scholarly journals The curious case of a massive right heart thrombosis: a case report

2021 ◽  
Vol 5 (7) ◽  
Author(s):  
Jessica Artico ◽  
Manuel Belgrano ◽  
Rossana Bussani ◽  
Gianfranco Sinagra
Keyword(s):  
Multimodality Imaging ◽  
Cardiac Computed Tomography ◽  
Rare Condition ◽  
Surgical Removal ◽  
Large Area ◽  
Good Clinical Condition ◽  
Life Threatening ◽  
Thrombotic Complications ◽  
The Right ◽  
Complete Investigation

Abstract Background Intraventricular masses are a relatively rare condition ranging from asymptomatic to potentially life-threatening situations. Case summary Herein, we report a case of a 49-year-old woman under investigation for a massive right ventricular (RV) mass who underwent complete investigation for possible differential diagnosis, in the suspect of RV tumour. Multimodality imaging with cardiac computed tomography and magnetic resonance imaging showed the presence of a massive thrombus partially obliterating the right ventricle. Surgical removal of the mass showed a large area of stratified thrombosis with an underlying area of endocardial fibrosis. The patient has been then discharged in good clinical condition and with lifetime oral anticoagulation. Discussion  Massive RV thrombosis is a rare yet potentially fatal condition. Invasive management is preferable and lifetime anticoagulation is required to reduce possible downstream thrombotic complications.

scholarly journals Unilateral Viable Twin Tubal Ectopic Pregnancy: A Case Report

2020 ◽  
Vol 2 (2) ◽  
pp. 01-03
Author(s):  
Afaf Felemban
Keyword(s):  
Ectopic Pregnancy ◽  
Standard Treatment ◽  
Lower Abdominal Pain ◽  
Rare Condition ◽  
Surgical Removal ◽  
Tubal Ectopic Pregnancy ◽  
Threatening Condition ◽  
Life Threatening ◽  
Laparoscopic Salpingectomy ◽  
The Right

Unilateral ectopic twin is a rare condition with only a few cases of viable ectopic twins reported. We report a 41 year- old, Gravida 6 Para 5 at 6 weeks gestation, presented to the Emergency Department with complaint of lower abdominal pain and vaginal spotting. Pelvic ultrasound showed twins with positive fetal heart beats in the right tube. Laparoscopic salpingectomy was performed to remove to fetus. Conclusion: viable ectopic pregnancy is a life threatening condition and can be diagnosed with ultrasound. Surgical removal is the standard treatment option.

scholarly journals A rare case of mobile ball-like mass in right atrium associated with dilated cardiomyopathy

2021 ◽  
Vol 2 (5) ◽  
Author(s):  
Jing Dong ◽  
◽  
Yiqun Gao ◽  
Shunji Liang ◽  
Guorong Deng ◽  
...  
Keyword(s):  
Anticoagulant Therapy ◽  
Right Atrium ◽  
Early Recognition ◽  
Therapeutic Option ◽  
Venous Pressure ◽  
Rare Condition ◽  
Good Clinical Condition ◽  
Mobile Mass ◽  
2D Echocardiogram ◽  
The Right

Mobile thrombus in the Right Atrium (RA) is a rare condition. Here, we described a case of a 59-year-old male who presented in emergency room with complaints of progressively worsening dyspnea for 7 years. He was normotensive, had elevated jugular venous pressure and clear lungs. ECG revealed ventricular tachycardia. After successfully electrical defibrillation, an urgent 2D echocardiogram was obtained and revealed the enlargement of all heart chambers and a ball-like, mobile mass in the right atrium. An emergent CT scan revealed no sign of pulmonary embolism. Based on morphological features on echocardiogram, we highly suspected it as RA thrombus. The patient was treated with anticoagulant therapy comprising of low molecular heparin and warfarin since he rejected surgical treatment. Repeat echocardiogram was performed 7 days after anticoagulant therapy and showed disappearance of the RA mass. He was subsequently maintained on warfarin (INR=2.4- 3.0) and other medications for heart failure. The patient was followed up as outpatient and kept in good clinical condition. We concluded that early recognition of this rare situation and prompt management can help in preventing life-threatening complications, and anticoagulant therapy was a therapeutic option for RA thrombus.

scholarly journals A Case of Unilateral Coccidioidal Chorioretinitis in a Patient with HIV-Associated Meningoencephalitis

2019 ◽  
Vol 2019 ◽  
pp. 1-3 ◽  
Author(s):  
Christopher B. Toomey ◽  
Andrew Gross ◽  
Jeffrey Lee ◽  
Doran B. Spencer
Keyword(s):  
Risk Factors ◽  
Vision Loss ◽  
Complement Fixation ◽  
Rare Condition ◽  
Threatening Condition ◽  
Life Threatening ◽  
History Of ◽  
Blurry Vision ◽  
Systemic Symptoms ◽  
The Right

Intraocular coccidioidomycosis is a rare condition, with the most commonly reported presentation being an idiopathic iritis in patients who live in or have traveled thorough endemic areas. A paucity of reports exists describing the chorioretinal manifestations of coccidioidomycosis. Here we report a case of unilateral coccidioidal chorioretinitis and meningoencephalitis in an AIDS patient that led to near complete unilateral loss of vision. A 48-year-old Hispanic female with poorly controlled HIV/AIDS in southern California presented with a three-week history of headache, nausea, vomiting, right eye blurry vision, and a one-day history of subjective fever. Examination of the right eye revealed vitritis and several large chorioretinal lesions scattered throughout the periphery and macula with optic disc pallor. Serum coccidioidomycoses complement fixation (CF) was positive (titers of 1 : 256). Neuroimaging revealed a new area of enhancement in the left anterior frontal lobe consistent with meningoencephalitis. The patient was treated with intravenous fluconazole and intravitreal voriconazole with resolution of systemic symptoms and vitritis but persistence of unilateral, severe chorioretinal scarring and vision loss. In conclusion, in spite of the rarity of intraocular coccidioidomycosis, one must carry a degree of suspicion for this vision- and life-threatening condition as a potential etiology of chorioretinitis in individuals with pertinent risk factors.

scholarly journals A case report of isolated severe valve stenosis in a previous tricuspid valve repair: an integrated multimodality imaging and invasive haemodynamic evaluation

2020 ◽  
Vol 4 (4) ◽  
pp. 1-5
Author(s):  
Jesper Khedri Jensen ◽  
Christian Alcaraz Frederiksen ◽  
Mads Jønsson Andersen ◽  
Steen Hvitfeldt Poulsen
Keyword(s):  
Case Report ◽  
Tricuspid Valve ◽  
Multimodality Imaging ◽  
Rare Condition ◽  
Tricuspid Valve Repair ◽  
Valve Prosthesis ◽  
Case Summary ◽  
Ring Annuloplasty ◽  
Final Treatment ◽  
The Right

Abstract Background Tricuspid valve (TV) stenosis is a very rare condition and the aetiology is primarily due to rheumatic disease, carcinoid disease, congenital heart disease, endocarditis, and following degeneration of biological valve prosthesis. Case summary We present a 45-year-old man with a rare case of symptomatic TV stenosis (TS) in a previously isolated TV repair. A meticulous multimodality diagnostic approach is presented in order to determine the severity of the TS and to evaluate the right ventricular function. Discussion This case report presents an integrated multimodality imaging and haemodynamic approach to evaluate and document the suspicion of development of a symptomatic significant stenosis in a previous TV repair. The initial TV repair was done without ring annuloplasty, because only the anterior leaflet was affected and bicuspidalization of the valve made it patent. In addition, minimizing the amount of implanted material was intended to minimize the risk of reinfection. The final treatment was performed as a TV replacement with insertion of a bioprosthesis.

scholarly journals A case report: a rare case of severe aortic incompetence

2020 ◽  
Vol 4 (3) ◽  
pp. 1-5
Author(s):  
Mandeep Singh Sondh ◽  
Rohit Tandon ◽  
Rajiv Gupta ◽  
Gurpreet Singh Wander
Keyword(s):  
Aortic Valve ◽  
Rare Case ◽  
Multimodality Imaging ◽  
Cardiac Computed Tomography ◽  
Interventricular Septum ◽  
Left Ventricular ◽  
Left Ventricular Cavity ◽  
Valve Prosthesis ◽  
Aortic Incompetence ◽  
The Right

Abstract Background Aneurysms of the sinus of Valsalva (SOV) are thin-walled outpouchings most commonly involving the right or non-coronary sinuses. Because they are asymptomatic, they are rarely discovered before they rupture and form an aorto-cardiac fistula. We present a rare case of unruptured aneurysm of the right coronary SOV burrowing into the interventricular septum with severe aortic incompetence and left ventricular dysfunction. To our knowledge, burrowing of the SOV aneurysm (SVA) into the interventricular septum and its large sac-like appearance has never been described using three dimensional (3D) echocardiography before. Case summary A 37-year-old man presented to the cardiology outpatient department with complaints of dyspnoea and palpitations (New York Heart Association Class II–III) for the last 6 months. He was evaluated with transthoracic echocardiography which showed a large mobile sac-like structure with irregular borders bulging and prolapsing into the left ventricular cavity with each cardiac cycle along with severe aortic incompetence. On transoesophageal echocardiogram, the right coronary cusp showed malcoaptation with deformed aortic sinus causing severe aortic incompetence. Cardiac computed tomography showed sparing of right coronary artery at the origin. A diagnosis of SVA was made. The patient underwent aortic valve replacement along with partial resection of the aneurysm. The patient had an uneventful postoperative course. Follow-up echocardiography after 4 weeks showed well-seated aortic valve prosthesis with residual SVA. The ejection fraction decreased from 46–48% to 36–38%. Discussion Comprehensive multimodality imaging can be used for management strategy of SVA.

scholarly journals COVID-19 related thrombi in ascending and descending thoracic aorta with peripheral embolization: a case report

2021 ◽  
Vol 5 (2) ◽  
Author(s):  
Jan W Buikema ◽  
Folkert W Asselbergs ◽  
Janneke Tekstra
Keyword(s):  
Thoracic Aorta ◽  
Thrombus Formation ◽  
The Body ◽  
Angiotensin Converting Enzyme 2 ◽  
Peripheral Embolization ◽  
Increased Risk ◽  
Life Threatening ◽  
Thrombotic Complications ◽  
The Right ◽  
The Brain

Abstract Background COVID-19 (severe acute respiratory syndrome coronavirus 2) infected patients have increased risk for thrombotic events, which initially may have been under recognized. The existence of cardiovascular emboli can be directly life threatening when obstructing the blood flow to vital organs such as the brain or other parts of the body. The exact mechanism for this hypercoagulable state in COVID-19 patients yet remains to be elucidated. Case summary A 72-year-old man critically ill with COVID-19 was diagnosed with a free-floating and mural thrombus in the thoracic aorta. Subsequent distal embolization to the limbs led to ischaemia and necrosis of the right foot. Treatment with heparin and anticoagulants reduced thrombus load in the ascending and thoracic aorta. Discussion One-third of COVID-19 patients show major thrombotic events, mostly pulmonary emboli. The endothelial expression of angiotensin-converting enzyme-2 receptors makes it feasible that in patients with viraemia direct viral-toxicity to the endothelium of also the large arteries results in local thrombus formation. Up to date, prophylactic anticoagulants are recommended in all patients that are hospitalized with COVID-19 infections to prevent venous and arterial thrombotic complications.

scholarly journals Wandering Spleen - A Possible Cause of Adrenal “Mass” - Case Report

2019 ◽  
Vol 0 (0) ◽  
Author(s):  
Slavica Markovic ◽  
Milan Paunovic ◽  
Biljana Vuletic ◽  
Zorica Raskovic ◽  
Gordana Kostic ◽  
...  
Keyword(s):  
Negative Attitude ◽  
Rare Condition ◽  
Good Health ◽  
Anterior Wall ◽  
Wandering Spleen ◽  
Anatomical Location ◽  
Ectopic Spleen ◽  
Life Threatening ◽  
Low Incidence ◽  
The Right

Abstract Wandering spleen is a very rare clinical condition characterized by spleen absence in the normal anatomical location in the upper left quadrant of the abdomen and its presence at another location in the abdomen or pelvis. The ectopic spleen is extremely rare in children, where its increased mobility is the result of a congenital disturbance of the fixation for the anterior wall due to the absence or weakness of the supporting ligaments. Wandering spleen is usually asymptomatic, but its torsion is possible, as well as infarction or rupture which demand an urgent diagnosis and surgical treatment. The diagnosis of wandering spleen can easily be overlooked due to low incidence and insufficient clinical experience, which multiplies patient’s risk from life-threatening conditions. We present a case of wandering spleen in an 11-year-old girl with acute abdominal pain, which after ultrasound examination raised suspicion on the right adrenal gland tumor. Additional diagnostics verified an ectopic spleen in the right adrenal box, after which the recommended preventive splenopexy was seriously considered. Due to the fixation of the vital spleen in the new position, but also the negative attitude of the parents towards the surgical intervention, clinical monitoring was selected, with exclusion of intense physical activity that carries the risk of traumatization of the spleen. As the girl has been in good health for over 3 years and without symptoms, we consider that the selection of conservative access although difficult, was correct. We hope that our experience in treating wandering spleen in girls will increase the number of valid facts about this rare condition.

scholarly journals Purposeful use of multimodality imaging in the diagnosis of caseous mitral annular calcification: a case series report

2022 ◽  
Vol 22 (1) ◽  
Author(s):  
Krunoslav Michael Sveric ◽  
Ivan Platzek ◽  
Elena Golgor ◽  
Ralf-Thorsten Hoffmann ◽  
Axel Linke ◽  
...  
Keyword(s):  
Multimodality Imaging ◽  
Cardiac Computed Tomography ◽  
Case Series ◽  
Rare Condition ◽  
Definitive Diagnosis ◽  
Mitral Annular Calcification ◽  
Typical Structure ◽  
Benign Condition ◽  
Outer Capsule ◽  
Annular Calcification

Abstract Background Caseous mitral annular calcification (CMAC) is a rare liquefactive variant of mitral annular calcification (MAC) and superficially mimics a cardiac vegetation or abscess. CMAC is viewed as a benign condition of MAC, while MAC has clinical implications for patients’ lives. Correctly diagnosing CMAC is essential in order to avoid unnecessary interventions, cardiac surgery or even psychological suffering for the patient. Case presentation We report on 6 patients with suspected intra-cardiac masses of the mitral annulus that were referred to our institution for further clarification. A definitive diagnosis of CMAC was achieved by combining echocardiography (Echo), cardiac magnetic resonance imaging (MRI) and cardiac computed tomography (CT) for these patients. Echo assessed the mass itself and possible interactions with the mitral valve. MRI was useful in differentiating the tissue from other benign or malign neoplasms. CT revealed the typical structure of CMAC with a “soft” liquefied centre and an outer capsule with calcification. Conclusion CMAC is a rare condition, and most clinicians and even radiologists are not familiar with it. CMAC can be mistaken for an intra-cardiac tumour, thombus, vegetation, or abscess. Non-invasive multimodality imaging (i.e. Echo, MRI, and CT) helps to establish a definitive diagnosis of CMAC and avoid unnecessary interventions especially in uncertain cases.

Ossification of the Achilles Tendon: A Case Report

1994 ◽  
Vol 15 (1) ◽  
pp. 44-47 ◽  
Author(s):  
Masahito Hatori ◽  
Atsushi Kita ◽  
Yoshinori Hashimoto ◽  
Nikichi Watanabe ◽  
Minoru Sakurai
Keyword(s):  
Case Report ◽  
Achilles Tendon ◽  
Previous History ◽  
Rare Condition ◽  
Chief Complaint ◽  
Surgical Removal ◽  
Intramembranous Ossification ◽  
History Of ◽  
Bony Mass ◽  
The Right

Ossification of the Achilles tendon is a rare condition. We recently treated a patient with ossification of bilateral Achilles tendons. The patient was a 50 year old male whose chief complaint was discomfort around the Achilles tendon. He had a previous history of treatment of bilateral club feet On the roentgenograms, the length of the bony mass in the Achilles tendon was 5.5 cm on the right side and 1.5 cm on the left side. The left side was treated by surgical removal of a bony mass and suture of the tendon. Microscopic examination of the extirpated specimen revealed bone formation through enchondral and intramembranous ossification in the Achilles tendon.

scholarly journals BLOOD CYSTS OF THE CARDIAC VALVES IN ADULTS Review and analysis of published cases

2021 ◽  
Author(s):  
Uberto Bortolotti ◽  
Igor Vendramin ◽  
Andrea Lechiancole ◽  
Sandro Sponga ◽  
Angela Pucci ◽  
...  
Keyword(s):  
Mitral Valve ◽  
Pulmonary Valve ◽  
Multimodality Imaging ◽  
Imaging Techniques ◽  
Fibrous Tissue ◽  
Surgical Removal ◽  
Cardiac Valves ◽  
Pertinent Literature ◽  
Systemic Complications ◽  
Life Threatening

Background and aim of the study: Blood cysts of cardiac valves are generally seen in newborns and infants and very rarely in adults. Although in most cases they are incidental findings they may be associated to severe cardiac or systemic complications. This study analyzes incidence, presentation and treatment of valvular blood cysts in adults. Methods: A review of the pertinent literature through a search mainly on PubMed and Medline was performed. Results: In patients ≥ 18 years of age, our search disclosed 54 patients with mitral blood cysts (mean age, 48±18 years), 9 with a tricuspid valve cyst (mean age, 67±15 years), 3 with a blood cyst on the pulmonary valve (age 31, 43 and 44 years) and 1 aortic valve cyst in a 22-year-old man. Most patients were asymptomatic while stroke, syncope or myocardial infarction occurred in 6 patients with a mitral valve cyst. Blood cysts were removed surgically in 70% of patients with a mitral cyst, in 55% with a tricuspid cyst and in all those with a pulmonary or aortic cyst. At histology the cyst wall was composed mainly by fibrous tissue and with the inner surface lined with typical endothelium. Conclusions: Blood cysts of cardiac valves are rare in adults but may cause life-threatening complications particularly when located on the mitral valve. For such reason surgical removal appears advisable, with low-risk procedures. Widespread use of multimodality imaging techniques will most likely increase the number of valvular blood cysts diagnosed also in adults.

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