Myxoma is a rare benign tumor of the heart. Cardiac myxomas are the most common primary cardiac tumor in adults, commonly found within the left atrium. It can occur at any age and is more common in females than males. This case report aims to identify the clinical symptoms of cardiac myxoma, which can be lifethreatening if neglected. Here, we present the case of a 30-year-old female with past smoking history. For the past three to four weeks before this hospitalization, her symptoms worsened including shortness of breath with exertion, dry cough, and pleuritic chest pain. Outpatient treatment with antibiotics and nebulizers did not relieve her symptoms. She went to the emergency room and underwent computed tomography of the chest with contrast showing bilateral lower lobe pulmonary emboli and a large mass in the right atrium. Intravenous unfractionated heparin was initiated. A transthoracic echocardiogram confirmed a 3.76 cm × 4.95 cm mass in the right atrium. The patient underwent surgical resection of the right atrial mass the following day and was discharged four days later in a stable condition. Pathology of the mass confirmed atrial myxoma.
Background: Novel coronavirus 2019 (COVID-19) has been the focus of the medical world since being declared a pandemic in March 2020. While the pathogenesis and heterogeneity of COVID-19 manifestations is still not fully understood, viral evasion of cellular immune responses and inflammatory dysregulation are believed to play essential roles in disease progression and severity. Case Presentation: We present the first case of a patient with COVID-19 with massive pulmonary embolism treated successfully with systemic thrombolysis, VA-ECLS, and bail out catheter directed thrombolysis. He was discharged from the hospital after an eventful hospital course on therapeutic anticoagulation with warfarin. Conclusions: We present the first case of a patient with COVID-19 with massive pulmonary embolism (PE) treated successfully with systemic thrombolysis, VA-ECLS and bail out catheter directed thrombolysis. In our experience catheter directed thrombolysis comes with an acceptable bleeding risk despite use of mechanical circulatory support, particularly with meticulous attention to vascular access and dose response monitoring.
In this report, we present a case of interventricular septal dissection (IVSD) following inferior wall myocardial infarction (MI) in a 64-year-old patient; the patient ultimately recovered after prompt resuscitation and intervention, despite the high mortality associated with these cases.A 64-year-old male with a history of hypertension and obesity was brought to the hospital following an episode of syncope at home. He had been experiencing chest tightness over the past few days prior to the admission. On physical exam, he had a heart rate of 72 beats per minute and blood pressure of 73/52 mmHg. His electrocardiogram revealed ST-segment elevations in leads II, III, and aVF. Emergent coronary angiography revealed 100% occlusion of the right coronary artery (RCA) with no collateral supply and 95% stenosis of the left anterior descending (LAD) artery. Aspiration thrombectomy and balloon angioplasty and subsequent stenting of the RCA were performed. Transthoracic echocardiogram with color Doppler was performed, which confirmed the presence of a defect in the septum. Color Doppler demonstrated a clear jet entering the ventricular septum from the left ventricle (LV), with the jet traversing the entire length of the septum through a dissection and entering into the right ventricle (RV), consistent with complete IVSD. The patient subsequently underwent a successful bovine pericardial patch repair of the ventricular septum.IVSD is a rare anomaly of the IVS. An echocardiogram is a useful tool to establish the diagnosis. The mortality rate after ventricular septal rupture remains high. Fortunately, our patient had interventricular dissection without rupture. Prompt surgical repair remains the choice of treatment for this condition.
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