Left ventricular noncompaction.

According to the World Health Organization classification of cardiomyopathies, left ventricular noncompaction is still an unclassified cardiomyopathy. In 2006, the American Heart Association classified this entity as a primary cardiomyopathy of genetic origin. In 2008, the European Society of Cardiology updated the classification scheme similar to the World Health Organization classification.

A ventricular septum filleted down the middle.

Trauma inflicted by sharp penetrating objects can cause unusual and complex injuries to the heart. We present a case where penetrating trauma caused an unusual ventricular laceration that filleted the ventricular septum into two separate sections creating an artificial chamber in between. The ventricular septal defect was clearly displayed with echocardiography and required special cardiac surgical intervention.

Safety of exercise testing in the chest pain unit: 31-mm ST elevation in variant angina.

We discuss a patient who presented with symptoms classic for variant angina with dramatic 31-mm ST elevation secondary to exercise testing in the chest pain unit, in whom neither myocardial infarction nor severe arrhythmia resulted. Although exercise testing is deemed generally safe, it has not been studied for safety per se in patients with variant angina. Further studies are needed to determine if the magnitude of ST elevation during exercise testing carries prognostic significance.

Massive posterior mitral annular calcification causing dynamic left ventricular outflow tract obstruction: mechanism and management implications.

We report a case of massive posterior mitral annular calcification causing severe systolic anterior motion of the anterior mitral leaflet and dynamic left ventricular outflow tract obstruction. Mechanism of genesis of systolic anterior motion by this unusual mechanism is illustrated. Importance of recognizing this mechanism and its implications for surgical therapy are discussed.

Left atrial thrombosis in pregnant women with mitral stenosis and sinus rhythm.

Objective: The purpose of this study was to describe pregnant patients with mitral stenosis who had intracardiac thrombosis in the absence of atrial fibrillation.

Study Design: We reviewed the clinical course of 3 pregnant women with severe mitral stenosis and normal sinus rhythm who had clinically significant intracardiac thrombosis.

Results: The first patient was examined at 21 weeks of gestation with embolic stroke that was the result of left atrial thrombus.