We present cases of athlete’s heart, idiopathic HCM, and glycogen storage cardiomyopathy (PRKAG2). The two non-athlete patients (Pts) underwent genetic studies and myocardial biopsies. […]

A fifty-two-year-old Caucasian woman was admitted for severe epigastric pain irradiating to the back. Physical examination and electrocardiogram were normal. Laboratory tests showed leucocytosis (11100 cells/uL) and increased levels of C-reactive protein (15.6 mg/dl). Due to the suspicion of acute aortic syndrome (AAS), she underwent computed tomography (CT), which showed a low attenuation circumferential mural thickening of the aorta (43 Hounsfield units (HU)), which enhanced (73 HU) after contrast administration (-), suggestive of aortitis. Transesophageal echocardiogram also revealed thickened thoracic […]

Many patients die immediately after suffering a heart wound; on the other hand, many others die before the surgery, during surgery or later, due to complications. We admitted a 33-year-old man after a suicide attempt occurring one hour before, with eleven knife-wounds localized in the left-anterior chest wall (). Physical exam showed hypotension, dyspnea, high central venous pressure and mild external bleeding. Hemodynamic monitoring, tracheal intubation, vasopressor perfusion, fluid therapy and urgent echocardiogram and tomography were undertaken. ACT showed severe […]

A 60-year-old Caucasian female with a history of rheumatic mitral stenosis, permanent atrial fibrillation and chronic lymphocytic leukemia was admitted due to decompensated chronic heart failure. The transthoracic echocardiogram depicted a severe mitral stenosis (anatomic valve area of 0.9 cm2), mild mitral regurgitation, aneurysmatic left atrium and mildly compromised left ventricular ejection fraction. Given the indication for mitral valve replacement, coronary angiography was performed, revealing an abnormal vascularized mass at the level of the left atrium beyond normal coronary arteries […]

A 61-year-old female patient with chronic obstructive pulmonary disease, and no other comorbidities, was referred for cardiological assessment due to aggravated exertional dyspnea (New York Heart Association – NYHA class III) and atypical chest pain. Physical examination disclosed only a diastolic murmur in the second intercostal space in the right sternal border. The transthoracic echocardiogram (TTE) showed aortic regurgitation (), with non-dilated cardiac chambers and preserved biventricular function. The acoustic window limited the evaluation of the valvular lesion severity and […]

A 45-year-old male without past medical history presented with retrosternal chest pain and ST-segment elevation in inferolateral leads at ECG. Invasive coronary angiography, along with optical coherence tomography performed as part of the clinical study, showed normal coronaries, and myocardial infarction with non-obstructive coronary arteries (MINOCA) was diagnosed (-). Due to ongoing chest pain, triple-rule-out computed tomography angiography (CTA) was undertaken to exclude aortic dissection and pulmonary embolism. Incidentally, anomalous left circumflex artery (LCx) originating from the right sinus of […]

A 34-year-old man was referred to our institution after an echocardiography performed at another center because of tachycardia (atrial flutter), which showed heterogeneous pericardial mass infiltrating the right chambers. Thoracic computed tomography (CT) and cardiac magnetic resonance (MR) imaging were performed for more accurate assessment of the exact tumor location, size, and potential infiltration of other cardiac and mediastinal structures. CT () and MR imaging () confirmed an 8-cm ill-defined heterogeneous enhancing pericardial mass infiltrating the anterior and superior walls […]

A 61-year-old man with type II diabetes mellitus was referred with breathlessness on exertion. On auscultation, there was a continuous ejection systolic murmur on the left upper sternal border. Transthoracic echocardiography showed a dilated vessel in aortic wall in the parasternal long axis view () and a spherical lesion in the apical 4-chamber view (). A coronary computed tomographic angiographic (CTCA) study revealed a dilated and ectatic right coronary artery (RCA). It arose from the ascending aorta at the 12 […]

An 80-year-old woman with a history of mitral and aortic prosthesis replacement with biological prostheses due to endocarditis presented worsening dyspnea. A transthoracic echocardiogram demonstrated a paravalvular regurgitation between the left ventricle and left atrial appendage. Given her high-risk surgery (EuroSCORE-II: 38%), a percutaneous approach was performed for definitive closure. Transesophageal echocardiography (TEE) peri-procedure allowed the visualization of a partial dehiscence of the mitral prosthesis (Panel A, ). Through the 3D images, a tunneled defect with wall dissection measuring 12.5 […]

A 74-year-old woman with a history of membranous glomerulonephritis and a recent diagnosis of mediastinal adenopathy was admitted to the emergency department with acute heart failure. She complained of progressive dyspnea and weakness in the last week. Physical examination revealed hypotension, tachypnea, jugular vein distention, and desaturation. The most relevant laboratory findings were: anemia, lymphocytopenia, lactic acidosis, and increased lactate dehydrogenase. An electrocardiogram showed rapid atrial fibrillation and low-voltage QRS complexes. An echocardiogram revealed severe pericardial effusion and diffuse heterogeneous […]