Journal of Cardiology Cases最新文献

{"title":"Takotsubo syndrome presenting as ventricular fibrillation cardiopulmonary arrest coupled with complete heart block","authors":"Atsuko Hashimoto MD ,&nbsp;Yuki Nishimura MD ,&nbsp;Junya Komatsu MD ,&nbsp;Hiroki Nakayama MD ,&nbsp;Hiroki Sugane MD ,&nbsp;Hayato Hosoda MD ,&nbsp;Koji Nishida MD ,&nbsp;Yoko Nakaoka MD ,&nbsp;Shinji Mito MD ,&nbsp;Ryu-ichiro Imai MD ,&nbsp;Shu-ichi Seki MD ,&nbsp;Sho-ichi Kubokawa MD ,&nbsp;Kazuya Kawai MD, PhD, FJCC ,&nbsp;Naohisa Hamashige MD, PhD ,&nbsp;Yoshinori Doi MD, PhD, FJCC","doi":"10.1016/j.jccase.2025.10.001","DOIUrl":"10.1016/j.jccase.2025.10.001","url":null,"abstract":"<div><div>Life-threatening arrhythmia can occur in patients with takotsubo syndrome (TTS). However, it is unusual for a TTS patient to present with ventricular fibrillation cardiopulmonary arrest (VF-CPA) coupled with complete heart block at the initial presentation. An 83-year-old woman underwent a VF-CPA. After she was successfully defibrillated, her electrocardiogram showed deep T-wave inversions with unusually prolonged QT-intervals (QTc = 0.493) at leads V1-V6 together with complete heart block. Echocardiogram and left ventriculogram showed broad ballooning from the mid left ventricle (LV) to the apex, consistent with TTS. A repeated echocardiogram 11 days after the VF-CPA event showed total recovery of the LV wall motion. She later testified that she had experienced slow pulse rate 3 days prior to the event. In conclusion, TTS presenting as VF-CPA as well as complete heart block is most unusual. As a possible sequence of events, it is postulated that TTS triggered by complete heart block was followed by VF-CPA. Prominent post-TTS QT prolongation, partly influenced by complete heart block, is considered as a possible mechanism for the VF-CPA event in this TTS patient.</div></div><div><h3>Learning objective</h3><div>Although life-threatening arrhythmia can occur in patients with takotsubo syndrome (TTS), a TTS patient presenting with ventricular fibrillation cardiopulmonary arrest (VF-CPA) together with complete heart block is most unusual. Prominent post-TTS QT prolongation, partly influenced by complete heart block, is considered as a possible mechanism for the VF-CPA event in this TTS patient. It is important to recognize that TTS may be at times triggered by complete heart block.</div></div>","PeriodicalId":52092,"journal":{"name":"Journal of Cardiology Cases","volume":"33 1","pages":"Pages 23-26"},"PeriodicalIF":0.0,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145876937","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":"Transcatheter pulmonary valve implantation for re-intervention in recurrent right ventricular outflow tract obstruction","authors":"Babu Ezhumalai MD, DM, FNB ,&nbsp;Arun Arul David MD, DNB ,&nbsp;Praveen Jeya Arulraj MD, DNB ,&nbsp;Muthukumaran Chinnasamy Sivaprakasam MD, DM","doi":"10.1016/j.jccase.2025.09.006","DOIUrl":"10.1016/j.jccase.2025.09.006","url":null,"abstract":"<div><div>Transcatheter pulmonary valve implantation (TPVI) has emerged as a less invasive alternative to surgical conduit replacement in patients with recurrent right ventricular outflow tract (RVOT) obstruction, particularly after repair of tetralogy of Fallot (TOF). We report a case of successful TPVI using a balloon-expandable MyVal transcatheter heart valve in a 58-year-old male with a complex cardiac history, including multiple prior surgeries and interventions for TOF and RVOT re-stenosis. The patient presented with severe symptoms, and multimodality imaging revealed severe right ventricle to pulmonary artery conduit stenosis, right-sided chamber dilation, and moderate biventricular dysfunction. Following thorough pre-procedural planning, TPVI was performed with conduit pre-dilation, deployment of a Cheatham platinum-covered stent to prevent conduit rupture, and implantation of a 23-mm MyVal valve. Post-procedural imaging confirmed optimal valve positioning, elimination of transconduit gradient, and resolution of pulmonary regurgitation. The patient was discharged on dual antiplatelet therapy with significant symptomatic improvement. This case highlights TPVI as a safe and effective re-intervention strategy in anatomically suitable high-risk patients with RVOT conduit dysfunction. While short-term outcomes are favourable, further data are warranted to assess long-term valve durability, particularly with newer valve technologies such as MyVal valve in the pulmonary position.</div></div><div><h3>Learning objectives</h3><div>This case report demonstrates that transcatheter pulmonary valve implantation using a balloon-expandable MyVal valve with covered-stent reinforcement provides a safe, effective, and minimally invasive re-intervention for recurrent right ventricular outflow tract conduit obstruction in complex post-tetralogy of Fallot patients. It underscores the value of meticulous preprocedural imaging, coronary compression testing, and tailored device selection to ensure optimal valve deployment, gradient elimination, and symptomatic improvement, offering a compelling alternative to high-risk redo surgical conduit replacement.</div></div>","PeriodicalId":52092,"journal":{"name":"Journal of Cardiology Cases","volume":"33 1","pages":"Pages 18-22"},"PeriodicalIF":0.0,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145876936","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 fatal case of extensive arteriovenous malformation","authors":"Tomoyuki Watanabe MD, PhD ,&nbsp;Masumi Iwai-Takano MD, PhD, FJCC ,&nbsp;Rei Sekine MD ,&nbsp;Yuko Hashimoto MD, PhD","doi":"10.1016/j.jccase.2025.10.005","DOIUrl":"10.1016/j.jccase.2025.10.005","url":null,"abstract":"<div><div>Arteriovenous malformation (AVM) is a rare congenital vascular anomaly that can progress to severe complications, including high-output heart failure and coagulopathy. We describe an 84-year-old woman with an extensive AVM extending from the right upper limb to the anterior chest. She was admitted with decompensated heart failure and elevated fibrin degradation products. Despite initial improvement, she experienced sudden cardiac arrest on hospital day 13. Resuscitation allowed transient electrocardiographic recording, which showed ST-segment elevation in precordial leads and aVR, suggesting acute coronary syndrome. Autopsy revealed extensive AVM with intralesional thrombi, concentric ventricular hypertrophy, and histological evidence of hyperacute ischemia, but no coronary thrombosis. The findings suggest possible mechanisms including thrombus lysis or distal embolization consistent with myocardial infarction with non-obstructive coronary artery, potentially influenced by AVM-related coagulopathy, as well as the contribution of long-standing pulmonary hypertension. This case underscores the fatal risks of extensive AVM and highlights the importance of recognizing not only heart failure progression but also thromboembolic and pulmonary hypertensive complications, along with consideration of palliative care in advanced disease.</div></div><div><h3>Learning objective</h3><div>Arteriovenous malformation is a rare congenital vascular anomaly that can cause progressive symptoms, including high-output heart failure depending on its size and location. In advanced stage, complications related not only to heart failure but also to coagulation abnormalities should be carefully considered.</div></div>","PeriodicalId":52092,"journal":{"name":"Journal of Cardiology Cases","volume":"33 1","pages":"Pages 27-30"},"PeriodicalIF":0.0,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145877095","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 rare case of left ventricular cardiac rupture in the acute phase of takotsubo syndrome","authors":"Shu Iwata MD,&nbsp;Shoichiro Yatsu MD, PhD,&nbsp;Jun Shitara MD, PhD,&nbsp;Hirohisa Endo MD, PhD,&nbsp;Hideki Wada MD, PhD,&nbsp;Manabu Ogita MD, PhD,&nbsp;Satoru Suwa MD","doi":"10.1016/j.jccase.2025.09.005","DOIUrl":"10.1016/j.jccase.2025.09.005","url":null,"abstract":"<div><div>Takotsubo syndrome (TTS), often triggered by emotional or physical stress, is characterized by transient left ventricular dysfunction that mimics acute coronary syndrome. We present a case involving an 85-year-old woman with a history of atrial fibrillation who developed sudden severe chest pain during sleep. Initial evaluation suggested ST elevation myocardial infarction; however, emergency coronary angiography revealed patent coronary arteries, leading to a diagnosis of TTS. Immediately after angiography, the patient experienced sudden loss of consciousness, which resulted in death with diminished circulating plasma volume. Autopsy confirmed mid-antero-septal wall rupture with massive left pleural thrombus, suggesting cardiac rupture due to TTS as the cause of death. Our case represents a rare case of TTS complicated by cardiac rupture in the ultra-acute phase, highlighting the critical importance of early recognition and urgent intervention in high-risk patients.</div></div><div><h3>Learning objective</h3><div>Takotsubo syndrome (TTS) usually has a favorable prognosis but can cause severe complications such as cardiogenic shock, left ventricular outflow obstruction, and, rarely, cardiac rupture (CR). Although uncommon, CR is life-threatening and requires vigilance in high-risk patients. This case highlights the critical importance of early recognition and urgent intervention in high-risk patients with TTS to prevent catastrophic outcomes.</div></div>","PeriodicalId":52092,"journal":{"name":"Journal of Cardiology Cases","volume":"33 1","pages":"Pages 1-5"},"PeriodicalIF":0.0,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145876931","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":"Long-term follow-up of patients with catecholaminergic polymorphic ventricular tachycardia related to a novel CALM2 variant","authors":"Seiko Ohno MD, PhD ,&nbsp;Koichi Kato MD, PhD ,&nbsp;Megumi Fukuyama MD, PhD ,&nbsp;Keiichi Hirono MD, PhD ,&nbsp;Kunihiro Nishida MD, PhD ,&nbsp;Minoru Horie MD, PhD","doi":"10.1016/j.jccase.2025.09.003","DOIUrl":"10.1016/j.jccase.2025.09.003","url":null,"abstract":"<div><div>Genes encoding calmodulin (<em>CALM1</em>, <em>CALM2</em>, and <em>CALM3</em>) have been recently reported as causative for lethal arrhythmias including catecholaminergic polymorphic ventricular tachycardia (CPVT), especially in severe cases with young onset. Inherited arrhythmias caused by pathogenic variants in calmodulin-related genes are known as calmodulinopathy. Most of the pathogenic variants in calmoduinopathy are de novo ones, which reflect the severe phenotypes of the diseases. We recently identified a novel variant in <em>CALM2</em>, c.188 C&gt;A, p.T63K, by targeted gene sequencing methods in a 42-year-old woman who was asymptomatic and being treated with a beta-blocker. She first experienced syncope during exercise as a 13-year-old, and bidirectional ventricular tachycardia was induced by exercise stress test. She was diagnosed with CPVT, and taking beta-blockers prevented her symptoms. No pathogenic variant was identified in the genetic testing targeted only for <em>RYR2</em> and <em>CASQ2</em> at that time. Here we report on the importance of repeated genetic testing for non-genotyped patients with inherited arrhythmias and the long follow-up of a calmodulinopathy patient with mild phenotype.</div></div><div><h3>Learning objective</h3><div>Genetic testing for inherited arrhythmias has been greatly improved, and many novel causative genes have been identified. If a patient received genetic testing a few decades ago and was non-genotyped, a pathogenic variant might be identified by repeated genetic testing. In addition, some of the calmodulinopathy patients might have milder phenotypes than previously observed.</div></div>","PeriodicalId":52092,"journal":{"name":"Journal of Cardiology Cases","volume":"33 1","pages":"Pages 6-8"},"PeriodicalIF":0.0,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145876932","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":"Total clinical course of left insular stroke-induced bradycardia–tachycardia and takotsubo syndrome: A case report of stroke–heart syndrome","authors":"Keisuke Kawai MD ,&nbsp;Yusuke Kihara MD ,&nbsp;Hajime Iguchi MD ,&nbsp;Masaharu Ishihara MD, FJCC ,&nbsp;Minoru Kishi MD ,&nbsp;Masahide Iwai MD ,&nbsp;Hiroya Sakuramoto MD","doi":"10.1016/j.jccase.2025.09.004","DOIUrl":"10.1016/j.jccase.2025.09.004","url":null,"abstract":"<div><div>We report the total course of left insular stroke-induced bradycardia–tachycardia and takotsubo syndrome in a 71-year-old woman. The patient presented with aphasia and right hemiparesis, and was diagnosed with acute stroke involving the left insular cortex. Eight hours after admission, she exhibited bradycardia–tachycardia syndrome with atrial fibrillation. On day 2 of hospitalization, T-wave inversions of the electrocardiogram were first observed, and echocardiography revealed reduced contraction exclusively at the left ventricular apex, which disappeared on day 35. The T-wave inversion deepened twice afterward. On days 10 and 12 of hospitalization, she experienced asystole episodes of 10.9 and 10.6 s, respectively, without losing consciousness. After day 22, her heart rate never dropped below 40 beats/min during admission. The patient's heart rate remained above 50 beats/min for 21 months after hospital discharge.</div></div><div><h3>Learning objective</h3><div>A left insular stroke can induce bradycardia–tachycardia syndrome, and the time to resolution of the conduction disturbance was 22 days after the initial stroke event. Given the delayed recovery of the cardiac conduction system in stroke-induced bradycardia, there may be unnecessary device implantations. In hemodynamically stable patients with bradycardia due to insular stroke, it may be advisable to wait longer before implanting a permanent pacemaker.</div></div>","PeriodicalId":52092,"journal":{"name":"Journal of Cardiology Cases","volume":"33 1","pages":"Pages 9-12"},"PeriodicalIF":0.0,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145876933","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":"Multidisciplinary care and advanced therapeutics in end-stage heart failure: A case report","authors":"Takehiro Ishimaru MD ,&nbsp;Masahiro Yamamoto MD, PhD ,&nbsp;Atsushi Nozuhara MD ,&nbsp;Tomoko Matsuda AS, RN ,&nbsp;Chikage Kiyofuji MD ,&nbsp;Kenichi Tsujita MD, PhD, FJCC","doi":"10.1016/j.jccase.2025.09.002","DOIUrl":"10.1016/j.jccase.2025.09.002","url":null,"abstract":"<div><div>The patient was a 72-year-old woman diagnosed with dilated-phase hypertrophic cardiomyopathy at age 60 years. At the age of 67 years, the patient began to experience recurrent heart failure (HF) that required frequent hospital admissions, and at the age of 71 years, home-based dobutamine (DOB) infusions were initiated, which reduced the number of HF-related hospitalizations. Two months prior to the patient's death, she was admitted for a compression fracture of the lumbar spine and congestive HF. Despite continued DOB (3 μg/mL/min) infusions, her health deteriorated progressively because of back pain and worsening HF. The fentanyl patch was ineffective in treating the pain, prompting the initiation of a subcutaneous morphine injections, which provided significant relief. The patient's condition improved, and she was discharged 3 days after the discontinuation of morphine; however, she was readmitted 2 days later with symptoms related to low cardiac output. As subcutaneous morphine induced nausea as a side effect, a combination of morphine and haloperidol was administered. This approach effectively alleviated her distress, allowing her to maintain oral intake until the day before she died, 20 days after readmission.</div></div><div><h3>Learning objectives</h3><div>End-stage heart failure (HF) is often complicated with symptoms such as dyspnea, fatigue, pain, and nausea, which can worsen the quality of life. In our patient with end-stage HF, home-based dobutamine infusions reduced the number of hospitalizations. Furthermore, several types of continuous tranquilizers relieved her symptoms. A multidisciplinary approach with treatment strategies tailored to a patient's specific case may improve the quality of life of patients in palliative care for end-stage HF.</div></div>","PeriodicalId":52092,"journal":{"name":"Journal of Cardiology Cases","volume":"33 1","pages":"Pages 13-17"},"PeriodicalIF":0.0,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145876935","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":"Transcatheter arterialization of deep veins in a patient with no-option CLTI with thromboangiitis obliterans: A case report","authors":"Kazuhiro Asano MD,&nbsp;Tatsuya Nakama MD,&nbsp;Shunsuke Kojima MD,&nbsp;Kotaro Obunai MD","doi":"10.1016/j.jccase.2025.10.004","DOIUrl":"10.1016/j.jccase.2025.10.004","url":null,"abstract":"<div><div>We report the first documented case of severe no-option ischemia due to thromboangiitis obliterans (TAO) successfully treated with transcatheter arterialization of deep veins (TADV). A 55-year-old man with TAO presented with a non-healing ulcer despite smoking cessation and multiple endovascular interventions. Owing to the absence of other revascularization options, TADV was performed using a modified venous arterialization simplified technique. A 5.0 × 250 mm covered stent graft was deployed from the tibioperoneal trunk to the distal posterior tibial vein, and valvotomy was performed with a 2.5-mm cutting balloon. Two weeks later, coil embolization was required to reduce a steal phenomenon from a plantar perforator vein. The TADV circuit remained patent for more than one year, with marked wound size reduction and successful limb salvage, although additional intervention for superficial femoral artery restenosis was required. This case suggests that TADV may offer a feasible therapeutic option for patients with TAO and no revascularization alternatives. While promising, further clinical experience and long-term data are needed to confirm its safety and efficacy in this unique patient population.</div></div><div><h3>Learning objective</h3><div>Transcatheter arterialization of deep veins may enable limb salvage in patients with no-option severe ischemia due to thromboangiitis obliterans.</div></div>","PeriodicalId":52092,"journal":{"name":"Journal of Cardiology Cases","volume":"33 1","pages":"Pages 31-35"},"PeriodicalIF":0.0,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145877096","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 case of caseous calcification of the mitral annulus with mobile mass","authors":"Ken Umetani MD ,&nbsp;Ryotaro Ishikawa MD ,&nbsp;Masato Nakajima MD ,&nbsp;Yuichiro Akiyama MD ,&nbsp;Aritaka Makino MD ,&nbsp;Keita Sano MD","doi":"10.1016/j.jccase.2025.07.004","DOIUrl":"10.1016/j.jccase.2025.07.004","url":null,"abstract":"<div><div>A 75-year-old woman had a 4-year history of hemodialysis and underwent aortic valve replacement for aortic valve stenosis one year previously. She was referred to our hospital to treat atrial fibrillation. Echocardiography at the initial visit incidentally revealed mitral annular calcification (MAC) involving the posterior mitral leaflet and mobile mass attached to this MAC. The high intensity echogenic mobile mass extended from the sub-valvular tissue to the papillary tendon. The differential diagnosis of this mass included a caseous calcification of the mitral annulus (CCMA), and intra-cardiac thrombus or tumor. Computed tomography imaging features were consistent with CCMA. Anticoagulation was administered for one month to rule out thrombus and to prevent systemic thromboembolism. The size of this mobile mass did not change but the severity of mitral regurgitation worsened from mild to moderate during the month. Surgical treatment was performed to prevent thromboembolism and treat mitral regurgitation. A biological mitral valve and tricuspid annular ring were implanted. The histopathologic examination of the excised mobile mass revealed fibrinous material with calcification. We report a case of CCMA that appeared in a short period of time, and the attached mobile mass was suggested to be the contents of CCMA.</div></div><div><h3>Learning objective</h3><div><ul><li><span>1)</span><span><div>A mobile high intensity echocardiographic mass consisting of fibrinous material with calcification is a characteristics feature of a caseous calcification of the mitral annulus (CCMA), and is suggested to be the contents of CCMA.</div></span></li><li><span>2)</span><span><div>Mitral regurgitation worsened over a short period in a patient with CCMA.</div></span></li><li><span>3)</span><span><div>CCMA with a mobile mass is extremely rare, and it is important to understand its clinical imaging features and clinical course.</div></span></li></ul></div></div>","PeriodicalId":52092,"journal":{"name":"Journal of Cardiology Cases","volume":"32 6","pages":"Pages 224-227"},"PeriodicalIF":0.0,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145625164","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":"Large, ball-shaped left atrial hematoma encapsulated by a thin membrane-like organized thrombus requiring urgent surgical resection","authors":"Keita Tashiro MD ,&nbsp;Yasuhiro Ikami MD, PhD ,&nbsp;Tomoyasu Suzuki MD, PhD ,&nbsp;Daisuke Izumi MD, PhD, FJCC ,&nbsp;Tsuyoshi Yoshida MD, PhD ,&nbsp;Yasuhiko Tanabe MD, PhD ,&nbsp;Keiichi Honma MD ,&nbsp;Takayuki Inomata MD, PhD, FJCC","doi":"10.1016/j.jccase.2025.07.005","DOIUrl":"10.1016/j.jccase.2025.07.005","url":null,"abstract":"<div><div>A 57-year-old female patient presented with dyspnea. Chest radiography revealed pulmonary congestion and bilateral pleural effusion. Electrocardiogram revealed sinus tachycardia. Transthoracic echocardiography revealed a large mass measuring 32 × 25 mm in the left atrium that caused mitral valve obstruction during diastole. Emergency surgery was performed, and the mass was found to be a hematoma encapsulated by a thin membrane-like organized thrombus. No atrial fibrillation or coagulation abnormalities were observed during follow-up.</div></div><div><h3>Learning objective</h3><div>A ball-shaped left atrial thrombus without atrial fibrillation or mitral stenosis is a rare lesion. Previous studies have not reported a large left atrial hematoma encapsulated by a thin membrane-like organized thrombus. Blood flow into the left atrial mural thrombus may have caused the rapid enlargement of the large, ball-shaped left atrial thrombus.</div></div>","PeriodicalId":52092,"journal":{"name":"Journal of Cardiology Cases","volume":"32 6","pages":"Pages 221-223"},"PeriodicalIF":0.0,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145625163","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}