Research in Cardiovascular Medicine
Volume:5 Issue: 16, Jul-Sep 2016

Cardiac inflammatory myofibroblastic tumor is a rare tumor that can cause potentially fatal outcomes..
We describe a case where the tumor originated on the mitral valve and extended through the left ventricular outflow tract and aortic valve and into the left main artery obstructing it. Due to the hemodynamic instability of the patient, we proceeded for cardiac catheterization with the intention to aspirate the mass but were forced to do percutaneous intervention to stabilize the patient and bridge him to surgery..
The patient underwent surgery several days later with complete resection of the tumor and coronary stent retrieval but his left ventricular ejection fraction remained poor after several months and he was referred for cardiac transplantation..

The cardiac manifestations of influenza A are broad, ranging from self-limited pericarditis to fatal cardiomyopathy. The 2009 H1N1 influenza A (H1N1) strain is a rare cause of pericarditis, and its role in developing a pericardial effusion leading to tamponade has infrequently been reported..
We describe a case of a young female with no prior cardiovascular history who presents with a pericardial effusion and shock secondary to cardiac tamponade from pericarditis due to H1N1 influenza A..
This case highlights the potential severity of H1N1 infections and the utility of considering cardiac tamponade in patients presenting with influenza symptoms and circulatory collapse..

The use of extracorporeal membrane oxygenation (ECMO) is considered a risk factor for, or even a potential contraindication to, lung transplantation. However, only a few pediatric cases have been described thus far..
A 9-year-old boy with idiopathic pulmonary arterial hypertension developed cardiac arrest after the insertion of a central catheter. ECMO was used as a bridge to lung transplantation. However, after prolonged resuscitation, he developed medullary ischemia and medullary syndrome. After 6 weeks of ECMO and triple combination therapy for pulmonary hypertension, including continuous intravenous prostacyclin, he was weaned off support, and after 2 weeks, bilateral lung transplantation was performed. At 4 years post-transplant, he has minimal problems. The medullary syndrome has also alleviated. He is now back to school and can walk with aids..
Increasing evidence supports the use of ECMO as a bridge to LT, reporting good outcomes. In the modern era of PAH therapy, it is feasible to use prolonged ECMO support as a bridge to lung transplant, with the aim of weaning off this support; however, its use requires more experience and knowledge of long-term outcomes..

Giant coronary artery aneurysm is an extremely rare form of coronary artery disease. The most common cause of coronary artery aneurysms is atherosclerosis. Although it is usually asymptomatic, it may have various clinical presentations, including angina, myocardial infarction or sudden death..
A 32-year-old woman presented with edema of the upper and lower limbs, palpitation, and chest pain, and was diagnosed with a giant right coronary artery aneurysm that had initially mimicked a mediastinal cyst. Although computed tomography (CT) suggested a mediastinal cyst, trans-thoracic echocardiography revealed an extra pericardial cyst. The definitive diagnosis of right coronary artery aneurysm was made based on CT angiography and coronary angiography findings. As treatment, aneurysmectomy was performed, and she was discharged on the sixth postoperative day with good general health condition..
Coronary artery aneurysm should be a differential diagnosis in cases of mediastinal cyst and mass lesion..

The right ventricular outflow tract (RVOT) palliation has been shown to be a proper interventional procedure for lowering risk of mortality and improving clinical condition in cyanotic congenital heart disease (CHD) patients..
The present study aimed to assess the consequences of RVOT palliation in patients with TOF..
Patients and This prospective case series was performed on 17 children who suffered from cyanotic CHD. The study endpoints were assessed by pulse oximetry, echocardiography, and electrocardiography immediately and also 12 months after RVOT palliation procedure..
The mean age of patients was 24.76 (median 10 months). Comparing laboratory and respiratory parameters 12 months after RVOT palliation showed a significant increase in arterial oxygen saturation (from 69.34 ± 13.07 to 86.29 ± 6.64, P = 0.001), RPA index of right pulmonary artery (from 5.49 ± 1.67 mm to 7.59 ± 1.79 mm, P The right ventricular outflow tract palliation in children with cyanotic CHD leads to long-term favorable outcome regarding improvement in oxygen saturation, increase in Z score of both left and right pulmonary arteries and also considerable decrease in spell. Also, death and complications are rare following RVOT palliation..

Thrombolytic therapy in patients with sub-massive pulmonary embolism (SMPTE) needs further assessment..
The current study aimed to assess a potential benefit of thrombolytic and non-thrombolytic therapy in patients with SMPTE..
Patients and One hundred-nineteen patients were enrolled with SMPTE from 2006 to 2010 in the tertiary care center of Rajaie medical and research center. The patients who had pulmonary thromboemboli (PTE) and received thrombolytic plus heparin therapy and or non-thrombolytic (unfractionated heparin alone) were evaluated for hemodynamic changes (blood pressure, pulse rate, pulmonary artery systolic pressure, right ventricular failure and right ventricle enlargement), before and after 48 hours of treatment. The mortality rate was also assessed..
Forty-five percent of the patients with SMPTE received thrombolytic therapy (streptokinase) and 55% of SMPTE patients received non-thrombolytic therapy (unfractionated heparin). Pulse rate, pulmonary arterial pressure and tricuspid regurgitation gradient in patients receiving thrombolytic therapy reduced significantly (P = 0.001, P = 0.01 and P = 0.001, respectively). There was no significant difference before and after treatment regarding systolic blood pressure (P = 0.4), diastolic blood pressure (DBP) (P = 0.5), systolic arterial pressure (SPAP) (P = 0.1), Right ventricular (RV) function (P = 0.1) and RV size (P = 0.1). In patients who received a non-thrombolytic therapy, there were no significant differences between the groups regarding SBP (P = 0. 2), DBP ( P= 0. 4) and PR (P = 0. 1), SPAP (P = 0.6), TRG (P = 0.4), RV function (P = 0.4) and RV size (P = 0.2) before and after treatment. There were no significant differences between the groups according to mortality rate..
Thrombolytic therapy lead to earlier relief of hemodynamic condition in comparison to non-thrombolytic therapy but no changes were observed in mortality rate..

Women with congenital heart disease (CHD) may experience menstrual disturbances secondary to hemodynamic instability during the mensturation phase..
We investigated the menstrual bleeding pattern and its relationship with certain clinical findings in adult women with CHD..
Patients and Clinical data and menstrual bleeding pattern of adult women ≥15 years old who were referred to adult CHD clinic between March and September 2014 were recorded. Patients with syndromic congenital anomalies were excluded..
Data of 304 women (151 and 153 with simple and complex CHD groups, respectively) were recorded. Their mean (SD) age was 25.2 (1) years (range, 15 - 46 years). The median (IQR) age at menarche was 13 (12 - 14.25) years. Menarche was later in patients with CHD than in the normal population. Furthermore, the simple group showed earlier menarche than the complex group. The most common menstrual abnormality was menorrhagia in both groups (14.5% and 20.5% in the simple and complex groups, respectively). The incidence of menstrual abnormality was higher, though not significantly, in the complex group (40% vs. 25% in the simple group; P = 0.2). Menorrhagia was associated with the severity of oxygen desaturation (P = 0.007)..
Menstrual abnormalities are common in women with CHD, and therefore this group of patients should be aware of the menstrual function and its abnormalities..