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BMJ Case Rep 2021 Jun 11;14(6). Epub 2021 Jun 11.

Imperial College Healthcare NHS Trust, London, UK

Hyperthyroidism represents a state of hypercoagulability and hypofibrinolysis, which predisposes an individual to the increased risk of thromboembolism. We present a case of a 25-year-old patient presenting with an acute myocardial infarction secondary to plaque rupture with thrombotic occlusion of proximal left anterior descending artery, in a patient known to have Graves' disease. She had a sudden ventricular fibrillation arrest and a precordial thump given and cardiopulmonary resuscitation started. Read More

Am J Obstet Gynecol 2021 Jun 8. Epub 2021 Jun 8.

In the United States, it is estimated that 1% to 4% of pregnant women are infected with hepatitis C virus, which carries approximately a 5% risk of transmission from mother to infant. Hepatitis C virus can be transmitted to the infant in utero or during the peripartum period, and infection during pregnancy is associated with an increased risk of adverse fetal outcomes, including fetal growth restriction and low birthweight. The purpose of this document is to discuss the current evidence, provide updated recommendations regarding screening, review treatment, and address management of hepatitis C virus during pregnancy. Read More

Eur Heart J Case Rep 2021 Mar 10;5(3):ytab077. Epub 2021 Mar 10.

Cardiovascular Division, University of Nebraska Medical Center, 982265 Nebraska Medical Center, Omaha, NE 68198, USA.

Background: Coronary embolism is a rare cause of myocardial infarction (MI). We present a case report which emphasizes the importance of intracoronary imaging in these cases to identify the pathophysiological mechanism of MI.

Case Summary: A 53-year-old male with no past medical history presented to the hospital with typical angina. Read More

Zhonghua Wei Zhong Bing Ji Jiu Yi Xue 2021 May;33(5):568-572

Department of Cardiology, the Second People's Hospital of Wuxi Affiliated to Nanjing Medical University, Wuxi 214000, Jiangsu, China. Corresponding author: Su Tong, Email:

Objective: To evaluate the diagnostic value of circulating microRNA-1 (miR-1) in early coronary artery plaque rupture in patients with stable coronary artery disease (SCAD).

Methods: A prospective cohort study was conducted. Sixty-seven patients with SCAD admitted to the department of cardiology of the Third Affiliated Hospital of Soochow University from January to June in 2019 were enrolled. Read More

Vascular 2021 Jun 10:17085381211023229. Epub 2021 Jun 10.

Office of Healthcare-Associated Infection Management, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Ji'nan, China.

Purpose: To evaluate the safety and efficacy of transbrachial and transfemoral approaches combined with visceral protection for the endovascular treatment of juxtarenal aortoiliac occlusive disease (AIOD) over an average 19-month follow-up period.

Methods: In this retrospective analysis, all patients with juxtarenal AIOD at a single institution were reviewed from June 2015 to January 2020. Patient characteristics, angiographic results, and follow-up outcomes were retrospectively recorded. Read More

Eur Heart J Case Rep 2021 May 17;5(5):ytab176. Epub 2021 May 17.

Master of Public Health, Tehran Heart Center, Tehran University of Medical Sciences, North Kargar Ave., Tehran 1411713138, Iran.

Background: Rupture of sinus of Valsalva (RSV) to right atrium (RA) causes significant left to right shunt, tricuspid regurgitation, and right ventricular failure. If left uncorrected it can lead to biventricular heart failure. Hence, early invasive management is advised. Read More

Eur Heart J Case Rep 2021 May 24;5(5):ytab142. Epub 2021 May 24.

Department of Cardiovascular Medicine, McLaren Macomb Regional Medical Center, 1000 Harrington Street, Mount Clemens, MI 48043, USA.

Background: Takotsubo cardiomyopathy (TCM) can clinically present as an acute coronary syndrome; however, the former has regional wall motion abnormalities that extend beyond a single coronary vascular territory without any plaque rupture. Takotsubo cardiomyopathy classically involves apical ballooning of left ventricle (LV). It is uncommon for TCM to present as cardiopulmonary arrest (CPA) along with third-degree atrioventricular (AV) block. Read More

Eur Heart J Case Rep 2020 Dec 19;4(6):1-6. Epub 2020 Oct 19.

Department of Cardiothoracic and Vascular Surgery, Post Graduate Institute of Medical Education & Research, Sector 12, Chandigarh 160012, India.

Background: Aortobronchial fistula (ABF) formation following the rupture of thoracic pseudoaneurysm is a rare clinical entity. Its aetiology includes atherosclerosis, infections, trauma, post-surgery, and post-endovascular aortic repair. The clinical presentation of ABF includes intermittent or massive haemoptysis, acute respiratory distress, hypotension, and even death. Read More

Eur Heart J Case Rep 2019 Dec 26;3(4):1-6. Epub 2019 Oct 26.

Cardiology Department, Royal Free Hospital, Pond Street, London NW3 2QG, UK.

Background: Acute ST elevation myocardial infarction (STEMI) is a medical emergency and is most commonly due to atherosclerotic plaque rupture and occlusion of coronary vessels. This case demonstrates that eosinophilic granulomatosis with polyangiitis (EGPA) myocarditis can mimic acute STEMI.

Case Summary: A 44-year-old woman presented with acute chest pain, shortness of breath, and collapse with ST elevation on electrocardiography. Read More

Eur Heart J Case Rep 2021 Mar 7;5(3):ytab037. Epub 2021 Mar 7.

Department of Cardiothoracic Surgery, Humanitas Clinical and Research Centre, IRCCS, Via Alessandro Manzoni, 56, Rozzano, 20089 Milan, Italy.

Background: Left ventricular (LV) aneurysms complicate anterior myocardial infarctions (MIs) in 8-15% of cases. In case of associated LV dysfunction, rapidly evolving heart failure may follow, and urgent surgery becomes life-saving.

Case Summary: Following an acute anterior MI treated by percutaneous coronary intervention, which resulted in apical hypokinesis, depressed LV function, and moderate mitral regurgitation, a 70-year-old male patient kept in contact with our cardiology department through phone calls. Read More

Pan Afr Med J 2021 11;38:255. Epub 2021 Mar 11.

Faculté de Médecine d'Antananarivo, Antananarivo, Madagascar.

The management of breast cancer during pregnancy is a challenge for physicians due to mother´s desire to carry the pregnancy to term despite the need for chemotherapy. This study reports the case of a 37-year-old multiparous woman at 20 weeks and 4 days of amenorrhea (WA). She was hospitalized for dyspnoea (stage IV according to New York Heart Association (NYHA) classification). Read More

J Interv Cardiol 2021 17;2021:6661763. Epub 2021 May 17.

Department of Cardiology, Zhongshan Hospital, Fudan University, Shanghai Institute of Cardiovascular Diseases, Shanghai 200032, China.

Objectives: The present study aimed to investigate the short- and long-term clinical outcomes of self-made polyurethane-covered stents (PU-CS) in patients for the management of coronary artery perforation (CAP) during percutaneous coronary intervention (PCI).

Background: Coronary artery perforation is reckoned as a serious complication in PCI and associated with considerable morbidity and mortality. Covered stents have been used for treating the life-threatening CAP during PCI. Read More

J Card Surg 2021 Jun 8. Epub 2021 Jun 8.

Department of Cardiothoracic Surgery, Faculty of Medicine, University of Coimbra, Coimbra, Portugal.

Left ventricular free wall rupture (LVFWR) is a rarest but often lethal mechanical complication of acute myocardial infarction (AMI). The mortality rate for LVFWR is described from 75% to 90% and it is the cause for 20% of in-hospital deaths after AMI. Death results essentially from the limited time available for emergent intervention after onset of symptoms. Read More

Am J Emerg Med 2021 May 20;49:80-82. Epub 2021 May 20.

C.S. Mott Children's Hospital, University of Michigan, Emergency Department, Ann Arbor, MI 48109, United States.

This case report describes a rare etiology of cardiogenic shock, particularly in the pediatric population. A healthy 17 year old male presents from an outside hospital in undifferentiated shock requiring vasopressor support. Ruptured sinus of Valsalva aneurysm was diagnosed by echocardiogram and the patient went emergently to the operating room for surgical repair. Read More

Cureus 2021 Apr 28;13(4):e14740. Epub 2021 Apr 28.

Internal Medicine, Corpus Christi Medical Center, Corpus Christi, USA.

Kounis syndrome (KS) is defined as an allergic or hypersensitivity reaction leading to coronary vasospasm and acute coronary syndrome. The inflammatory mediators released during the body's reaction to an allergen causes vasoconstriction, plaque rupture, platelet aggregation, and even thrombosis of an existing coronary stent. Over the years, many allergens including drugs, environmental exposures, and animal and insect bites have been implicated in KS. Read More

Am J Case Rep 2021 Jun 4;22:e931060. Epub 2021 Jun 4.

Pathological Anatomy Section, Careggi University Hospital, Florence, Italy.

BACKGROUND Erdheim-Chester disease (ECD) is a rare form of non-Langerhans cell histiocytosis characterized by foamy histiocytes, Touton-like giant cells, and fibrosis, typically affecting the diaphyseal and metaphyseal region of the long bones but that can involve any organ or tissue. ECD is usually associated with the BRAF V600E mutation or with other molecular mutations inserted in the MAPK cascade. CASE REPORT We present the case of a 63-year-old man with a previous history of myocardial infarction who underwent an emergency splenectomy for splenic rupture after an accidental fall. Read More

Quant Imaging Med Surg 2021 Jun;11(6):2861-2878

Department of Cardiovascular Surgery, Beijing Aortic Disease Centre, Beijing Anzhen Hospital, Capital Medical University, Beijing Institute of Heart Lung and Blood Vessel Diseases, Beijing Engineering Research Centre for Vascular Prostheses, Beijing, China.

Infectious aortitis (IA) is a rare and life-threatening cardiovascular disease. Early diagnosis and timely intervention are crucial for reducing mortality associated with mycotic aortic aneurysms (MAAs); however, early diagnosis is challenging due to the nonspecific symptoms. Some cases are diagnosed at an advanced stage or after developing complications, such as rupture or aortic fistula. Read More

Vasc Health Risk Manag 2021 25;17:255-258. Epub 2021 May 25.

Department of Cardiology, Institute of Cardiovascular Diseases, Timisoara, Romania.

We report the case of a 48-year-old man, admitted for atrial fibrillation with rapid heart rate and intense chest pain. A quick evaluation revealed a giant aortic aneurysm with severe aortic regurgitation and pericardial fluid without a trace of aortic dissection. Because of high suspicion of aortic rupture, an emergency surgery was planned, and a Bentall procedure was performed. Read More

J Card Surg 2021 Jun 1. Epub 2021 Jun 1.

Department of Cardiothoracic Surgery, Heart and Vascular Centre, Maastricht University Medical Centre, Maastricht, The Netherlands.

Background: Left ventricular free-wall rupture (LVFWR) is one of the most lethal complications after acute myocardial infarction (AMI). The optimal therapeutic strategy is controversial. The current meta-analysis sought to examine the outcome of patients surgically treated for post-AMI LVFWR. Read More

J Clin Med 2021 May 26;10(11). Epub 2021 May 26.

BHF Centre for Cardiovascular Science, University of Edinburgh, Edinburgh EH16 4SA, UK.

The application of high-sensitivity cardiac troponins in clinical practice has led to an increase in the recognition of elevated concentrations in patients without myocardial ischaemia. The Fourth Universal Definition of Myocardial Infarction encourages clinicians to classify such patients as having an acute or chronic myocardial injury based on the presence or absence of a rise or a fall in cardiac troponin concentrations. Both conditions may be caused by a variety of cardiac and non-cardiac conditions, and evidence suggests that clinical outcomes are worse than patients with myocardial infarction due to atherosclerotic plaque rupture, with as few as one-third of patients alive at 5 years. Read More

Int J Mol Sci 2021 May 26;22(11). Epub 2021 May 26.

Department of Medicine 2-Cardiology and Angiology, Friedrich-Alexander-University Erlangen-Nürnberg (FAU), Universitätsklinikum, 91054 Erlangen, Germany.

In the 1900s, researchers established animal models experimentally to induce atherosclerosis by feeding them with a cholesterol-rich diet. It is now accepted that high circulating cholesterol is one of the main causes of atherosclerosis; however, plaque localization cannot be explained solely by hyperlipidemia. A tremendous amount of studies has demonstrated that hemodynamic forces modify endothelial athero-susceptibility phenotypes. Read More

Int J Mol Sci 2021 May 27;22(11). Epub 2021 May 27.

Chair and Department of Experimental and Clinical Physiology, Laboratory of Centre for Preclinical Research, Medical University of Warsaw, Banacha 1b, 02-097 Warsaw, Poland.

Myocardial infarction is one of the major causes of mortality worldwide and is a main cause of heart failure. This disease appears as a final point of atherosclerotic plaque progression, destabilization, and rupture. As a consequence of cardiomyocytes death during the infarction, the heart undergoes unfavorable cardiac remodeling, which results in its failure. Read More

Diagnostics (Basel) 2021 May 22;11(6). Epub 2021 May 22.

Department of Otorhinolaryngology, Faculty of Dental Medicine, Medical University of Warsaw, 02-097 Warsaw, Poland.

A chronic inflammatory process characteristic of obstructive sleep apnea promotes vascular endothelial dysfunction and atherogenesis. This process can lead to destabilization and rupture of cardiovascular plaques, which clinically manifests as an acute coronary syndrome or stroke. The aim of this study was to investigate the inflammatory pathway leading to plaque destabilization in non-to-mild and moderate-to-severe groups of OSA patients. Read More

Kyobu Geka 2021 Jun;74(6):446-448

Department of Thoracic and Cardiovascular Surgery, Shizuoka Saiseikai General Hospital, Shizuoka, Japan.

Traumatic cardiac rupture is mostly accompanied by tamponade and/or hemopericardium. We experienced a rare case of traumatic right atrial rupture with left hemothorax, but without hemopericardium. A 36-year-old male had a traffic accident, and was transported to our hospital. Read More

Rom J Anaesth Intensive Care 2020 Dec 31;27(2):77-79. Epub 2020 Dec 31.

Institutul de Urgenta pentru Boli Cardiovasculare Prof Dr C C Iliescu Bucharest, Romania.

Cardiogenic shock is a constant challenge for the intensivist when complicating a myocardial infarction, due to the high rate of associated morbidity and mortality, especially in the setting of mechanical complications such as papillary muscle rupture. We present the case of a 49-year-old woman with cardiogenic shock due to acute myocardial infarction (AMI) complicated by severe mitral valve insufficiency due to papillary muscle rupture. She was treated initially by medical optimization, followed by mitral valve replacement and complete surgical revascularization, requiring rescue mechanical circulatory support by extracorporeal membrane oxygenation (ECMO). Read More

Front Pediatr 2021 14;9:660519. Epub 2021 May 14.

Pediatric Heart Center, Children's Hospital of Fudan University, National Children's Medical Center, Shanghai, China.

Aortic valve rupture (AVR) due to blunt chest trauma is extremely rare in the pediatric population, and little attention has been paid to such damages. Early diagnosis of AVR may not be easy in patients with multiple competing injuries and poor acoustic windows. We report a case of delayed diagnosis of AVR in a 12-year-old boy after falling from a height of 15 meters, who presented with recurrent hemoptysis and ventilator dependence. Read More

Interv Cardiol Clin 2021 Jul;10(3):323-332

The Heart Center, St Francis Hospital, 100 Port Washington Blvd, Flower Hill, NY 11576, USA; Cardiovascular Research Foundation, 1700 Broadway, 9th Floor, New York, NY 10019, USA; New York-Presbyterian Hospital/Columbia University Irving Medical Center, New York, NY, USA. Electronic address:

Advances in intravascular imaging have enabled assessment of the underlying plaque morphology in acute coronary syndromes, which allows for the initiation of individualized therapy. The atherothrombotic substrates for acute coronary syndromes consist of plaque rupture, erosion, and calcified nodule, whereas spontaneous coronary artery dissection, coronary artery spasm, and coronary embolism constitute rarer nonatherothrombotic etiologies. This review provides a brief overview of the data from clinical studies that have used intravascular optical coherence tomography to assess the culprit plaque morphology. Read More

Eur J Orthop Surg Traumatol 2021 May 29. Epub 2021 May 29.

Bellvitge Biomedical Research Institute (IDIBELL), L'Hospitalet de Llobregat, Barcelona, Spain.

Introduction: Approximately 75% of patients with carpal tunnel syndrome (CTS) are diagnosed as idiopathic. Despite this, the presence of an underlying cause such as an anatomical variant or a systemic disease must always be suspected, especially in cases of bilateral presentation without an obvious cause, recurrence or complications. The anatomical variant known as the bifid median nerve (BMN) is a very rare abnormality that can occasionally lead to CTS. Read More

Matrix Biol 2021 May 25. Epub 2021 May 25.

The Wilf Family Cardiovascular Research Institute, Department of Medicine (Cardiology), Albert Einstein College of Medicine, 1300 Morris Park Avenue Forchheimer G46B, Bronx, NY 10461, United States. Electronic address:

Tissue injury results in profound alterations in the collagen network, associated with unfolding of the collagen triple helix, proteolytic degradation and generation of fragments. In the infarcted myocardium, changes in the collagen network are critically involved in the pathogenesis of left ventricular rupture, adverse remodeling and chronic dysfunction. We hypothesized that myocardial infarction is associated with temporally and spatially restricted patterns of collagen denaturation that may reflect distinct molecular mechanisms of collagen unfolding. Read More

PLoS One 2021 27;16(5):e0252042. Epub 2021 May 27.

Department of Neurology, Yonsei University College of Medicine, Seoul, Korea.

Background: High blood pressure is a major risk factor for the development and rupture of cerebral aneurysm. Endovascular coil embolization and surgical clipping are established procedures to treat cerebral aneurysm. However, longitudinal data of blood pressure after the treatment of cerebral aneurysm and its impact on long-term prognosis are not well known. Read More