Thrombotic and Hemorrhagic Complications Following Left Ventricular Assist Device Placement: An Emphasis on Gastrointestinal Bleeding, Stroke, and Pump Thrombosis.

The left ventricular assist device (LVAD) is a mechanical circulatory support device that supports the heart failure patient as a bridge to transplant (BTT) or as a destination therapy for those who have other medical comorbidities or complications that disqualify them from meeting transplant criteria. In patients with severe heart failure, LVAD use has extended survival and improved signs and symptoms of cardiac congestion and low cardiac output, such as dyspnea, fatigue, and exercise intolerance. However, these devices are associated with specific hematologic and thrombotic complications.

A Unique Case of Tension Empyema Caused by Prevotella denticola.

A 45-year-old male presented to the emergency department after being found unresponsive. Vitals, laboratory findings, and chest X-ray revealed concern for tension empyema. Thoracostomy was performed, and hemodynamics subsequently improved.

Anomalous Origin of the Right Coronary Artery From the First Septal Perforator.

A 68-year-old white male presented to the clinic for chest pain and shortness of breath with exertion. Through coronary angiography, the patient was found to have an anomalous origin of the right coronary artery off the first septal perforator branch of the left anterior descending artery. The patient was treated with conservative medical therapy as symptoms had resolved, and the patient did not wish to undergo further procedures.

A Rare Case of Intracavitary Cardiac Metastasis of Endometrial Carcinosarcoma.

A 59-year-old female, with past medical history including endometrial carcinosarcoma with a port-a-cath device, presented due to shortness of breath. Transesophageal echocardiogram demonstrated a mass extending from the right atrium, involving the tricuspid valve, and extending into the right ventricle. Our differential diagnosis included thrombus as well as endocarditis and malignancy; a thrombus was considered to be the most likely etiology due to the port-a-cath device.

Massive Mural Thrombus Masquerading as Myxoma.

A 75-year-old Caucasian female with a past medical history including insulin-dependent diabetes mellitus, hypertension, and dyslipidemia, presented to the emergency room for having palpitations for three weeks. Echocardiography revealed a very large left atrial mass mimicking myxoma. Mass was excised and examined by pathology, revealing a mural thrombus.

A Unique Case of a Right Atrial Myxoma Infected With Escherichia coli.

A 70-year-old white male, with past medical history of coronary artery disease, peripheral arterial disease status-post bilateral femoral artery stents, insulin-dependent diabetes mellitus, hypertension, hyperlipidemia, arthritis, tobacco use, and alcohol use, presented with shortness of breath and an abnormal finding on a recent transesophageal echo. This had revealed a large, fixed mass in the right atrium. Our differential diagnosis had included thrombus, endocarditis, myxoma, papillary fibroelastoma, sarcoma, and metastatic tumor.

Rapidly enlarging mycotic coronary artery aneurysm caused by bacterial seeding involving methicillin-sensitive Staphylococcus aureus and Klebsiella pneumoniae.

Coronary artery aneurysms are uncommon. A rare subcategory caused by infectious etiologies are called mycotic coronary artery aneurysms (MCAA), which have an exceedingly high mortality rate. In this report, we present a rare case of a rapidly expanding MCAA involving Staphylococcus aureus and Klebsiella pneumoniae affecting the left circumflex artery.

Foreign body reaction toward hydrophilic polymer at the site of endovascular procedure: A report of two cases.

Hydrophilic polymer-coated devices have been increasingly utilized for various endovascular procedures, however not been without adverse effects. We report two cases of subacute cutaneous lesions on the neck encountered in our dermatology clinic. Histopathologic findings were significant for a nodular aggregate of epithelioid histiocytes and lymphocytes with numerous foreign body giant cells in the dermis.