scholarly journals When multimodality cardiac imaging saves the day: rare cause of embolic strokes

2020 ◽  
Vol 13 (1) ◽  
pp. e232786
Author(s):  
Polyvios Demetriades ◽  
Laura Speke ◽  
Lowella Wilson ◽  
Jamal Nasir Khan
Keyword(s):  
Female Patient ◽  
Cardiac Imaging ◽  
Crucial Role ◽  
Thrombus Formation ◽  
Hypereosinophilic Syndrome ◽  
Treatment Monitoring ◽  
Left Ventricular ◽  
Cardiovascular Mri ◽  
Ventricular Thrombus

Hypereosinophilic syndrome (HES) is a rare disorder characterised by eosinophilic infiltration of tissues. Myocardial infiltration occurs in 50%–60% of HES and leads to a condition called Loeffler’s endocarditis. This can lead to endomyocardial injury with resultant superimposed thrombus formation and embolic stroke. We describe the case of a 57-year-old female patient presenting with neurological symptoms who was found to have multiple embolic strokes on a background of long-standing eosinophilia. Following a series of investigations, including transthoracic and transoesophageal echocardiographies and cardiovascular MRI, she was confirmed to have Loeffler’s endocarditis with left ventricular thrombus. She was treated successfully with steroids and anticoagulation. We describe the pathophysiology of HES and Loeffler’s endocarditis and stress the crucial role of multimodality cardiac imaging in establishing its diagnosis and treatment monitoring.

Role of intramural platelet thrombus in the pathogenesis of wall rupture and intra-ventricular thrombosis following acute myocardial infarction

2011 ◽  
Vol 105 (02) ◽  
pp. 356-364 ◽  
Author(s):  
Leonard Shan ◽  
Xiao-Ming Gao ◽  
Helen Kiriazis ◽  
Yang Liu ◽  
Abhirup Lobo ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Thrombus Formation ◽  
Blood Clot ◽  
Inflammatory Cells ◽  
Left Ventricular ◽  
Haemodynamic Monitoring ◽  
Ventricular Thrombus ◽  
Anti Platelet Drug ◽  
Platelet Thrombus

SummaryLeft ventricular thrombus (LVT) and rupture are important mechanical complications following myocardial infarction (MI) and are believed to be due to unrelated mechanisms. We studied whether, in fact, wall rupture and LVT are closely related in their pathogenesis with intramural platelet thrombus (IMT) playing a pivotal role. Male 129sv and C57Bl/6 mice underwent operation to induce MI, and autopsy was performed to confirm rupture deaths. Haemodynamic features of rupture events were monitored by telemetry in conscious mice. Detailed histological examination was conducted with special attention to the presence of IMT in relation to rupture location and LVT formation. IMT was detected in infarcted hearts of 129sv (82%) and C57Bl/6 (39%) mice with rupture in the form of a narrow streak spanning the wall or an occupying mass dissecting the infarcted myofibers apart. IMT often contained dense inflammatory cells and blood clot, indicating a dynamic process of thrombus formation and destruction. Notably, IMT was found extending into the cavity to form LVT. Haemodynamic monitoring by telemetry revealed that rupture occurred either as a single event or recurrent episodes. Importantly, the anti-platelet drug clopidogrel, but not aspirin, reduced the prevalence of rupture (10% vs. 45%) and IMT, and suppressed the degree of inflammation. Thus, IMT is a key pathological element in the infarcted heart closely associated with the complications of rupture and LVT. IMT could be either triggered by a wall tear or act as initiator of rupture. IMT may propagate towards the ventricular chamber to trigger LVT.

scholarly journals SEEING IS BELIEVING- THE CRUCIAL ROLE OF CARDIAC IMAGING IN SUSPECTED CARDIAC SARCOIDOSIS

2021 ◽  
Vol 77 (18) ◽  
pp. 2257
Author(s):  
Jose Aguilar-Gallardo ◽  
Alaa Omar ◽  
Glenmore Lasam ◽  
Javier Arreaza ◽  
Johanna Contreras
Keyword(s):  
Cardiac Imaging ◽  
Crucial Role ◽  
Cardiac Sarcoidosis

scholarly journals Left ventricular thrombus formation in myocardial infarction is associated with altered left ventricular blood flow energetics

2018 ◽  
Vol 20 (1) ◽  
pp. 108-117 ◽  
Author(s):  
Pankaj Garg ◽  
Rob J van der Geest ◽  
Peter P Swoboda ◽  
Saul Crandon ◽  
Graham J Fent ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Blood Flow ◽  
Thrombus Formation ◽  
Left Ventricular ◽  
Left Ventricular Thrombus ◽  
Ventricular Thrombus

scholarly journals Role of Perioperative TEE in Diagnosing and Management of a Case of Dynamic LVOT Obstruction/SAM

2015 ◽  
Vol 3 (2) ◽  
pp. 58-61
Author(s):  
GD Puri ◽  
V Rajkumar
Keyword(s):  
Transesophageal Echocardiography ◽  
Crucial Role ◽  
Left Ventricular Outflow Tract ◽  
Ventricular Outflow Tract ◽  
Hemodynamic Instability ◽  
Left Ventricular ◽  
Systolic Anterior Motion ◽  
Left Ventricular Outflow ◽  
Perioperative Transesophageal Echocardiography

ABSTRACT Systolic anterior motion (SAM) of the mitral leaflets can lead to hemodynamic instability in post bypass period. Perioperative transesophageal echocardiography (TEE) plays a crucial role in the management of SAM. Perioperative echocardiography helps to (a) identify cause of left ventricular outflow tract obstruction, (b) assess SAM and diagnose severity and (c) management of SAM. A case is presented illustrating identification and management of SAM in post bypass period. How to cite this article Kumar A, Rajkumar V, Kumar A, Puri GD. Role of Perioperative TEE in Diagnosing and Management of a Case of Dynamic LVOT Obstruction/SAM. J Perioper Echocardiogr 2015;3(2):58-61.

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