We describe asymptomatic sinus arrest and post-hiccup cough syncope in a patient with medullary infarction. A 78-year-old woman developed arrhythmia, hiccup, and cough syncope attacks. Neurological examination was not remarkable. Cough syncope occurs after hiccup attacks. Bradycardia and decreased blood pressure were also present after the beginning cough. Holter 24-hour ...

BACKGROUND: This study aimed to investigate whether left atrial appendage (LAA) dysfunction evaluated by transesophageal echocardiography (TEE) during sinus rhythm is predictable of paroxysmal atrial fibrillation (PAF) as an embolic source in the acute stage of stroke. METHODS AND RESULTS: We measured and analyzed LAA flow velocity (LAA-FV) and LAA ...

BACKGROUND: Paroxysmal atrial fibrillation (PaAF) may present as a single self-terminating episode of atrial fibrillation (AF) or a more persistent form after sinus conversion. We investigated predictors of recurrence in patients with PaAF. HYPOTHESIS: Left atrial function would be an useful parameter for predicting PaAF recurrence. METHODS: The study population ...

Objective: The ORBIT I trial evaluated the safety and performance of an orbital atherectomy system (OAS) for the treatment of de novo calcified coronary lesions. Background: Severely calcified coronary arteries pose an ongoing treatment challenge. Stent placement in calcified lesions can result in stent under expansion, malapposition, and procedural complications. ...

A 71-year-old man underwent intracoronary stent implantation for acute inferior myocardial infarction (MI). Immediately after diagnostic intravascular ultrasound (IVUS) at 8 months' follow-up, an acute occlusion of the sinus node (SN) artery appeared, which developed sinus arrest with junctional escape rhythm. The serum level of high-sensitivity troponin T (TpT) was ...

Invasive thymoma is a malignant tumor of the anterior mediastinum that could have intravenous affinity associated with a high recurrence rate. This report highlights the need of coronary sinus exploration when intraatrial thymoma recurrence is diagnosed. Surgical resection of invaded coronary sinus can be achieved safely with a good result.

A 68-year-old woman with a history of dilated non-ischemic cardiomyopathy presented with syncope. The index ECG showed sinus rhythm with left bundle branch block. On telemetry episodes of sinus rhythm with narrower QRS complexes conduced in 2:1 pattern were noted. Invasive electrophysiological study was performed to determine cause of syncope. Normal conduction ...

ABSTRACT: BACKGROUND: A growing population of patients lives with severe coronary artery disease not amenable to coronary revascularization and with refractory angina despite optimal medical therapy. Percutaneous reduction of the coronary sinus is an emerging treatment for myocardial ischemia that increases coronary sinus pressure to promote a transcollateral redistribution of ...

Anomalous origin of a coronary artery is rare and does not generally lead to myocardial infarction and paroxysmal supraventricular tachycardia (PSVT). We report an uncommon case of anomalous origin of the right coronary artery (RCA) originating from the left sinus of Valsalva with PSVT and myocardial ischemia. A 58-year-old man ...

We report a rare case of a 5-year-old child who presented with chronic hypoxemia and a normal cardiac examination, and was found to have a persistent left superior vena cava draining directly into the left atrium. The coronary sinus was absent. This case introduces a contradiction to the generally accepted ...

The aim of this study was to evaluate left atrial deformations using speckle tracking echocardiography for predicting left atrial appendage (LAA) thrombus in patients with suspected cardioembolic stroke who were in normal sinus rhythm. A total of 153 ischemic stroke patients (89 males, 64 females) in sinus rhythm who were ...

An asymptomatic 5-year-old girl presented with bradycardia during a routine well-child visit. Further evaluation revealed profound sinus bradycardia, exercise-induced bidirectional ventricular tachycardia, and supraventricular tachycardia. An echocardiogram showed heavy trabeculations in the left ventricular myocardium. This patient's presentation suggested catecholaminergic polymorphic ventricular tachycardia and left ventricular noncompaction. Genetic testing revealed ...

OBJECTIVE: To explore the value of transthoracic and right heart contrast echocardiography in the diagnosis of coronary sinus septal defect (CSSD), also known as unroofed coronary sinus. METHODS: The echocardiographic characteristics of 20 patients with CSSD who underwent surgery in our hospital between October 1999 and June 2012 were reviewed ...

Unroofed coronary sinus (UCS) is a rare cardiac anomaly that results in communication between the coronary sinus and the left atrium. We described an unusual presentation of UCS in a 48-year-old female that was not corrected during an initial secundum ASD repair 22 years ago.

ABSTRACT: BACKGROUND: Echocardiographic left atrial (LA) strain parameters have been associated with atrial fibrillation (AF) in prior studies. Our goal was to determine if strain measures [peak systolic longitudinal strain (LAS) and stiffness index (LASt)] changed after cardioversion (CV); and their relation to AF recurrence.Methods and results46 participants with persistent ...

Background: Prompt diagnosis and management of atrial tachyarrhythmias (ATAs) during catheter ablation of atrial fibrillation (AF) is still challenging. Methods and Results: In 88 patients undergoing catheter ablation of AF, 128 regular ATAs were induced or converted from AF. The coronary sinus activation time (CSAT) around the mitral annulus (MA) was measured ...

BACKGROUND: Duration of anticoagulation therapy is one of the major concerns about management of new-onset atrial fibrillation (AF) after myocardial revascularization. We evaluated whether right and left atrial contractility was restored early after electrical sinus conversion in patients who experienced new-onset AF after off-pump coronary artery bypass grafting. METHODS: From ...

A 79-year-old woman underwent transesophageal echocardiography to evaluate the severity of her mitral regurgitation prior to urgent bypass. Evaluation of the right-sided chambers was notable for a mass in the right atrial appendage (RAA). Surgical excision and pathologic examination proved this to be a thrombus. This is the first reported ...

ABSTRACT: BACKGROUND: Radiofrequency catheter ablation (RFCA) has been used for the ablation of premature ventricular contractions (PVCs) or ventricular tachycardia (VT). To date, the mapping and catheter ablation of the arrhythmias originating from the left ventricular outflow tract (LVOT) has not been specified. This study investigates the electrocardiogram (ECG) feature ...

Background Left atrial ablation is a surgical standard technique for the treatment of persistent or chronic atrial fibrillation (p-AF and c-AF, respectively).Objective The aim of the study is to evaluate midterm results of left atrial ablation according to modified Maze procedure in patients affected by p-AF or c-AF and concomitant mitral or ...

Abstract  A coronary sinus approach using a Gore-Tex Patch was used to repair an intracardiac left ventricular pseudoaneurysm after a previous bioprosthetic mitral valve replacement. At follow-up six months after surgery, echocardiography and a computed tomographic scan revealed almost complete obliteration of the pseudoaneurysm cavity. (J Card Surg 2012;27:692-695).

Intraluminal Interaction of Tissue and Stented CS Lead. Introduction: The aim of our investigation was to examine the intraluminal interaction of the vascular tissue and the implanted coronary sinus lead stabilized with stent on two human hearts removed before transplantation. Methods and results: The coronary sinus lumen was sectioned under operational ...

A Holter recording obtained from a patient with atrial fibrillation showed ventricular extrasystoles often in bigeminal rhythm. Most extrasystoles were followed by a long return cycle, and only in a few instances the postextrasystolic interval was short. The latter phenomenon was interpreted as a manifestation of poor retrograde concealed penetration ...

To describe the relation between emotional stress and cardiovascular events, and review the literature on the cardiovascular effects of emotional stress, in order to describe the relation, the underlying pathophysiology, and potential therapeutic implications. Targeted PUBMED searches were conducted to supplement the authors' existing database on this topic. Cardiovascular events ...

BACKGROUND: The aim of this study is to evaluate the cardiac functions of term small for gestational age (SGA) babies with mild growth retardation by echocardiography during the postnatal period. METHODS AND RESULTS: Thirty term SGA (2271±207g/38-41weeks (mean 39.5weeks)) and 30 term AGA (3298±338g/38-41weeks (mean 39weeks)) newborns as the control ...

Left-ventricular apical hypoplasia is a rare entity. Although it has typical imaging features on cardiovascular magnetic resonance, recognizing this condition on echocardiography can be challenging. This report describes an asymptomatic pediatric patient who initially presented with a left-ventricular mass on echocardiography.

Lenticulostriate vasculopathy (LSV) is a sonographic finding in infancy with obscure etiology and variable diagnostic and prognostic significance. Ischemic infarct in the territory of the lenticulostriate vessels after mild head trauma is a rare pathology. There are no publications on LSV followed by ischemic infarct. We present the case of ...

Left ventricular noncompaction (LVNC) is a rare form of cardiomyopathy of emerging importance. We report a case of a 3- months- old boy who presented with congestive heart failure due to LVNC.

Postero-septal accessory pathways (AP) are a rare cause of intraventricular dyssynchrony and severe LV dysfunction in children. Beside the common treatment with radiofrequency ablation of septal substrates we present the case of a successful pharmacologic resynchronization in a 13/12 years old male toddler with Wolff-Parkinson-White syndrome (WPW) and severe LV ...

Myocardial bridging is a congenital coronary anomaly with a variety of clinical manifestations. Traditionally, myocardial bridging has been considered a benign condition, but some cases of myocardial ischemia, infarction and sudden cardiac death due to myocardial bridging have been reported. Various studies have suggested that in their intramyocardial segments, these ...

Objective:A relationship between depression and mortality has been well established, but underlying mechanisms remain unclear. We investigated the influence of cerebral small vessel disease (CSVD), characterized by white matter lesions (WMLs) and lacunar infarcts, on the relationship between mood mortality during 6 years follow-up.Methods:Mood problems were assessed with the mental ...

Japanese yew is a widely used ornamental plant. However, most people are unaware that it is also a poisonous plant. It has potent cardiac toxicities that can lead to sudden cardiac death. A 37-year-old female patient presented to the emergency room with altered mental status and sustained ventricular tachycardia (VT). ...

Functional mitral valve regurgitation (MR), a condition affecting millions of primarily elderly patients worldwide, is associated with poor clinical outcomes. Functional MR has traditionally been considered a disorder of regional or global left ventricular (LV) remodeling secondary to myocardial disease, in which anatomically normal leaflets fail to coapt adequately. The ...

Mitral regurgitation (MR) has been associated with adverse outcomes after myocardial infarction (MI). Without structural valve disease, functional MR has been related to left ventricular (LV) remodeling and geometric deformation of the mitral apparatus. The aims of this study were to elucidate the mechanistic components of MR after high-risk MI ...

This report describes the de novo occurrence of pacemaker-mediated tachycardia (PMT) in a patient with a dual-chamber implantable cardioverter-defibrillator and stable retrograde ventriculoatrial conduction time. The same rate-adaptive post-ventricular atrial refractory period (PVARP) duration had previously prevented PMT. Oversensing of atrial false signals from a defective lead shortened the PVARP ...

Techniques of implanting pacing leads in the right ventricle (RV) have evolved over time and involve the use of preshaped stylets. However, in the presence of venous abnormalities, it could be very challenging to do the same. We describe two cases with complex superior vena caval (SVC) anatomy which could ...

Left ventricular noncompaction is a condition characterized by prominent ventricular trabeculations, often accompanied by systolic dysfunction. The present case involves an adult with a small ventricular septal defect, initially exhibiting mild systolic dysfunction and slightly prominent left ventricular trabeculations progressing over 13 years to severe dilated cardiomyopathy and overt noncompaction. ...

There is currently no established standard treatment for in-stent restenosis (ISR) after the implantation of a drug-eluting stent (DES). The aim of this study was to investigate the efficacy of DES versus balloon angioplasty (BA) for the treatment of DES ISR in a multicenter registry cohort. After matching propensity scores ...

Myocardial bridging describes the clinical entity whereby a segment of coronary artery is either partially or completely covered by surrounding myocardium. It represents the most frequent congenital coronary anomaly and has an estimated prevalence of ≤13% on angiographic series. With the emergence of cardiac computed tomography and its ability to ...

ABSTRACT: Left ventricular assist devices (LVADs) offer effective therapy for severe heart failure (HF) as bridge to transplantation or destination therapy. Rarely, the sustained unloading provided by the LVAD has led to cardiac reverse remodelling and recovery, permitting explantation of the device. We describe the clinical course of severe peri-partum ...

Introduction: Although mineralocorticoid receptor (MR) antagonists are indicated in systolic heart failure, they are underprescribed in patients with appropriate indications for their prescription and often used in those in whom the evidence for probable benefit is scant. The rate of adverse events in practice has exceeded that foreshadowed by randomized ...

Robotic navigation systems aim to improve ablation catheter maneuverability, tissue contact, and stability. These attributes suggest that such systems could enhance outcomes in the ablation of ventricular tachycardia (VT). To date, however, ablation has been confined to the atria. We present a case in which robotic catheter navigation alongside three-dimensional ...

Abstract  Accessory mitral valve (AMV) is an unusual congenital cardiac anomaly typically presenting with left ventricular outflow obstruction. We describe a patient with AVM presenting with transient ischemic attack. (J Card Surg ****;**:1-2).

Coffin-Lowry syndrome (CLS) is an X-linked dominant condition characterized by moderate to severe mental retardation, characteristic facies, and hand and skeletal malformations. The syndrome is due to mutations in the gene that encodes the ribosomal protein S6 kinase-2, a growth factor-regulating protein kinase located on Xp22.2. Cardiac anomalies are known ...

Left ventricular aneurysm (LVA) describes a region of ventricular wall that is thinner than the adjacent myocardial segments, balloons outward and exhibits either akinesis or dyskinesis. Congenital LVA is diagnosed by exclusion with a very low incidence, especially in adult patients with very few cases reported. Clinically, most congenital LVA ...

Recurrent congestive heart failure (CHF) attributable to myocarditis is a seldom-discussed entity in the scientific literature. This report describes the case of an 8-year-old girl who had three clinically identical episodes of CHF, beginning at the age of 5 years, with each episode preceded by a viral prodrome. The clinical features ...

Purpose To evaluate the prevalence of structural cardiac lesions using echocardiography in apparently healthy boys referred for pre-participation screening (PPS). Subjects and methods 3100 male soccer players were evaluated by echocardiography in addition to the standard PPS. Results In 56 subjects (1.8%), a structural cardiac lesion with potential future complication ...

Congestive heart failure in the newborn period is uncommon and is most commonly related to congenital structural heart disease. However, the differential diagnosis is broad and includes arrhythmias, congenital or acquired myopathies, sepsis, severe anemia, or other conditions leading to high-output cardiac failure. Here we report on a 4-day-old girl ...

The investigators report similar phenotypes of hypertrophic cardiomyopathy with left ventricular apical aneurysm and thrombus in 2 brothers aged 8 years apart. This report highlights the genetic predisposition for this unique, high-risk phenotype, the issue of prophylactic anticoagulation, and the importance of nonstandard echocardiographic imaging views in the assessment of ...

ABSTRACT: Cor triatriatum is a rare congenital cardiac malformation and it usually refers to the left atrium. We report an unusual case of cor triatriatum in a 33 - year old woman presented with congestive heart failure caused by left ventricular systolic dysfunction.