IHJ Cardiovascular Case Reports (CVCR)最新文献

Brugada-type electrocardiographic pattern (BTEP) is caused by inherited sodium channelopathy of the cardiomyocyte which can be augmented in fever. We are reporting the first case series of BTEP unmasked by dengue fever in Malaysia. Detecting BTEP is crucial in regions where both dengue fever and Brugada syndrome is prevalent.

Sudden cardiac death is the final event caused in several cases by ventricular arrhythmias. Transvenous implantable cardioverter-defibrillators have been the standard therapy for the prevention of sudden cardiac death. The most frequent complications associated with TV-ICD is related to intracavitary electrodes. S-ICD has been developed as an alternative system. Novel S-ICD device in prevention of SCA was implanted in 8 patients with an average follow up period of 2.5 years. Bleeding and inappropriate shock was reported in one patient. Appropriate shock for ventricular tachycardia was observed in 5 patients. There was no death reported in any of the patients.

A 30-year-old lady with severe Rheumatic Mitral stenosis underwent PTMC. Despite a good result, echocardiogram on post-op day one showed a mobile mass attached to the mitral chordae causing diagnostic dilemma between a thrombus and damaged chordae, despite undergoing a cardiac MR to assess the nature of the mass. However, the mass disappeared after 4 weeks of receiving oral anticoagulation, favouring the diagnosis of a thrombus on MV apparatus.

Push up induced brachial artery pseudo aneurysm (BAPA) in the antecubital fossa is rare. When there is involvement of the ulnar and radial artery, percutaneous closure using thrombin is preferred to surgery or covered stent. A 52-year-old man, known hypertensive on angiotensin receptor blocker, presented with a giant right antecubital fossa pseudo aneurysm after a push-up exercise. The neck of the aneurysm was located where the brachial artery was dividing into UA and RA. Ultrasound guided neck compression had no effect. A staged direct thrombin injection thrombosed the sac. A follow period of 15 months showed normal flow in the BA, RA, and UA.

Wellen's sign occurs due to either critical stenosis in the proximal left anterior descending artery (LAD) or coronary steal phenomenon. Here we report a case of a 57-year-old gentleman with anomalous origin of the right coronary artery from mid LAD, where both these phenomena contributed together leading to Wellen's sign.

We present the case of a 23 year old male, marijuana smoker, who suffered acute anterior wall MI. OCT study revealed red thrombus with adequate minimum lumen area in LAD, which was managed with DAPT. Repeat OCT study revealed complete resolution of thrombus with underlying plaque erosion.

Electrical alternans i.e., beat to beat of variation of QRS amplitude has been classically described in pericardial tamponade. Rarely, alternative causes are found in patients with QRS alternans. We report a case of atypical electrical alternans in a middle-aged female in the absence of pericardial effusion. A careful analysis of QRS complexes in our case suggested a unique pattern of alternans varying with respiratory movements instead. On evaluation, we found large left sided pleural effusion as the key underlying mechanism of the atypical alternans.

Iatrogenic aortocoronary dissection is a scarcely reported complication of cardiac catheterization, which can be fatal if not managed promptly. We present a case of extensive aortocoronary dissection extending into aortic arch in a patient undergoing primary percutaneous coronary intervention (PCI) of right coronary artery (RCA) and its successful percutaneous management.

OCT can assess the extent and depth of calcification in severely calcific coronary lesions to define the most apt lesion-modification therapy. We present a 56-year-old male with a severely calcific LAD/D1 bifurcation lesion requiring rotablation prior to OCT, followed by a 2 mm cutting balloon for lesion preparation. Subsequently a 2.25 × 32 mm stent was post-dilated to 24atm with an NC balloon. However, a waist necessitated subsequent post-dilation with a 2.5 × 10 mm OPN NC balloon at 38 atm. OCT vessel sizing and accurate plaque characterization allowed a successful outcome in this complex situation.

We report a case of endovascular management of a patient who presented with occlusion of the stent in the Celiac artery. A 44-year-old male presented with postprandial angina, and a history of Celiac artery Stenting done with a Herculink Elite® Renal Stent system 3 years earlier. The patient was successfully treated by endovascular recanalization of the celiac artery stent with percutaneous transcatheter balloon angioplasty and stenting. In this case we discuss the various techniques and hardware used in a challenging peripheral transcatheter intervention for successful revascularization of the celiac artery.