Stroke resulting from an isolated pulmonary arteriovenous malformation.

Isolated pulmonary arteriovenous malformations (PAVM) are rare, but can be responsible for paradoxical embolic events. It is important to recognise these situations early and intervene quickly to attain the best outcome. We describe the case of a 45-year-old woman with a long-standing history of migraines with aura who presented to the emergency department with left-sided weakness and slurred speech.

Acute streptococcal myocarditis presenting as acute ST-elevation myocardial infarction.

Acute streptococcal myocarditis is an uncommon diagnosis in the developed world. Its presentation masquerading as acute myocardial infarction is still uncommon. We describe a case of a young male presenting with a recent diagnosis of streptococcal pharyngitis followed by a classical presentation of post streptococcal myocarditis.

Chronic total occlusion angioplasty through supplying collaterals.

Chronic total occlusions are typically difficult to recannalize especially when adverse angiographic morphologies are identified. We describe a case of chronic total occlusion crossing retrograde through the supplying collaterals followed by successful angioplasty and stenting.

A role for CXCL12 (SDF-1alpha) in the pathogenesis of multiple sclerosis: regulation of CXCL12 expression in astrocytes by soluble myelin basic protein.

The pathogenic mechanisms that contribute to multiple sclerosis (MS) include leukocyte chemotaxis into the central nervous system (CNS) and the production of inflammatory mediators, resulting in oligodendrocyte damage, demyelination, and neuronal injury. Thus, factors that regulate leukocyte entry may contribute to early events in MS, as well as to later stages of lesion pathogenesis. CXCL12 (SDF-1alpha), a chemokine essential in CNS development and a chemoattractant for resting and activated T cells, as well as monocytes, is constitutively expressed at low levels in the CNS and has been implicated in T cell and monocyte baseline trafficking.

The Mayo Clinic Risk Score predicts in-hospital mortality following primary angioplasty.

Background: The Mayo Clinic Risk Score (MCRS) is a validated numeric score that predicts outcome following primary percutaneous coronary intervention (PCI).

Purpose: We evaluated the ability of MCRS to risk stratify patients undergoing primary angioplasty.

Methods: Patients undergoing primary angioplasty within 6 hours of the onset of chest pain in the New York State percutaneous coronary intervention reporting system (n = 3,005) had their MCRS calculated using predictive variables: age, presence of cardiogenic shock, renal failure, class III-IV congestive heart failure, left main coronary disease and multivessel coronary disease.

Late cardiac perforation following transcatheter atrial septal defect closure.

Transcatheter closure of secundum atrial septal defect (ASD) has become an alternative to surgery. We present a patient with hemodynamic collapse secondary to cardiac perforation occurring 6-months after the placement of an Amplatzer Septal Occluder and discuss the utilization/complications of this device.