdiagnosed as undifferentiated pleomorphic sarcomas, to ensure accurate prognosis and management. It demonstrates the diagnostic utility of MDM2 and vimentin, and the value of imaging in suggesting malignancy based on tumor topography—specifically, when arising from the posterior left atrial wall. Recognizing these patterns may help avoid misclassification and guide timely surgical and oncologic decisions.</div></div>","PeriodicalId":52092,"journal":{"name":"Journal of Cardiology Cases","volume":"34 1","pages":"Pages 9-14"},"PeriodicalIF":0.0,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148377918","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":"Clinical and diagnostic challenges in a case of hyperacute left ventricular rupture attributed to takotsubo syndrome","authors":"Sakuya Sudo,&nbsp;Teruhiko Imamura MD, PhD","doi":"10.1016/j.jccase.2026.03.007","DOIUrl":"10.1016/j.jccase.2026.03.007","url":null,"abstract":"","PeriodicalId":52092,"journal":{"name":"Journal of Cardiology Cases","volume":"34 1","pages":"Pages 40-41"},"PeriodicalIF":0.0,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148377860","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}