Contemporary review of the evolution of various treatment modalities for mitral regurgitation.

Introduction: Mitral regurgitation is one of the most common forms of valvular heart diseases for which there have been several innovative treatment strategies that have developed over the last several decades. We describe the various treatment modalities that have been used for the last several decades. All articles in PubMed, Cochrane, and Embase were screened from inception to August 2024 for the following - 'Mitral valve regurgitation' 'Mitral valve repair' 'Mitral valve replacement' 'Robotic mitral surgery' 'Transcatheter mitral valve repair.

Incidental Finding of Giant Coronary Artery Aneurysms Successfully Treated with Medical Therapy.

We report a case of a 30-year-old male who presented with signs and symptoms of respiratory infection with left lower lobe consolidation and cardiomegaly on a chest radiography. The presence of cardiomegaly lead to further cardiac evaluation revealing giant coronary aneurysms. The patient was treated conservatively with Coumadin and aspirin and has done well at four years of follow-up.

Dehiscence and embolization of CorMatrix tricuspid valve replacement in the setting of infective endocarditis: a case report.

Background: Due to increased morbidity and mortality, prosthetic valve infective endocarditis (IE) with dehiscence requires urgent intervention. Early identification and therapy may prevent embolization.

Case Summary: A 27-year-old Caucasian woman with a history of hepatitis C, intravenous drug abuse, and tricuspid valve (TV) replacement was admitted for recurrent IE.

Cardiac amyloidosis: A case report and review of literature.

Background: Cardiac amyloidosis, a disease caused by the precipitation of amyloid proteins in the myocardial extracellular matrix has been historically difficult to diagnose due to lack of specific clinical manifestations and necessity of biopsy to demonstrate amyloid deposition. However, advances in cardiovascular imaging techniques have facilitated earlier recognition of this disease. In addition, while once thought of as incurable, treatment strategies are emerging for cardiac amyloidosis, making early diagnosis essential.

Elusive left ventricular thrombus: Diagnostic role of cardiac magnetic resonance imaging-A case report and review of the literature.

Identification of left ventricular mural thrombus (LVT) may be challenging depending on the imaging modality used. We present a case of LVT which was incidentally identified on cine cardiac magnetic resonance imaging (CMR). A sixty-four years old female presented with worsening dyspnea on exertion with troponin elevation.

Incidental echocardiographic finding: Fractured inferior vena cava filter.

Inferior vena cava filters have gained increasing popularity in recent decades and knowledge on rare complications becomes vital to practicing physicians. A 30-year-old African American male with diabetes mellitus, hypertension, end-stage renal disease, history of deep venous thrombosis and placement of venacaval filter who was seen in the cardiology clinic for cardiac risks stratification prior to renal transplant. Patient denied any cardiac symptoms.

Vascular Complications of Percutaneous Transradial Cardiac Catheterization.

The percutaneous transradial approach for coronary angiography and percutaneous coronary intervention is increasing in the United States. Although its vascular safety profile is better than the traditional femoral approach, it is important to learn about potential complications. In this article, we present two cases of vascular complications, namely, pseudoaneurysm and radial artery occlusion, after transradial cardiac catheterization, along with a review of the relevant literature.

Incidental finding of aberrant mitral valve chorda during a transesophageal echocardiography evaluation for suspected endocarditis.

Congenital defects involving anomalous chordae of the mitral valve with attachment in the left atrium are an extremely rare finding and may result in valvular insufficiency. Few cases have been reported in the literature with multiple variations in anatomical location and insertion of aberrant chordae within the left ventricle and left atrium. Reported cases have presented with cardiovascular symptoms leading to diagnosis of anomalous mitral valve chordae.

Contrast induced neurotoxicity following coronary angiogram with Iohexol in an end stage renal disease patient.

Neurotoxicity is an infrequent adverse reaction to iodinated contrast agents. Contrast induced neurotoxicity following coronary angiogram is very rare. Renal disease is a risk factor for contrast induced neurotoxicity.

Successful Biopsy and Removal of a Tricuspid Valve Papillary Fibroelastoma in Cardiac Catheterization Laboratory: A Case Report.

Papillary fibroelastomas are rare benign cardiac tumours with a predilection for cardiac valves. Because of the rarity of these tumours, management is individualized, but some recommend surgical removal of all papillary fibroelastomas due to the increased risk of embolization. We report a case of a 71-year-old man who presented with a sessile mass on the tricuspid valve.

Horseshoe thrombus in a patient with mechanical prosthetic mitral valve: A case report and review of literature.

Patients with prosthetic cardiac valves are at high risk for thromboembolic complications and need life long anticoagulation with warfarin, which can be associated with variable dose requirements and fluctuating level of systemic anticoagulation and may predispose to thromboembolic and or hemorrhagic complications. Prosthetic cardiac valve thrombosis is associated with high morbidity and mortality. A high index of suspicion is essential for prompt diagnosis.

Transhepatic venous approach to permanent pacemaker placement in a patient with limited central venous access.

The end-stage renal disease population poses a challenge for obtaining venous access required for life-saving invasive cardiac procedures. In this case report, we describe an adult patient with end-stage renal disease in whom the hepatic vein was the only available access to implant a single-lead permanent cardiac pacemaker. A 63-year-old male with end-stage renal disease on maintenance hemodialysis and permanent atrial fibrillation/atrial flutter presented with symptomatic bradycardia.

Coumadin ridge: An incidental finding of a left atrial pseudotumor on transthoracic echocardiography.

Coumadin ridge is a normal anatomic variant that is occasionally found in the left atrium. It can present as a linear or nodular mass which can undulate with cardiac motion and if particularly prominent, can easily be mistaken for a tumor or thrombus. Careful evaluation and consideration of the common variants discussed in this review can help limit misdiagnosis, as well as unnecessary workup and treatment.

Incidental findings of pericardial calcification.

Calcification of the pericardium is a relatively rare finding and often has an uncertain etiology. Incidental findings of pericardial calcification may increase due to widespread application of cardiac computed tomography for the assessment of coronary atherosclerosis in the appropriate clinical setting using coronary artery calcium scoring and/or coronary angiography. Pericardial calcification alone is asymptomatic and is neither necessary nor sufficient for the diagnosis of pericardial constriction.

Transthoracic echo: A sensitive tool for detecting cardiac extension of renal cell carcinoma?

Renal cell carcinoma is a common urological malignancy with the unique ability to invade the inferior vena cava (IVC) and to extend into the right atrium of the heart. Of those with Renal cell carcinoma only 4%-25% are found to have IVC invasion and of those only 2%-10% extend into the right atrium. If treated surgically, extension of tumor thrombus is not a determinant of survival; therefore it is imperative to determine the presence and extent of tumor thrombus in order to determine surgical approach and tumor resection.

Case of early right ventricular pacing lead perforation and review of the literature.

We report a case of a 77-year-old patient with complete atrioventricular block. She underwent permanent pacemaker implantation complicated by right ventricular lead perforation. This was suspected on transthoracic echocardiogram and confirmed by chest computed tomography.

Altered right ventricular contractile pattern after cardiac surgery: monitoring of septal function is essential.

Assessment of right ventricular (RV) function is important in the management of various forms of cardiovascular disease. Accurately assessing RV volume and systolic function is a challenge in day-to-day clinical practice due to its complex geometry. Tricuspid annular plane systolic excursion (TAPSE) and systolic excursion velocity (S') have been reviewed to further assess their suitability and objectivity in evaluating RV function.

Atrium of stone: A case of confined left atrial calcification without hemodynamic compromise.

Dystrophic cardiac calcification is often associated with conditions causing systemic inflammation and when present, is usually extensive, often encompassing multiple cardiac chambers and valves. We present an unusual case of dystrophic left atrial calcification in the setting of end stage renal disease on hemodialysis diagnosed by echocardiography and computed tomography. Significant calcium deposition is confined within the walls of the left atrium with no involvement of the mitral valve, and no hemodynamic effects.

Left ventricular pseudoaneurysm: A case report and review of the literature.

Left ventricular (LV) pseudoaneurysm is a rare complication that is reported in less than 0.1% of all patients with myocardial infarction. It is the result of cardiac rupture contained by the pericardium and is characterized by the absence of myocardial tissue in its wall unlike true aneurysm which involves full thickness of the cardiac wall.

Biventricular pulsus alternans: An echocardiographic finding in patient with pulmonary embolism.

Pulsus alternans is characterized by regular rhythm with beat-to-beat alternation of systolic pressures. Left ventricular alternans is usually found in severe left ventricular dysfunction due to cardiomyopathy, coronary artery disease, systemic hypertension, and aortic stenosis. Right ventricular alternans is usually associated with left ventricular alternans, right ventricular dysfunction, pulmonary embolism, and pulmonary hypertension.

Side matters: An intriguing case of persistent left superior vena-cava.

Persistent left superior vena cava, usually an incidental finding, is the most common thoracic vein anatomical variation draining into the coronary sinus. Central venous catheter procedures may be complicated secondary to the presence of a persistent left superior vena cava, leading to life-threatening complications such as arrhythmias, cardiogenic shock, and cardiac arrest. We present a case of persistent superior vena cava diagnosed on transthoracic echocardiogram (TTE) in a patient with congestive heart failure.

Noncoronary sinus of Valsalva rupture into the right atrium with a coexisting perimembranous ventricular septal defect.

Ruptured sinus of Valsalva is very uncommon, and is < 1% of all congenital defects. The incidence ranges from 0.1%-3.

Low ADAMTS-13 in plavix induced thrombotic thrombocytopenic purpura.

Thrombotic thrombocytopenia purpura (TTP) was first described in 1924 as a "pathologic alteration of the microvasculature, with detachment or swelling of the endothelium, amorphous material in the sub-endothelial space, and luminal platelet aggregation leading to compromise of the microcirculation". Ticlopidine induced TTP has been highly associated with autoimmune induced reduction in ADAMTS-13 activity. These findings, to a lesser extent, have also been found in clopidogrel induced TTP.

Saphenous graft on transesophageal echocardiogram masquerading as an abnormal vascular communication into the right atrium.

An unknown aberrant flow in the right atrium observed on doppler with transesophageal echocardiogram (TEE) in a patient with prior coronary bypass. TEE revealed normal size left ventricle with severely dilated left atrium. There was moderate aortic regurgitation and moderate aortic stenosis noted.

Spontaneous multiarterial dissection immediately after childbirth.

Spontaneous coronary artery dissection and vertebral artery dissection are rare, life-threatening conditions. The pathophysiology of spontaneous coronary artery dissection during the peripartum period is poorly understood. We present a case of spontaneous multivessel dissection in a 32-year-old postpartum woman who presented with neck and chest pain.