Migration of Hepatocellular Carcinoma Into the Right Atrium.

A 40-year-old man with a medical history of hepatitis B presented with abdominal distention and leg swelling. A computed tomography scan of the abdomen revealed cirrhosis and a large mass extending from the liver into the inferior vena cava and extending into the right atrium. A transthoracic echocardiogram revealed a large right atrial mass extending from the inferior vena cava with possible attachment to the interatrial septum.

Coexisting Pulmonary Artery Sling and Persistent Left Superior Vena Cava.

Congenital vascular anomalies such as pulmonary artery sling and persistent left superior vena cava are rare vascular disorders. We describe a case of a patient who presented with pneumonia and was found to have a pulmonary artery sling as a potential cause of the pneumonia.

Effect of variable left ventricular ejection fraction assessed by equilibrium radionuclide angiocardiography using different software packages on the diagnosis of cardiotoxicity in patients with cancer.

Background: The equilibrium radionuclide angiocardiography (ERNA) scan is an established imaging modality for assessing left ventricular ejection fraction (LVEF) in oncology patients. This study aimed to explore the interchangeability of two commercially available software packages (MIM and JS) for LVEF measurement for a cancer-therapy-related cardiac dysfunction (CTRCD) diagnosis.

Methods: This is a single-center retrospective study among 322 patients who underwent ERNA scans.

Unroofed Coronary Sinus as Potential Cause of Ischemic Stroke Following Left Atrial Appendage Closure.

Unroofed coronary sinus is a rare type of atrial septal defect with a strong association with persistent left superior vena cava. We describe a case with unroofed coronary sinus and persistent left superior vena cava as a cause of recurrent embolic strokes following left atrial appendage closure for atrial fibrillation. ().

Functionally Bicuspid Quadricuspid Aortic Valve.

• QAV is a rare congenital defect. • AR is the main valvular pathology leading to heart failure, presenting between ages 50 and 60. • Transesophageal echocardiography plays a pivotal role in the diagnosis of QAV.

Readability Assessment of Online Patient Education Materials on Atrial Fibrillation.

Health literacy is emerging as an important factor for medical outcomes as more patients turn to the internet for information about their disease. However educational materials on complex conditions such as atrial fibrillation tend to still be esoteric and result in compromised patient autonomy. We add to the current literature by examining the reading level of websites of major healthcare intuitions and general medicine websites.

Calcification of tricuspid valve chordae tendineae on echocardiography and computed tomography.

We present the appearance of chordae tendineae calcification on transthoracic echocardiography and ECG-gated cardiac computed tomography in a 75 year-old woman. While the etiology is unclear, the abnormality can be clearly delineated on a properly performed CT study. We also discuss modification of the cardiac CT protocol to optimize visualization of the tricuspid valve apparatus.

Extension of Adrenocortical Carcinoma into the Right Atrium.

Adrenocortical carcinoma (ACC) is a rare and highly aggressive malignant neoplasm which can produce intravascular extension into the inferior vena cava (IVC) rarely extend into the right atrium (RA). We report a case of a male patient with large ACC with extension into the IVC and RA. Computed tomography showed a large right adrenal mass with contiguous tumor thrombus extending into IVC and RA with extension to the level of tricuspid valve.

Chordae Tendineae Rupture in the United States: Trends of Outcomes, Costs and Surgical Interventions.

Objectives: To describe national trends in the incidence and outcomes of patients with chordae tendineae rupture (CTR).

Methods: Patients who were diagnosed with CTR between 2000 and 2012 were identified in National (Nationwide) Inpatient Sample (NIS) registry. CTR was defined using validated International Classification of Diseases, 9th Edition, Clinical Modification diagnosis (ICD9-CM) codes.

Comparison of Echocardiography, Cardiac Magnetic Resonance, and Computed Tomographic Imaging for the Evaluation of Left Ventricular Myocardial Function: Part 1 (Global Assessment).

Assessing left ventricular function is an essential part of the cardiovascular evaluation as it plays an important role in managing the patient and predicting prognosis. Recent advances in the imaging modalities currently allow a non-invasive comprehensive assessment of cardiac mechanics and precise estimation of cardiovascular hemodynamics. In this review, we will discuss and compare the currently available techniques and novel approaches utilized by echocardiography, cardiac magnetic resonance, and computed tomography for the assessment of global left ventricular performance.

Comparison of Echocardiography, Cardiac Magnetic Resonance, and Computed Tomographic Imaging for the Evaluation of Left Ventricular Myocardial Function: Part 2 (Diastolic and Regional Assessment).

Assessing left ventricular diastolic and regional function is a crucial part of the cardiovascular evaluation. Diastolic function is as important as systolic function for left ventricular performance because it is the determinant of the ability of the left atrium and ventricle to fill at relatively low pressures. Additionally, diastolic function plays an important role in the management and prognosis of patients with symptoms and signs of heart failure.

Trends in Cardiac Tamponade Among Recipients of Permanent Pacemakers in the United States: From 2008 to 2012.

Objectives: The aim of this study was to describe the trends and predictors of cardiac tamponade among permanent pacemaker (PPM) recipients in the United States between 2008 and 2012.

Background: Limited data exist regarding the burden, trend, and predictors of tamponade in patients following PPM implantation.

Methods: The National (Nationwide) Inpatient Sample database was used to identify PPM implantations between 2008 and 2012.

In-Hospital Outcomes and Complications of Coronary Artery Bypass Grafting in the United States Between 2008 and 2012.

Objective: To investigate the frequency and predictors of in-hospital complications among patients undergoing coronary artery bypass grafting (CABG) in the United States.

Design: Retrospective national database analysis SETTINGS: United States hospitals.

Participants: A weighted sample of 1,910,236 patients undergoing CABG surgery identified from the National (Nationwide) Inpatient Sample from 2008 to 2012.

Impact of Hospital Teaching Status on Mortality, Length of Stay and Cost Among Patients With Cardiac Arrest in the United States.

Limited data exist regarding the in-hospital outcomes in patients with cardiac arrest (CA) in teaching versus nonteaching hospital settings. Using the Nationwide (National) Inpatient Sample (2008 to 2012), 731,107 cases of CA were identified using International Classification of Diseases, Ninth Edition codes. Among these patients, 348,368 (47.

Evaluation of Known or Suspected Cardiac Sarcoidosis.

Sarcoidosis is a multisystem disorder of unknown cause, and cardiac sarcoidosis affects at least 25% of patients and accounts for substantial mortality and morbidity from this disease. Cardiac sarcoidosis may present with heart failure, left ventricular systolic dysfunction, AV block, atrial or ventricular arrhythmias, and sudden cardiac death. Cardiac involvement can be challenging to detect and diagnose because of the focal nature of the disease, as well as the fact that clinical criteria have limited diagnostic accuracy.

Pleuropericarditis complicated by a pericardial cyst.

We report the case of a 36-year-old woman with a recent upper respiratory illness who presented with chest pressure, lasting for five days, which improved with leaning forward. Physical examination and laboratory studies were unremarkable. Chest computed tomography scan revealed a 6.