Between a Rock and a Hard Place: Metastatic Calcinosis of Left Ventricular Outflow Tract Secondary to Renal Failure Resulting in Symptomatic Aortic Regurgitation.

• Cardiac complications are the most common cause of death in dialysis patients. • Cardiac complications include coronary disease, arrhythmias, and valvular disease. • Valvular calcification can lead to valve dysfunction, conduction issues, and embolism.

Right Atrial Appendage Thrombus in Atrial Fibrillation: A Case Report and Review of the Literature.

Atrial fibrillation (Afib) is the most common abnormal heart rhythm in adults and has become a significant public health concern affecting 2% to 3% of the population in Europe and North America. Left atrial appendage (LAA) thrombi is the source of 90% of left-sided cardiac thrombi in patients with Afib, which can cause stroke and other systemic vascular events. Right atrial appendage (RAA) thrombi formation in Afib is much less common but complications include pulmonary embolism or paradoxical migration across patent foramen ovale with risk of systemic embolization.

A Complex Ventricular Septal Defect Causing Severe Aortic Insufficiency.

We report a case of a 60-year-old male with decompensated heart failure secondary to severe aortic insufficiency in the setting of a complex ventricular septal defect. The case highlights the use of multimodality imaging, including transthoracic echocardiogram, transesophageal echocardiogram, and cardiac magnetic resonance imaging, which contributed to the findings and diagnosis of the defect noted and was confirmed during surgery. The images provide an exceptional understanding of a complex ventricular septal defect and the associated pathology, which resulted in severe aortic regurgitation leading to cardiomyopathy.

A case report of an unusual left atrial mass.

Background: Cardiac foreign bodies (FBs) are rare findings that may present as cardiac masses initially. Here, we present an exceptional and rare case of a hypodermic needle FB that transmigrated to the left atrium and presented as a left atrial mass.

Case Summary: A 28-year-old woman with multiple psychiatric disorders including intentional FB ingestion and self-inflicting injuries presented to the emergency room with abdominal pain, nausea, vomiting, diarrhoea, and chest pain that radiated to the left arm and face for 2 weeks.

Renal Cell Carcinoma with Right Ventricular Metastatic Spread: An Unusual Finding with Poor Prognosis.

• RCC is the most common type of renal cancer. • RCC is capable of passing through the renal vein into the IVC. • Surgical resection requiring cardiopulmonary bypass is currently the only curative treatment.

A Shortcut to Death: Aorto-Left Atrial Fistula in the Setting of MRSA Infective Endocarditis.

• AAFs convey very high mortality and require prompt diagnosis and management. • Echocardiography, especially TEE, plays a critical role in timely assessment. • Poor prognostic risk factors include shock, paravalvular leakage, and CHF.

Endocarditis with Perivalvular Abscess Presenting as Atrioventricular Block.

is an aerobic, Gram-negative bacillus first identified in 1819 (Yeung et al. 2018). infective endocarditis is extremely rare accounting for only 0.

Reducing 30-Day Readmissions for Chronic Obstructive Pulmonary Disease.

A quality improvement project to reduce 30-day readmissions for chronic obstructive pulmonary disease (COPD) is described. A telephone assessment using the Medical Research Council Scale was completed within the first 5 days after discharge in patients with a diagnosis of COPD to evaluate dyspnea level.

Association of cardiac events with coronary artery disease detected by 64-slice or greater coronary CT angiography: a systematic review and meta-analysis.

Background: The value of ≥64-slice coronary CT angiography (CCTA) to determine odds of cardiac death or non-fatal myocardial infarction (MI) needs further clarification.

Methods: We performed a systematic review and meta-analysis using publications reporting events/severity of coronary artery disease (CAD) in patients with suspected CAD undergoing CCTA. Patients were divided into: no CAD, non-obstructive CAD (maximal stenosis <50%), and obstructive CAD (≥50% stenosis).

An algorithm for identification of ST-elevation myocardial infarction patients by emergency medicine services.

Objective: ST-elevation myocardial infarction (STEMI) identification by emergency medicine services (EMS) leading to pre-hospital catheterization laboratory (CL) activation shortens ischemic time and improves outcomes. We examined the incremental value of addition of a screening clinical tool (CT), containing clinical information and a Zoll electrocardiogram (ECG)-resident STEMI identification program (ZI) to ZI alone.

Methods: All EMS-performed and ZI-analyzed ECGs transmitted to a percutaneous coronary intervention hospital from October 2009 to January 2011 were reviewed for diagnostic accuracy.

Prognostic significance of troponin T elevation in patients without chest pain.

Increased cardiac troponin with chest pain is important for the diagnosis, triage, and treatment of patients in the emergency department. However, the use of troponin for the diagnosis and triage of patients without chest pain is poorly established. The aim of this study was to determine 30-day and 1-year mortality and morbidity of troponin T increases in patients without chest pain.

Quantitative contrast enhanced magnetic resonance imaging for the evaluation of peripheral arterial disease: a comparative study versus standard digital angiography.

Objective: The purpose of this study is to evaluate the accuracy of semiautomated analysis of contrast enhanced magnetic resonance angiography (MRA) in patients who have undergone standard angiographic evaluation for peripheral vascular disease (PVD).

Background: Magnetic resonance angiography is an important tool for evaluating PVD. Although this technique is both safe and noninvasive, the accuracy and reproducibility of quantitative measurements of disease severity using MRA in the clinical setting have not been fully investigated.

Hemodynamic complications of ventricular septal rupture after acute myocardial infarction.

Ventricular septal rupture (VSR) is a rare but serious complication following acute myocardial infarction (MI). Patients may present with a new murmur associated with a thrill. Right heart catheterization will demonstrate elevated right atrial and pulmonary artery pressures as well as an oxygen step-up at the right ventricular level.