Journal of cardiovascular medicine
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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
ReviewPathology of plaque haemorrhage and neovascularization of coronary artery.
Intraplaque haemorrhage (IPH) is thought to play crucial roles in plaque progression and plaque rupture, resulting in acute coronary syndromes, which are the leading causes of morbidity and mortality in the developed countries. IPH is a common finding in atherosclerotic plaques. In the past decade, the use of anti-Glycophorin A antibodies that specifically and uniquely label membranes of the red cells triggered a cascade of pathologic and experimental studies concordantly documenting not only the presence but also the major role of IPH in plaque progression and complications. ⋯ Although the mechanisms by which IPH impacts plaque progression and plaque rupture gradually become clear, several questions such as causes of angioneogenesis, identification and treatment of plaques with angioneogenesis are still unanswered. Further studies are needed to resolve these issues; however, the investigation of IPH without a histopathological approach is unconceivable. This review will focus on the pathology of IPH and plaque neovascularization, pathophysiology and potential clinical impact.
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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.