Large Tricuspid Valve Myxoma in an Asymptomatic Patient with Uterine Myoma: An Uncommon Case

Tricuspid valve myxomas are very uncommon tumors that could be found after the occurrence of pulmonary thromboembolism, symptomatic tricuspid obstruction, and right-sided heart failure. Herein, we describe a 42-year-old woman evaluated for an abdominal mass. In preoperative consultation, a tricuspid valve mass was detected in echocardiography. She underwent the removal of a benign uterine myoma and a myxoma of the tricuspid valve. Tricuspid valve myxomas constitute a scarce diagnosis. They could be asymptomatic, occurring in unusual locations and in association with benign tumors in other organs. Our patient was asymptomatic, underscoring the significance of the early diagnosis of this type of tumor to prevent further catastrophic events.

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Prognostic significance of the get with the guidelines-heart failure (GWTG-HF) risk score in patients undergoing trans-catheter tricuspid valve repair (TTVR)

Heart and Vessels ◽

10.1007/s00380-021-01874-3 ◽

2021 ◽

Author(s):

Refik Kavsur ◽

Hannah Emmi Hupp-Herschel ◽

Atsushi Sugiura ◽

Tetsu Tanaka ◽

Can Öztürk ◽

...

Keyword(s):

Heart Failure ◽

Renal Function ◽

Mitral Regurgitation ◽

Risk Stratification ◽

Tricuspid Valve ◽

Risk Score ◽

Left Ventricular Ejection ◽

Tricuspid Valve Repair ◽

Valve Repair ◽

Get With The Guidelines

AbstractThe Get-With-The-Guidelines-Heart-Failure (GWTG-HF) score is a risk assessment tool to predict mortality in patients with heart-failure (HF). We aimed to evaluate the GWTG-HF score for risk stratification in HF patients with tricuspid regurgitation undergoing trans-catheter tricuspid valve repair (TTVR). In total, 181 patients who underwent TTVR via edge-to-edge repair (86%) or annuloplasty (14%) were enrolled. Patients were categorized into a low- (≤ 43 points), intermediate- (44–53 points) and high-risk score groups (≥ 54 points). TTVR led to an improvement of TR (p < 0.0001) and NYHA (p < 0.0001). Kaplan–Meier analysis and log-rank test revealed that higher GWTG-HF scores were associated with reduced rates of event-free survival regarding mortality (96% vs 89% vs 73%, respectively, p = 0.001) and hospitalization for heart failure (HHF) (89% vs 86% vs 74%, respectively, p = 0.026). After adjusting for important variables like renal function, left ventricular ejection fraction and mitral regurgitation, the GWTG-HF score remained an independent predictor of the composite endpoint of HHF or mortality (hazard ratio 1.04 per 1-point increase, p = 0.029). Other remaining predictors were renal function and mitral regurgitation. The GWTG-HF score used as a risk stratification tool of mortality and HHF maintains its prognostic value in a HF population with severe TR undergoing TTVR.

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Significance of the echocardiographic evaluation of left atrial myocardial strain for early diagnosis of heart failure with preserved ejection fraction

Kardiologiia ◽

10.18087/cardio.2021.8.n1418 ◽

2021 ◽

Vol 61 (8) ◽

pp. 68-75

Author(s):

E. K. Serezhina ◽

A. G. Obrezan

Keyword(s):

Heart Failure ◽

Early Diagnosis ◽

Ejection Fraction ◽

Left Atrial ◽

Myocardial Dysfunction ◽

Systolic Dysfunction ◽

Myocardial Strain ◽

Left Ventricular ◽

Preserved Ejection Fraction ◽

Echocardiographic Evaluation

This systematic review is based on 19 studies from Elsevier, PubMed, Embase, and Scopus databases, which were found by the following keywords: LA strain (left atrial strain), STE (speckle tracking echocardiography), HF (heart failure), and HFpEF (heart failure with preserved ejection fraction). The review focuses on results and conclusions of studies on using the 2D echocardiographic evaluation of left atrial (LA) myocardial strain for early diagnosis of HFpEF in routine clinical practice. Analysis of the studies included into this review showed a significant decline of all LA functions in patients with HFpEF. Also, multiple studies have reported associations between decreased indexes of LA strain and old age, atrial fibrillation, left ventricular hypertrophy, left and right ventricular systolic dysfunction, and LV diastolic dysfunction. Thus, the review indicates significant possibilities of using indexes of LA strain in evaluation of early stages of both systolic and diastolic myocardial dysfunction. Notably, LA functional systolic and diastolic indexes are not sufficiently studied despite their growing significance for diagnosis and prognosis of patients with HFpEF. For this reason, in addition to existing models for risk stratification in this disease, including clinical characteristics and/or echocardiographic data, future studies should focus on these parameters.

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Letter to the Editor: Delayed Presentation of Non-COVID-19 Patients During the COVID-19 Pandemic Is Not Limited to Children

Rambam Maimonides Medical Journal ◽

10.5041/rmmj.10447 ◽

2021 ◽

Vol 12 (3) ◽

pp. e0026

Author(s):

Klaus Rose ◽

◽

Oishi Tanjinatus ◽

Jane Grant-Kels ◽

Earl B. Ettienne ◽

...

Keyword(s):

Heart Failure ◽

Down Syndrome ◽

Head And Neck Cancer ◽

Emergency Room ◽

Ewing Sarcoma ◽

Pulmonary Thromboembolism ◽

Young Patients ◽

The Other ◽

Delayed Presentation ◽

Pediatric Department

We read with interest the report about four minors who were diagnosed late with non-COVID-19 diseases during the COVID-19 pandemic. We would like to emphasize that, firstly, such delays are not limited to minors, and secondly, that also in minors should we distinguish the administrative and the physiological meanings of the term “child” and hence distinguish administratively defined “children” who bodily are already mature from those young patients who bodily are indeed still children. The 16-year-old patient that was presented to the emergency room with endocarditis was bodily no longer a child, although administratively and probably also psychologically, due to his Down syndrome, he was still a child. Two of the other patients, one with hemolytic anemia (2.5 years old) and one with Ewing sarcoma (4 years old), were still pre-pubertal children, while the 13-year-old minor with a septic hip was already adolescent. The author of the cited paper works in a pediatric department and reports those patients that he has seen during his work. However, in our view there is nothing specifically pediatric in his observations. Several recent papers discuss delays of diagnosis and treatment of non-COVID-19 diseases during the pandemic, including head and neck cancer, appendicitis, heart failure and septicemia, pulmonary thromboembolism,6 pyelonephritis, and cancer in general.8 Some patients in these papers are administratively still “children,” some are adults, and appendicitis is discussed in both.3,4 The delay the COVID-19 pandemic has caused in the timely diagnosis of various diseases is not a “pediatric” challenge, but a challenge for medicine in general.

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Concomitant Tricuspid Valve Repair in Patients Undergoing LVAD Placement Reduces Incidence of Acute Right Heart Failure

The Journal of Heart and Lung Transplantation ◽

10.1016/j.healun.2013.01.949 ◽

2013 ◽

Vol 32 (4) ◽

pp. S55-S56

Author(s):

L.E. Rodriguez ◽

B.A. Bruckner ◽

T. Motomura ◽

J.D. Estep ◽

B. Trachtenberg ◽

...

Keyword(s):

Heart Failure ◽

Tricuspid Valve ◽

Right Heart Failure ◽

Tricuspid Valve Repair ◽

Valve Repair ◽

Right Heart

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Critically Ill Patients with Variable Heart Failure in Severe COVID-19 Disease: A Case Series

Integrative Journal of Medical Sciences ◽

10.15342/ijms.2021.336 ◽

2021 ◽

Vol 8 ◽

Author(s):

Joanne Michelle Gomez ◽

Mary Potkonjak ◽

Maria Isabel Planek ◽

Prutha Lavani ◽

Karolina Marinescu ◽

...

Keyword(s):

Heart Failure ◽

Pulmonary Embolism ◽

Early Diagnosis ◽

Cardiogenic Shock ◽

Critically Ill ◽

Case Series ◽

Cardiovascular Effects ◽

Massive Pulmonary Embolism ◽

System Disorder ◽

Obstructive Shock

COVID-19 disease, while primarily a respiratory disease, has proven itself a multi-system disorder with profound cardiovascular sequelae. In patients with SARS-CoV-2 infection, effective early diagnosis and management of concomitant cardiovascular manifestations of the disease are key to favorable outcomes. Here we present a case series of three patients with varied cardiovascular presentations of severe COVID-19 illness: cardiogenic shock from Takotsubo cardiomyopathy, arrhythmia in a patient with suspected hydroxychloroquine-associated cardiomyopathy, and right-sided heart failure with obstructive shock in the setting of massive pulmonary embolism. Through our experience, we aim to provide a better understanding of the unique spectrum of the cardiovascular effects of severe COVID-19 disease to guide management of the critically ill.

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Right Heart Failure and Patient Selection for Isolated Tricuspid Valve Surgery

Journal of Thoracic and Cardiovascular Surgery ◽

10.1016/j.jtcvs.2021.10.059 ◽

2021 ◽

Author(s):

Haytham Elgharably ◽

Ahmed Ibrahim ◽

Bradley Rosinski ◽

Lucy Thuita ◽

Eugene H. Blackstone ◽

...

Keyword(s):

Heart Failure ◽

Tricuspid Valve ◽

Patient Selection ◽

Right Heart Failure ◽

Valve Surgery ◽

Right Heart ◽

Tricuspid Valve Surgery ◽

Selection For

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Tummy Ouchie

Pediatric Medical Emergencies ◽

10.1093/med/9780190946678.003.0011 ◽

2020 ◽

pp. 103-110

Author(s):

Nkeiruka Orajiaka ◽

Meghan Dishong

Keyword(s):

Abdominal Pain ◽

Early Diagnosis ◽

Gold Standard ◽

Care Management ◽

Nonoperative Management ◽

Abdominal Mass ◽

Abdominal Ultrasound ◽

Abdominal Emergencies ◽

Morbidity Risk ◽

Red Currant

Intussusception is one of the most common abdominal emergencies in children. The classic triad of symptoms involves colicky abdominal pain, an abdominal mass, and red currant jelly stools, but this is seen in only about 15% of cases of children with intussusception. Early diagnosis and management reduce morbidity, risk for complications, and surgical intervention. Abdominal ultrasound is generally accepted as the gold standard for diagnosis. Treatment typically involves an air or hydrostatic enema; however, variability and controversies still exist in treatment and post-care management for nonsurgical cases. Variability also still exists in post-reduction care of children with intussusception. Feeding and monitoring times after nonoperative management differ between institutions. Some patients are advanced to feeds as tolerated while some others are placed in fasting to rest the bowel and prevent recurrence.

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Pulsatile Varicose Veins Caused by Tricuspid Valve Regurgitation

Phlebology The Journal of Venous Disease ◽

10.1177/026835559000500307 ◽

1990 ◽

Vol 5 (3) ◽

pp. 189-191 ◽

Cited By ~ 3

Author(s):

J. Dayantas ◽

A.C. Liatas ◽

M. Lazarides

Keyword(s):

Tricuspid Valve ◽

Varicose Veins ◽

Venous Pressure ◽

Postoperative Recovery ◽

Recent Experience ◽

Tricuspid Valve Regurgitation ◽

Prosthetic Valves ◽

Tricuspid Valve Insufficiency ◽

Valve Insufficiency ◽

Uncommon Case

We report an uncommon case of pulsatile varicose veins in a young woman caused by tricuspid valve insufficiency of rheumatic origin combined with an incompetent valve at the sapheno–femoral junction. She was treated with limited stripping of the great saphenous vein and local varicosities were excised. Postoperative recovery was complicated by a large haematoma in the thigh. Following our recent experience we believe that patients like this, with elevated venous pressure and requiring anticoagulant therapy for prosthetic valves, should be treated with sapheno–femoral dissociation alone.

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