Myocardial rupture and left ventricular pseudoaneurysm due to late STEMI presentation during the COVID-19 pandemic lockdown: a classical case report.

Background: Left ventricular (LV) pseudoaneurysm is a serious and rare complication of myocardial infarction (MI). It occurs when an injured myocardial wall ruptures and is contained by overlying adherent pericardium or scar tissue, most commonly it develops in patients with late presentation of MI and delayed revascularization.

Case Summary: A 64-year-old man presented to the emergency department with intermittent central chest pain radiating to back and neck and increasing on deep inspiration, which was considered to be of musculoskeletal origin for a week, but worsened despite medications.

Cardiac Computed Tomography to Identify and Guide Therapy of Intramural Hemorrhage in High-Risk Coronary Anatomy.

Coronary intramural hematoma can present with acute coronary syndrome. We present a 39-year-old man with post-assault stress-induced left main intramural hematoma. We used computed tomography coronary angiogram with lesion characterization and suspected the diagnosis of intramural hematoma despite its limited spatial resolution; computed tomography was used for follow-up imaging and proper monitoring of therapeutic measures.

Primary percutaneous coronary intervention in nonagenarians: is it worthwhile?

Background: Previous studies have demonstrated the feasibility of primary percutaneous coronary intervention (PPCI) in carefully selected nonagenarians. Although current guidelines recommend immediate revascularization in patients with ST elevation myocardial infarction (STEMI) it remains unclear whether PPCI reduces mortality in nonagenarians. The objective of this study is to compare mortality in nonagenarians presenting via the PPCI pathway who undergo coronary intervention, versus those who are managed medically.

Complex Chronic Total Occlusion Revascularization - A Comparison of Biradial Versus Femoral Access.

Background: Complex chronic total occlusion (CTO) cases often require dual access. Evidence suggests that radial access is associated with lower success rates in complex CTOs. Our primary outcome was to determine efficacy of biradial access compared with femoral access.

Computed tomography angiography planning identifies the target vessel for optimum infarct location and improves clinical outcome in alcohol septal ablation for hypertrophic obstructive cardiomyopathy.

Aims: Alcohol septal ablation (ASA) is an established treatment option in hypertrophic obstructive cardiomyopathy (HOCM). ASA is ineffective in some: inaccurate infarct and inability to identify a vessel contribute. We aimed to improve accuracy of infarct using CT angiography guidance and provide a more predictable and satisfactory outcome.

Ventricular Hinge Point Fibrosis as a Pathological Marker of Hypertrophic Cardiomyopathy in the Absence of Significant Left Ventricular Hypertrophy?

A 54-year-old woman presented with presyncope and nonsustained ventricular tachycardia. Cardiac magnetic resonance imaging showed normal cardiac dimensions and left ventricular function. Late gadolinium enhancement was noted at the anterior and posterior right ventricular/left ventricular hinge points.

Isolated Left Ventricular Hypoplasia in a Postpartum Patient.

A 22-year-old woman presented with lethargy and shortness of breath at 13 weeks postpartum. She was clinically tachypnoeic with signs of fluid overload. Telemetry revealed 2 different morphologies of nonsustained ventricular tachycardia, associated with chest discomfort.

Radiofrequency ablation of the interventricular septum to treat outflow tract gradients in hypertrophic obstructive cardiomyopathy: a novel use of CARTOSound® technology to guide ablation.

Aims: Septal reduction is needed for hypertrophic obstructive cardiomyopathy (HOCM) patients with severe left ventricular outflow tract (LVOT) gradients and symptoms despite medication. Myectomy cannot be performed in all. Alcohol septal ablation cannot be performed in 5-15% due to technical difficulties.

Effect of erythropoietin as an adjunct to primary percutaneous coronary intervention: a randomised controlled clinical trial.

Objective: The acute administration of high-dose erythropoietin (EPO) on reperfusing ischaemic myocardium has been reported to halve myocardial infarct (MI) size in preclinical studies, but its effect in ST elevation myocardial infarction patients undergoing primary percutaneous coronary intervention (PPCI) remains unknown. We investigated whether high-dose EPO administered as an adjunct to PPCI reduces MI size.

Design: Double-blinded, randomised, placebo-controlled.

CMR in Heart Failure.

Heart Failure (HF) is a common syndrome with multiple causes. Cardiovascular magnetic resonance (CMR) is a medical imaging technique with significant advantages, allowing the understanding of aetiology and pathophysiology of HF in the individual patient, permitting specific therapy to be administered and predicting prognosis. This paper discusses the diverse role of CMR in HF.

Evaluation of techniques for the quantification of myocardial scar of differing etiology using cardiac magnetic resonance.

Objectives: The aim of this study was to compare the reproducibility of 7 late gadolinium enhancement (LGE) quantification techniques across 3 conditions in which LGE is known to be important: acute myocardial infarction (AMI), chronic myocardial infarction (CMI), and hypertrophic cardiomyopathy (HCM).

Background: LGE by cardiac magnetic resonance is the gold-standard technique for assessing myocardial scar. No consensus exists on the best method for its quantification, and research in this area is scant.

Beta-blocker use in heart failure patients with airways disease.

Background: Beta-Blockers are often withheld from patients with obstructive airways disease, especially those with reversible airways disease due to fear of inducing bronchospasm. We report our single center experience of cautiously treating such patients who have concomitant chronic heart failure (CHF).

Hypothesis: The use of cardioselective beta-blockers under caution and specialist supervision may be tolerable in many CHF patients with obstructive airways disease, resulting in clinical improvement rather than detriment.