Journal of cardiovascular medicine
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Intraplaque hemorrhage (IPH) is an important co-factor for plaque progression and rupture. So far noninvasive MRI has shown promise for the in-vivo identification of IPH and for the prediction of plaque instability. Intravascular imaging techniques such as intravascular ultrasound or optical coherence tomography (OCT) cannot distinguish between IPH and other plaque components. ⋯ Microvessels are known to be the main source of blood extravasation due to their anatomically compromised structure. Coronary plaques with a high microvessel density undergo rapid plaque progression and are often associated with other features of plaque instability such as inflammatory cells. The combination of data from both MRI and OCT studies will allow a better understanding of the mechanism of plaque destabilization and the pathophysiology of cardiovascular events.
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An 8-year-old asymptomatic child was referred for surgical repair of coronary sinus atrial septal defect resulting in significant left-to-right shunt and right chamber volume overload. The septal fenestration was located near to its drainage site into the right atrium. Due to this seemingly favourable anatomy, transcatheter closure of the septal defect was performed using an Amplatzer Septal Occluder device. The echocardiographic postprocedural evaluation imaged the occluding device almost perpendicular to the atrial septum, seemingly floating above the mitral valve orifice, like an alien spaceship inside the heart.
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J Cardiovasc Med (Hagerstown) · Oct 2012
ReviewIntraplaque neovascularization and hemorrhage: markers for cardiovascular risk stratification and therapeutic monitoring.
Atherosclerotic disease results in major clinical events and remains a leading cause of morbidity and mortality in the western World. Atherosclerotic plaques have a heterogeneous presentation. Atherosclerotic plaques with a vulnerable phenotype have been associated with an increased risk for cardiovascular complications. ⋯ Pharmacological interventions showed an inhibiting effect of lipid-lowering drugs on plaque neovascularization. Imaging modalities such as contrast-enhanced ultrasound or MRI are able to visualize intraplaque neovascularization and hemorrhage noninvasively. Consequently, detection of intraplaque neovascularization and hemorrhage visualized with noninvasive imaging might improve the stratification of 'high-risk' patients.
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J Cardiovasc Med (Hagerstown) · Aug 2012
Case ReportsThe Macklin effect causing a pneumopericardium.
Pleuropericarditis is a common clinical entity that has been reported in association with several diseases. However, pleuropericarditis following blunt thoracic trauma is very rare and difficult to diagnose. Here we present a case of a young man who presented to the emergency department with acute shortness of breath following a motor vehicle accident. He was found to have a pleuro-pericardial communication worsened by barotrauma, resulting in tension pneumopericardium.
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J Cardiovasc Med (Hagerstown) · Jul 2012
Case ReportsFive-vessel aortic arch associated with a bicuspid aortic valve.
Little information exists regarding the prevalence of aberrant or ectopic aortic arch vessels in patients with different cardiovascular anomalies. We present a young patient with an aberrant right subclavian artery associated with an ectopic left vertebral artery and a bicuspid aortic valve.