Malignant pericardial effusions: A retrospective look at etiology and prognosis in a tertiary oncological center.

Purpose: Cancer and the associated treatments are important causes of pericardial effusion. However, the natural history of malignant pericardial effusion is largely unknown, especially in the context of newer cancer treatments. We investigated the causes of pericardial effusions in a tertiary oncology center, with particular focus on the prognosis of malignant effusions in the era of contemporary oncological therapies.

Myocarditis with Associated Left Ventricular Apical Thrombus.

myocarditis is a rare diagnosis with a high mortality rate, usually seen in people who are immunocompromised. Here, we report a case of a 44-year-old man on methotrexate for rheumatoid arthritis who presented in septic shock and was diagnosed with myocarditis. The myocarditis was associated with a left ventricular apical thrombus, with normal systolic function.

Acute myocarditis with thrombus near left ventricular outflow tract.

A young woman presented with fulminant heart failure. Transthoracic echocardiography revealed severe left ventricular dysfunction with a mass adjacent to the basal anterior wall, near the left ventricular outflow tract (LVOT). The cause of the acute heart failure and mass was unclear.

Abnormal right ventricular relaxation in pulmonary hypertension.

Left ventricular diastolic dysfunction is a well-described complication of systemic hypertension. However, less is known regarding the effect of chronic pressure overload on right ventricular (RV) diastolic function. We hypothesized that pulmonary hypertension (PHT) is associated with abnormal RV early relaxation and that this would be best shown by invasive pressure measurement.

Echocardiographic monitoring for clozapine cardiac toxicity: lessons from real-world experience.

Objective: We aimed to identify the baseline prevalence of cardiac dysfunction in patients commencing clozapine, assess adherence with echocardiographic monitoring recommendations, and evaluate the utility and cost of echocardiographic monitoring for the development of clozapine-associated myocarditis and cardiomyopathy.

Methods: A retrospective longitudinal cohort study was undertaken of 159 consecutive patients from a major tertiary centre commencing clozapine in the period January 2002 to July 2009.

Results: Some 73% of patients had a baseline study, and 11% had a six-month follow-up study.

A clinical decision rule to aid ordering of serum and urine protein electrophoresis for case-finding of paraproteins in hospitalized inpatients.

Objective: To develop a simple clinical decision rule that could increase the yield of serum and urine protein electrophoresis (SPE/UPE) without loss of sensitivity.

Design: A cross-sectional study of inpatients with a SPE/UPE performed over a 5-year period (2001-2006) with complete data on electrolytes, globulins, full blood count, creatinine, age, and gender.

Setting: A tertiary-care general teaching hospital serving the Hunter Valley in New South Wales, with a referral population of over 1 million.