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What Are These Anterior T Waves?: A High-Risk Ischemic Pattern That Should Be Recognized.
JACC Case Rep
January 2025
Cardiology Department, University Hospital Doctor Negrín, Las Palmas de Gran Canaria, Spain.
An 80-year-old woman with history of intermittent chest pain presented with a new self-limited episode. A 12-lead electrocardiogram was performed while she was asymptomatic, showing large T waves in V to V. We report a not so known electrocardiographic pattern that can be particularly valuable for identifying patients at high risk of extensive myocardial infarction and its subsequent complications.
View Article and Find Full Text PDFPregnancy-Associated Spontaneous Coronary Dissection in a 32-Year-Old During the Third Trimester.
JACC Case Rep
January 2025
Department of Cardiology, University of Giessen, Giessen, Germany.
We report a case of spontaneous coronary dissection (SCAD) in a 32-year-old pregnant patient during the seventh month of her second pregnancy. A 32-year-old pregnant woman in the 28th week of gestation was referred to our intensive care unit because of angina as well as elevated troponin levels. The initial electrocardiogram and transthoracic echocardiogram (TTE) were normal.
View Article and Find Full Text PDFUltra-High-Density Catheter Ablation of Purkinje Premature Ventricular Contractions Causing Electrical Storm.
JACC Case Rep
January 2025
Hospital Clínico Universitario Lozano Blesa, Zaragoza, Spain.
The postacute myocardial infarction electrical storm is a life-threatening entity. Resistance to ischemia in Purkinje fibers may be the origin of short-coupled premature ventricular contractions that trigger severe arrhythmic events. We present a case where the use of emergency catheter ablation, guided by a 3D navigation system and an ultra-high-density mapping catheter, successfully terminated the arrhythmic storm.
View Article and Find Full Text PDFTakotsubo Syndrome in a 47-Year-Old Woman With Repaired Tetralogy of Fallot.
JACC Case Rep
January 2025
Icahn School of Medicine Mount Sinai, New York, New York, USA.
Takotsubo syndrome or broken-heart syndrome is a rare form of nonischemic cardiomyopathy characterized by regional systolic dysfunction of the left ventricle without evidence of coronary artery disease or acute plaque rupture. This transient impairment in myocardial contractility leads to symptoms and signs that can mimic a myocardial infarction. We present a case of Takotsubo syndrome in a 47-year-old premenopausal woman with complex congenital heart disease who initially presented with acute onset of shortness of breath and chest tightness after a verbal altercation.
View Article and Find Full Text PDFCoronary CTA-Guided Bifurcation PCI: Role of FFR Virtual PCI and Myocardial Mass for Preprocedural Planning.
JACC Case Rep
January 2025
Center for Coronary Artery Disease, Minneapolis Heart Institute Foundation, Minneapolis, Minnesota, USA.
Coronary computed tomography angiography (CTA) analysis can help in the planning of percutaneous coronary intervention (PCI). Fractional flow reserve derived from coronary CTA (FFR), coronary CTA-derived regional myocardial mass, and FFR virtual PCI planner can facilitate decisions concerning sheath and guide catheter selection, stent lengths on the basis of predicted post-PCI FFR, optimal fluoroscopic angles, evaluation of provisional vs 2-stent bifurcation PCI techniques, and assessment of the magnitude of jeopardized myocardial mass in cases with side branch compromise. This case series illustrates the emerging opportunities for coronary CTA-based planning of bifurcation PCI.
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