Inferior Vena Cava Obstruction Following Surgical Repair of a Secundum Atrial Septal Defect.

Obstruction of the inferior vena cava (IVC) following surgical repair of an atrial septal defect (ASD) is a rare complication. We present the case of a patient who developed IVC obstruction following surgical repair of a large secundum ASD. The diagnostic and management approaches used to care for this patient are discussed.

Cardiac Eclipse: Congenital Absence of the Pericardium Manifesting as Atypical Chest Pain.

• Congenitally absent pericardium (CAP) is rare and usually diagnosed incidentally. • Although usually asymptomatic, CAP can present with life-threatening complications. • Proper diagnosis requires a high suspicion and focused multimodality imaging.

The Circulatory System in Liver Disease.

In the cirrhotic liver, distortion of the normal liver architecture is caused by structural and vascular changes. Portal hypertension is often associated with a hyperdynamic circulatory syndrome in which cardiac output and heart rate are increased and systemic vascular resistance is decreased. The release of several vasoactive substances is the primary factor involved in the reduction of mesenteric arterial resistance, resulting in sodium and water retention with eventual formation of ascites.