A tale of comet tail: multiple pellets in the heart.

A 66-year-old man who presented with chest pain was assessed with a CT coronary angiogram that showed multiple hyperdense bodies. Echocardiography documented a comet tail artefact, an uncommon ultrasonic finding but no other abnormality.

Significance of ST depression during exercise treadmill stress and adenosine infusion myocardial perfusion imaging.

Background: ST segment depression on the electrocardiogram during the exercise treadmill test (ETT) is used as a predictor of coronary artery disease (CAD), although it is recognised that both false-positive and false-negative results limit the value of this procedure. Although adenosine does not produce an inotropic or chronotropic effect upon the myocardium it may cause ST depression during infusion.

Methods: The 12-lead ECG recordings obtained during 825 adenosine stress and 425 ETT procedures, performed as part of a 2-day Tc-MIBI protocol, were retained for examination and comparison with the appearances at subsequent myocardial perfusion imaging (MPI).

Age and hemodynamic responses to tilt testing in those with syncope of unknown origin.

Objectives: We sought to determine whether there are age-related differences in vasovagal syncope.

Background: In those with suspected vasovagal (neurocardiogenic) syncope, tilt testing demonstrates different hemodynamic responses. These responses may be age related, reflecting differing underlying pathophysiology.