Impaired left ventricular mechanics in pulmonary arterial hypertension: identification of a cohort at high risk.

Background: Pulmonary arterial hypertension (PAH) is characterized by pulmonary vascular remodeling and right heart failure. The right (RV) and left ventricles (LV) do not function in isolation, sharing a common pericardial sac and interventricular septum. We sought to define the clinical and prognostic significance of ventricular interdependence in PAH and its association with LV filling patterns through speckle-tracking strain echocardiography.

Role of serial quantitative assessment of right ventricular function by strain in pulmonary arterial hypertension.

The aim of this study was to assess whether serial quantitative assessment of right ventricular (RV) function by speckle-based strain imaging is affected by pulmonary hypertension-specific therapies and whether there is a correlation between serial changes in RV strain and clinical status. RV longitudinal systolic function was assessed using speckle-tracking echocardiography in 50 patients with pulmonary arterial hypertension (PAH) before and after the initiation of therapy. The mean interval to follow-up was 6 ± 2 months.

Multivessel spontaneous coronary artery dissection associated with hormonal infertility therapy in a 39-year-old female.

Spontaneous coronary artery dissection (SCAD) is a rare and potentially lethal cause of chest pain and myocardial infarction in healthy young individuals. It more commonly affects females and has been correlated with hormonally-induced connective tissue changes in pregnancy and oral contraceptive use. We present the case of a previously healthy 39-year-old woman with multivessel SCAD associated with recent clomiphene and gonadotropin therapy for infertility, which is not a previously reported association, and we assert that this should be in the differential diagnosis of such patients with chest pain or myocardial infarction.

Amiodarone-induced hypothyroidism presenting as cardiorenal syndrome.

Here we present the case of a 90-year-old man with chronic heart and renal failure who was admitted with what appeared to be a simple heart failure exacerbation. However, further investigation led to the diagnosis of profound amiodarone-induced hypothyroidism as the cause of his acute decompensation, highlighting the importance of a broad differential diagnosis and thorough investigation.