Large left ventricular metastatis in patient with liposarcoma.

Abstract Metastasis to the heart and pericardium are rare. We present a 44-year-old male with pleural dedifferentiated liposarcoma and multiple metastases, with no previous cardiological history and/or cardiac symptoms. A transthoracic echocardiogram during the advanced stage of disease showed a lobulated, large and mobile mass, with homogeneous echogenicity, attached to the basal posterior wall of the left ventricle via a broad base and with intracavitary growth. This mass extends to inferolateral and inferoseptal wall of the left ventricle.

Coronary artery fistulas as a cause of angina: How to manage these patients?

Abstract Coronary artery fistulas represent the most common hemodynamically significant congenital defect of the coronary arteries and the clinical presentation is mainly dependent on the severity of the left-to-right shunt. We describe a case of a 55-year-old man with history of chest pain and without history of previous significant chest wall trauma or any invasive cardiac procedures. A coronary multislice computed tomography showed two large coronary fistulas arising from the left anterior descending coronary artery and ending in an angiomatous plexus draining into the common pulmonary trunk. Coronary angiography confirmed the CT finding and showed a third fistulous communication arising…

A case of arrhythmogenic right ventricular cardiomyopathy without ventricular arrhythmias

Abstract We submit a case report of a 21-year-old man admitted to our emergency room for acute right heart failure. Arrhythmogenic right ventricular cardiomyopathy (ARVC) was diagnosed but ventricular arrhythmias have never been detected. On the basis of the diagnosis of ARVC and for the frequent episodes of symptomatic bradycardia, the patient underwent implantation of a biventricular defibrillator (CRT-D). In ARVC symptoms usually appear between the ages of 30–50. Especially in young patients the most common clinical presentation of ARVC are palpitations and syncope due to ventricular tachycardia with left bundle branch morphology. In cases of older patients in whom the disease has been d…

Coronary artery fistulas: symptoms may not correlate to size. An emblematic case and literature review

<p>Coronary artery fistulas are rare anatomic abnormalities of the coronary arteries present in 0.002% of the general population and represent 14% of all anomalies of coronary arteries. Their clinical relevance focuses mainly on the mechanism of "coronary steal phenomenon”, causing myocardial functional ischemia even in the absence of stenosis, hence common symptoms are angina or dyspnea. Small size fistulas are mostly asymptomatic and have excellent prognosis if managed medically with regular follow-up consisting also in echocardiography every 2-5 years. Big-sized and symptomatic fistulas, on the contrary, should undergo invasive closure, either with a transcatheter approach or with …

Brugada phenocopy in diabetic ketoacidosis, the importance of the diagnostic approach

Abstract Brugada phenocopies (BrP) are clinical entities that present with identical ECG patterns to those of true Brugada Syndrome (BrS) but are elicited by various other clinical circumstances. Our manuscript shows an interesting case of a type-1 Class A BrP in a young patient with diabetic ketoacidosis and hyperkalemia.

A late diagnosis of aortic coarctation began as an acute coronary syndrome

Abstract Aortic coarctation accounts the 5%–10% of congenital heart disease. It is usually diagnosed during childhood but the postductal form is most common in adults and may be diagnosed incidentally in the context of investigation for hypertension. The age of correction is the most important factor for the relief of hypertension and long-term survival. We describe a case of a 63-year-old man, came to our emergency room for acute coronary syndrome. Cardiac catheterization with right femoral artery access was performed but for many difficulties during the introduction of catheters was therefore performed aortography that showed an interruption "a cul de sac" at the level of the descending t…

Role of CRT upgrading in pacing induced heart failure: A case report

Abstract We submit a case report of a 78-year-old male came to our department for systolic heart, failure (EF of 25%). He has clinical history of recurring atrial tachycardia and atrial flutter previously treated in our department unsuccessfully with antiarrhythmic drug therapy. The echocardiographic evidence of left atrial enlargement (left atrium area 40 cm 2 ) and the clinical history of permanent atrial tachycardia has discouraged any attempt of substrate ablation. As it is impossible get rhythm and rate control with drug therapy, the patient was subjected to an "ablate and pace" procedure with implantation of a VVIR mode pacemaker. Also, for the absence of indications (QRS width During…

Morbillo e fenomeno di Brugada: un caso clinico

Measles and Brugada pattern: A case report

No abstract available

Left ventricular noncompaction presenting like a double-chambered left ventricle

[Coronary artery ectasia: etiopathogenesis, diagnosis and treatment].

Coronary ectasia is a dilation of coronary arteries, angiographically defined if the diameter of the artery is ≥ 1.5 times greater than that of the intact adjacent vascular segment. An association has been found between coronary artery ectasia and a broad spectrum of different diseases, first of all atherosclerotic coronary artery disease. The mechanisms that determine the abnormal dilatation of the vascular lumen and the etiology of coronary artery ectasia are still poorly understood. Various hypotheses have been formulated over the time, the most accredited between these recognizes as main responsible an uncontrolled activity of a particular family of enzymes that degrade the extracellula…

Immediate decision making in a case of iatrogenic dissection of left main coronary artery: A successful synergetic treatment

Acute aortic dissection debut as STEMI: A case report

Abstract We submit a case report of a 66-year-old male, with hypertension and family history of cerebrovascular disease, who was referred to our department for right-inferior STEMI. According to the current ESC (European Society of Cardiology) guidelines for the management of STEMI, the patient was conducted to the cath lab to perform primary PCI. Despite the identification of the culprit lesion we had many difficulties during the procedure of angioplasty, so we decided to perform aortography that showed a Stanford type A acute aortic dissection involving the ostium of right coronary artery causing the right-inferior STEMI. In the early phase of a STEMI, exclusion of the presence of aortic …

BRUGADA PATTERN IN HEROIN ADDICTION: SYNDROME OR PHENOCOPY?

Brugada phenocopies (BrPs) are clinical entities that show an electrocardiogram (ECG) pattern similar to what is observed in Brugada syndrome (BrS). They are caused by different clinical conditions. We describe a case of BrP in a man that developed acute kidney failure secondary to rhabdomyolysis, after heroin addiction. His initial ECG showed Brugada type 1 pattern resolved after hemodialytic treatment. A provocative test with ajmaline, which resulted negative, was performed to confirm the diagnosis. BrPs can mimic a true BrS and a fast recognition of these clinical and electrocardiographic findings may avoid diagnostic mistakes thus preventing unnecessary or inaccurate treatmen

Bicuspid aortic valve and unruptured sinus of Valsalva aneurysm, a rare association

Bicuspid aortic valve (BAV) is one of the most common forms of congenital heart defect and is associated with other congenital vascular and cardiac defects. The most common comorbidity is dilation of thoracic aorta and clinical manifestations are usually related to function of the aortic valve and to other cardiovascular acquired complications. Sinus of Valsalva aneurysm (SVA) is an uncommon congenital cardiovascular anomaly and the combination of these two anomalies is very rare. Common complications are rupture and obstruction of the termination chamber due to space-occupying effect of large unruptured aneurysms. Early cardiac imaging can help limiting morbidity and mortality in these pat…