Cardiology

Symptoms of Refsum disease, such as retinitis pigmentosa, usually present in late childhood and adolescence, but cardiac manifestations are frequent in the late course of the disease.

When a patient presents with hemolytic anemia, thrombocytopenia, acute renal failure or neuropsychiatric symptoms after complicated cardiac surgery, TTP should be suspected. Make sure you know how to rapidly diagnose and treat this life-threatening emergency.

Severe cardiomyopathy presenting 20 years after anthracycline treatment for non-Hodgkin’s lymphoma during early adulthood. The patient's worsening heart failure was successfully managed with multidrug treatment with add-on vericiguat and ivabradine based on quadruple therapy. 

A case of severe stress cardiomyopathy, identified during the postoperative wake-up period, in a patient with scoliosis and pectus excavatum who underwent spinal corrective surgery.

A rare case of native valve endocarditis caused by C. striatum in a young adult despite no structural heart disease or indwelling medical devices. 

Aorto-right atrial fistula associated with Stanford type A aortic dissection is rare, and difficult to diagnose clinically. Intraoperative diagnosis in this case allowed effective treatment by direct suture.

Acute heart failure was triggered by a congenital arteriovenous malformation in the lower limb. An abdominal aortic stent graft and embolization effectively resolved the issue. 

Spinal CSF leak from a dural tear or CSF-venous fistula are known causes of spontaneous intracranial hypotension, but this is the first case caused by a primary CSF-lymphatic fistula unrelated to vascular malformation.

An unusual case of heart failure caused by ten years of anti-vascular endothelial growth factor treatment for polypoidal choroidal vasculopathy. The HF resolved after cessation of anti-VEGF injections. 

A 41-year-old man presented with severe hand and wrist pain in both hands, and mild epigastric pain. An ECG showed anterior STEMI with an ejection fraction of 35–40%. Angiography showed severe left anterior descending artery and first obtuse marginal artery stenosis.

An extensive history of treatment-resistant migraine was eventually found to be a superficial aneurysm after the patient developed a painless lump in the left temporal region.

The first reported case of constrictive pericarditis in a patient with fiberglass lung disease. Careful review of exposure history and histopathological examinations are the key to diagnosis.

Confirmed primary cardiac angiosarcoma in a healthy adolescent was seen to spontaneously regress after initial percutaneous biopsy, with subsequent increase in size of the mass 4 months later. 

Nephrotic syndrome is usually caused by primary renal disorders, but you should consider metabolic diseases in atypical cases. This 7-month-old presented with nephrotic syndrome, malignant hypertension, and hemolytic anemia.

Pulmonary arteriovenous fistula is a rare type of cyanotic pulmonary vascular malformation with right-to-left shunt. This case reports co-presentation in a patient with atherosclerotic heart disease.  

Left bundle branch area pacing, which captures the left conduction system and progresses along the Purkinje system, is a novel pacing technique that shows promise. However these two cases describe procedural complications to be wary of. 

Co-presentation of aortic aneurysms and a shaggy aorta carry catastrophic risks of brain infarction and spinal cord injury. Follow the surgical approach taken in this high-risk case.

Carney syndrome is a rare autosomal genetic disorder characterised by myxomas, skin pigmentation, and endocrine hyperfunction. In this case cardiac myxoma caused by Carney syndrome combined with heart failure resulted in heart transplantation.

A patient with a rapamycin-eluting stent developed eosinophilia and interstitial pneumonia, highlighting the need for awareness of possible side effects of stent implantation so treatment can be started promptly.

BRASH syndrome (bradycardia, renal failure, atrioventricular node blocking, shock, and hyperkalemia), in this case triggered by extreme dehydration, was complicated by concomitant digoxin.