Cardiac amyloidosis responding to bortezomib: case report and review of literature.

We report a case of a 53-year old patient with symptoms of congestive heart failure in whom a restrictive cardiomyopathy and a kappa-chain monoclonal gammopahty were diagnosed. Treatment with eight cycles of Bortezomib, a proteasome inhibitor, resulted in a significant regression of myocardial amyloid deposition and a notable clinical and hemodynamic improvement. Over the last few years, the management of cardiac amyloidosis has taken advantage of many of the advances of the chemotherapeutic regimens, as well as the wider availability of stem cell transplantation.

ST segment elevation in lead aVR: what to expect from this orphan?

Standard 12-lead electrocardiography is used to diagnose acute myocardial infarctions in patient presenting with ST elevation. The specificity of ST segment elevation for the corresponding area is more than 90 percent. It has been suggested that ST-segment elevation in lead aVR may indicate left main disease.

Atrial flutter and myotonic dystrophy in a male adolescent treated with radiofrequency catheter ablation.

A variety of cardiomyopathies are due to familial disease. Most are primarily associated with cardiac involvement and can lead to hypertrophic, dilated, or restrictive cardiomyopathy. Myotonic dystrophy (MD) is a multisystem disease with autosomal dominant inheritance and variable penetrance.

Initial description of radiofrequency catheter ablation as treatment for atrial flutter in Marfan's syndrome: a case report and literature review.

Marfan's syndrome is a common connective tissue disease with different musculoskeletal, ophthalmic and cardiac manifestations. Marfan's patients carry increased risk for cardiac arrhythmias. Only three cases of atrial flutter in Marfan's patients are described in the literature.

Methadone and torsade de pointes: case report and review of the literature.

Methadone, a synthetic opioid, has been used for more than 35 years to treat heroin addiction. It is also an effective therapy for chronic pain. An increase in the mean dose used nationally to treat these patients has been reported.

Tricuspid valve malfunction and ventricular pacemaker lead: case report and review of the literature.

Pacemaker implantation can be associated with several complications, including myocardial perforation with or without pericardial effusion, venous thrombosis, vegetations of the tricuspid valve (TV) or pacing lead, and tricuspid regurgitation (TR). The TR is thought to be derived from deformity or perforation of the TV by the pacing lead or secondary to atrioventricular discordance with asynchronous ventricular pacing. Severe TR can be deleterious to the patient because it raises the central venous pressure by increasing the right sided preload.

Idiopathic polymorphic ventricular tachycardia with normal QT interval in a structurally normal heart.

Polymorphic ventricular tachycardia (PVT) is a life-threatening arrhythmia that is typically related to long QT syndrome, organic heart disease, electrolyte abnormalities, cardiotoxic drugs, or adrenergic stimulation. A review of the literature reveals that PVT with normal QT interval and without underlying cause is quite rare. We report a case of idiopathic spontaneous PVT with structurally normal heart and without electrolyte abnormalities, drug reactions, or evidence of catecholamine induced arrhythmia.

Alveolar hemorrhage: an underdiagnosed complication of treatment with glycoprotein IIb/IIIa inhibitors.

Objective: Alveolar hemorrhage (AH) is a rare complication of treatment with GP IIb/IIIa inhibitors. Hemoptysis, a constant sign, lacks in specificity, and may occur in confounding syndromes such as pulmonary edema, pulmonary infarction, and pneumonia. Nonspecific symptoms and signs often delay the diagnosis, thereby allowing serious or even fatal disease progression.

Tako-tsubo syndrome as a consequence of transient ischemic attack.

An 82-year-old woman presented to the emergency department with chest pain after sustaining a transient ischemic attack 1 week prior to presentation. Electrocardiography revealed ST-segment elevation in leads I, II, aVF, and V3 through V6. Coronary angiography demonstrated nearly normal coronaries but left ventriculography showed apical akinesis and basal hyperkinesis.

Papillary fibroelastoma involving the left ventricular wall.

A 71-year-old white woman presented to her primary care physician for a routine visit and was found to have a new, previously undocumented cardiac murmur. A subsequent transthoracic echocardiogram revealed a 1 cm mobile mass arising from the lateral free wall of the left ventricle. Transesophageal echocardiography later confirmed these findings.