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Prathivadhi-Bhayankaram S, Ashwath ML. A case report of a giant coronary artery aneurysm masquerading as a ventricular mass. Eur Heart J Case Rep 2024; 8:ytae124. [PMID: 38572017 PMCID: PMC10990057 DOI: 10.1093/ehjcr/ytae124] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2023] [Revised: 02/19/2024] [Accepted: 03/08/2024] [Indexed: 04/05/2024]
Abstract
Background A coronary artery aneurysm is a dilation exceeding 1.5 times the diameter of the patient's largest coronary vessel. They are rare, varying in prevalence between 1.4 and 4.9%. Additionally, they carry a high risk of potential complications, including thrombosis and myocardial infarction, with a risk of rupture. We present an interesting case of a patient with initial imaging suggesting a mass in the right ventricle. Case summary This patient initially presented with acute hypoxic respiratory failure related to pulmonary oedema. His course was complicated by symptomatic ventricular tachycardia and an inferoposterior myocardial infarction. Further investigation revealed a left anterior descending artery and circumflex artery thrombosed aneurysm projecting into the right ventricle. Multimodal imaging was used to arrive at his diagnosis. He continues to do well on medical therapy for coronary artery disease and heart failure. Discussion Clinicians should be vigilant for this rare pathology, which may be easily missed yet poses a high mortality risk. Our case demonstrates the benefit of multimodal imaging, as this patient's aneurysm was initially mistaken for a ventricular mass.
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Affiliation(s)
- Sruti Prathivadhi-Bhayankaram
- Department of Internal Medicine, University of Iowa Carver College of Medicine, University of Iowa Hospitals and Clinics, 200 Hawkins Drive, Iowa City, IA 52242, USA
| | - Mahi L Ashwath
- Department of Internal Medicine, University of Iowa Carver College of Medicine, University of Iowa Hospitals and Clinics, 200 Hawkins Drive, Iowa City, IA 52242, USA
- Heart and Vascular Center, Department of Internal Medicine, University of Iowa Carver College of Medicine, University of Iowa Hospitals and Clinics, Iowa City, IA 52242, USA
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Peretto G, Sommariva E, Di Resta C, Rabino M, Villatore A, Lazzeroni D, Sala S, Pompilio G, Cooper LT. Myocardial Inflammation as a Manifestation of Genetic Cardiomyopathies: From Bedside to the Bench. Biomolecules 2023; 13:biom13040646. [PMID: 37189393 DOI: 10.3390/biom13040646] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2023] [Revised: 03/24/2023] [Accepted: 03/24/2023] [Indexed: 05/17/2023] Open
Abstract
Over recent years, preclinical and clinical evidence has implicated myocardial inflammation (M-Infl) in the pathophysiology and phenotypes of traditionally genetic cardiomyopathies. M-Infl resembling myocarditis on imaging and histology occurs frequently as a clinical manifestation of classically genetic cardiac diseases, including dilated and arrhythmogenic cardiomyopathy. The emerging role of M-Infl in disease pathophysiology is leading to the identification of druggable targets for molecular treatment of the inflammatory process and a new paradigm in the field of cardiomyopathies. Cardiomyopathies constitute a leading cause of heart failure and arrhythmic sudden death in the young population. The aim of this review is to present, from bedside to bench, the current state of the art about the genetic basis of M-Infl in nonischemic cardiomyopathies of the dilated and arrhythmogenic spectrum in order to prompt future research towards the identification of novel mechanisms and treatment targets, with the ultimate goal of lowering disease morbidity and mortality.
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Affiliation(s)
- Giovanni Peretto
- Department of Cardiac Electrophysiology and Arrhythmology, IRCCS San Raffaele Scientific Institute, 20132 Milan, Italy
- School of Medicine, Vita-Salute San Raffaele University, 20132 Milan, Italy
| | - Elena Sommariva
- Unit of Vascular Biology and Regenerative Medicine, Centro Cardiologico Monzino IRCCS, 20139 Milan, Italy
| | - Chiara Di Resta
- School of Medicine, Vita-Salute San Raffaele University, 20132 Milan, Italy
- Genomic Unit for the Diagnosis of Human Pathologies, IRCCS San Raffaele Scientific Institute, 20132 Milan, Italy
| | - Martina Rabino
- Unit of Vascular Biology and Regenerative Medicine, Centro Cardiologico Monzino IRCCS, 20139 Milan, Italy
| | - Andrea Villatore
- Department of Cardiac Electrophysiology and Arrhythmology, IRCCS San Raffaele Scientific Institute, 20132 Milan, Italy
| | | | - Simone Sala
- Department of Cardiac Electrophysiology and Arrhythmology, IRCCS San Raffaele Scientific Institute, 20132 Milan, Italy
| | - Giulio Pompilio
- Unit of Vascular Biology and Regenerative Medicine, Centro Cardiologico Monzino IRCCS, 20139 Milan, Italy
- Department of Biomedical, Surgical and Dental Sciences, Università degli Studi di Milano, 20122 Milan, Italy
| | - Leslie T Cooper
- Department of Cardiovascular Medicine, Mayo Clinic, Jacksonville, FL 32224, USA
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Marson P, Punzi L. Venice and its role in the history of cardiovascular medicine. Nutr Metab Cardiovasc Dis 2021; 31:2512-2513. [PMID: 34154887 DOI: 10.1016/j.numecd.2021.05.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/25/2021] [Revised: 05/11/2021] [Accepted: 05/11/2021] [Indexed: 11/30/2022]
Affiliation(s)
- Piero Marson
- Apheresis Unit, Department of Transfusion Medicine, University Hospital of Padua, Italy; Institute of History of Rheumatology, Venice - Italian Society of Rheumatology, Italy.
| | - Leonardo Punzi
- Institute of History of Rheumatology, Venice - Italian Society of Rheumatology, Italy
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Buja LM. The cell theory and cellular pathology: Discovery, refinements and applications fundamental to advances in biology and medicine. Exp Mol Pathol 2021; 121:104660. [PMID: 34116021 DOI: 10.1016/j.yexmp.2021.104660] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2021] [Accepted: 06/06/2021] [Indexed: 11/24/2022]
Abstract
This review explores the developments leading up to the establishment of the cell theory and cellular pathology and their subsequent refinements and applications while focusing on the individuals who have made seminal advances in the field. The links between cell biology, cell pathology and cell injury research are emphasized. Recognition also is given to the importance of technological advances in microscopy, histology, biochemical and molecular methods for discovery in cell biology and cell pathology. Particular attention is focused on the work of Rudolph Virchow and his former students in the formulation of the cell theory in biology and pathology and John F. R. Kerr and colleagues who identified and developed a comprehensive characterization of apoptosis, thereby giving impetus to the contemporary field of cell injury research. Cell injury research remains an important and fruitful field of ongoing inquiry and discovery.
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Affiliation(s)
- L Maximilian Buja
- Department of Pathology and Laboratory Medicine, McGovern Medical School, The University of Texas Health Science Center at Houston, Houston, TX 77030, United States of America.
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Thiene G, Zampieri F, Zanatta A, Basso C. The dawn of cardiovascular medicine in the Serenissima Republic of Venice, Land of the Doges. Eur Heart J 2021; 42:1125-1128. [PMID: 33351899 DOI: 10.1093/eurheartj/ehaa937] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Affiliation(s)
- Gaetano Thiene
- Department of Cardiac, Thoracic, Vascular Sciences and Public Health, University of Padua Medical School, Via A. Gabelli, Padua 61-35121, Italy
| | - Fabio Zampieri
- Department of Cardiac, Thoracic, Vascular Sciences and Public Health, University of Padua Medical School, Via A. Gabelli, Padua 61-35121, Italy
| | | | - Cristina Basso
- Department of Cardiac, Thoracic, Vascular Sciences and Public Health, University of Padua Medical School, Via A. Gabelli, Padua 61-35121, Italy
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Zampieri F, Thiene G, Basso C, Zanatta A. The three fetal shunts: A story of wrong eponyms. J Anat 2021; 238:1028-1035. [PMID: 33159333 PMCID: PMC7930758 DOI: 10.1111/joa.13357] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2020] [Revised: 10/21/2020] [Accepted: 10/21/2020] [Indexed: 11/27/2022] Open
Abstract
The fetal circulatory system bypasses the lungs and liver with three shunts. The foramen ovale allows the transfer of the blood from the right to the left atrium, and the ductus arteriosus permits the transfer of the blood from the pulmonary artery to the aorta. The ductus venosus is the continuation of the umbilical vein, allowing a large part of the oxygenated blood from the placenta to join the supradiaphragmatic inferior vena cava, bypassing the fetal liver and directly connecting the right atrium. These structures are named after the physicians who are thought to have discovered them. The foramen ovale and the ductus arteriosus are called the "foramen Botalli" and the "ductus Botalli," after Leonardo Botallo (1530-c. 1587). The ductus venosus is styled "ductus Arantii" after Giulio Cesare Arantius (1530-1589). However, these eponyms have been incorrectly applied as these structures were, in fact, discovered by others earlier. Indeed, the foramen ovale and the ductus arteriosus were described by Galen of Pergamon centuries earlier (c. 129-210 AD). He understood that these structures were peculiar to the fetal heart and that they undergo closure after birth. The ductus venosus was first described by Andreas Vesalius (1514-1564) 3 years before Arantius. Therefore, the current anatomical nomenclature of the fetal cardiac shunts is historically inappropriate.
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Affiliation(s)
- Fabio Zampieri
- Department of Cardiac, Thoracic, Vascular Sciences and Public HealthUniversity of PaduaPaduaItaly
| | - Gaetano Thiene
- Department of Cardiac, Thoracic, Vascular Sciences and Public HealthUniversity of PaduaPaduaItaly
| | - Cristina Basso
- Department of Cardiac, Thoracic, Vascular Sciences and Public HealthUniversity of PaduaPaduaItaly
- Cardiovascular Pathology UnitUniversity Hospital of PaduaPaduaItaly
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Clemente A, Seitun S, Mantini C, Gentile G, Federici D, Barison A, Rossi A, Cuman M, Pizzuto A, Ait-Ali L, Bossone E, Cademartiri F, Chiappino D. Cardiac CT angiography: normal and pathological anatomical features-a narrative review. Cardiovasc Diagn Ther 2020; 10:1918-1945. [PMID: 33381435 DOI: 10.21037/cdt-20-530] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
The normal and pathological anatomy of the heart and coronary arteries are nowadays widely developed topics and constitute a fundamental part of the cultural background of the radiologist. The introduction of cardiac ECG-gated synchronized CT scanners with an ever-increasing number of detectors and with increasingly high structural characteristics (increase in temporal resolution, increase in contrast resolution with dual-source, dual energy scanners) allows the virtual measurement of anatomical in vivo structures complying with heart rate with submillimetric precision permitting to clearly depict the normal anatomy and follow the pathologic temporal evolution. Accordingly to these considerations, cardiac computed tomography angiography (CCTA) asserts itself as a gold standard method for the anatomical evaluation of the heart and permits to evaluate, verify, measure and characterize structural pathological alterations of both congenital and acquired degenerative diseases. Accordingly, CCTA is increasingly used as a prognostic model capable of modifying the outcome of diseased patients in planning interventions and in the post-surgical/interventional follow-up. The profound knowledge of cardiac anatomy and function through highly detailed CCTA analysis is required to perform an efficient and optimal use in real-world clinical practice.
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Affiliation(s)
- Alberto Clemente
- Department of Radiology, CNR (National Council of Research)/Tuscany Region "Gabriele Monasterio" Foundation (FTGM), Massa, Italy
| | - Sara Seitun
- IRCCS Policlinico San Martino Hospital, Genoa, Italy
| | - Cesare Mantini
- Department of Neuroscience, Imaging and Clinical Science, Institute of Radiology, "G. d'Annunzio" University, Chieti, Italy
| | - Giovanni Gentile
- Radiology Unit, IRCCS ISMETT (Mediterranean Institute for Transplantation and Advanced Specialized Therapies), Palermo, Italy
| | - Duccio Federici
- Pediatric Cardiac Surgery, CNR (National Council of Research)/Tuscany Region "Gabriele Monasterio" Foundation (FTGM), Massa, Italy
| | - Andrea Barison
- Cardiology Division, CNR (National Council of Research)/Tuscany Region "Gabriele Monasterio" Foundation (FTGM), Pisa, Italy
| | - Andrea Rossi
- Arrhythmology Unit, Department of Invasive Cardiology, CNR (National Council of Research)/Tuscany Region "Gabriele Monasterio" Foundation (FTGM), Pisa, Italy
| | - Magdalena Cuman
- Pediatric Cardiology and GUCH Unit, CNR (National Council of Research)/Tuscany Region "Gabriele Monasterio" Foundation (FTGM), Massa, Italy
| | - Alessandra Pizzuto
- Pediatric Cardiology and GUCH Unit, CNR (National Council of Research)/Tuscany Region "Gabriele Monasterio" Foundation (FTGM), Massa, Italy
| | - Lamia Ait-Ali
- Institute of Clinical Physiology, National Research Council, Pisa, Italy
| | - Eduardo Bossone
- Department of Cardiology, Ospedale Cardarelli, Naples, Italy
| | | | - Dante Chiappino
- Department of Radiology, CNR (National Council of Research)/Tuscany Region "Gabriele Monasterio" Foundation (FTGM), Massa, Italy
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Affiliation(s)
- Gaetano Thiene
- Department of Medical-Diagnostic Science and Special Therapies, Cardiovascular Pathology Unit, University of Padua Medical School, Italy (G.T.)
| | - Jeffrey E Saffitz
- Department of Pathology, Beth Israel Deaconess Medical Center, Boston, MA (J.E.S.).
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10
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Lippi D. Gerbezius' Pulsus Mira Inconstantia and the First Descriptions of the Atrioventricular Block. Card Electrophysiol Clin 2018; 10:179-182. [PMID: 29784478 DOI: 10.1016/j.ccep.2018.02.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
This article reconstructs the steps leading to the identification of the atrioventricular block, from its first descriptions to current studies, highlighting the roles of Arthur Keith (1866-1955) and Martin Flack (1882-1931), who contributed to establish the theoretic basis for electrocardiography.
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Affiliation(s)
- Donatella Lippi
- Department of Clinical and Experimental Medicine, School of Sciences of Human Health, University of Florence, Largo Brambilla 3, Florence 50134, Italy.
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