Colorectal cancers typically metastasize to the lymph nodes, liver or lungs. Metastasis to the heart is rare and although a few cases of cardiac metastases from colon cancer are described in the literature, cases of metastatic rectal cancer to the heart are far fewer. A 69-year-old woman with a history of rectal adenocarcinoma treated with neo-adjuvant chemotherapy and radiation, followed by resection and adjuvant chemotherapy, presented with increasing dyspnea on exertion and lower extremity edema 5 years after oncology follow-up. Echocardiography revealed a mass within the right atrium, which was biopsied and found to be consistent with metastatic rectal adenocarcinoma and a thrombus. The patient was deemed to be a poor surgical candidate given her co-morbidities and overall prognosis. Chemotherapy was offered and refused by the patient. The medical literature has a paucity of similar cases of rectal adenocarcinoma metastasizing to the right atrium. Further studies are needed to help guide standardized treatment options.

Activating AMP‐activated protein kinase (AMPK) in skeletal muscle may increase expression of nicotinamide phosphoribosyltransferase (Nampt), a protein that has been implicated in the regulation of the aging process. We investigated whether incubation with the green‐tea compound epigallocatechin gallate (EGCG) directly activates AMPK in mouse skeletal muscle, and whether a single bout of acute exercise increases skeletal muscle Nampt concentrations in mice. The effect of various physiological EGCG concentrations on AMPK phosphorylation was determined in vitro in extensor digitorum longus (EDL) muscle. For exercise, mice ran on a treadmill for 1 hour (21.5 m/min, 10% grade). Liver and skeletal muscle tissues were removed immediately after exercise, and Western blots were performed. EGCG incubation did not alter AMPK phosphorylation in EDL muscle (p > 0.05). Total Nampt levels were higher in sedentary soleus than gastrocnemius muscle (mean ± S.E.M., 1.00 ± 0.08 vs. 2.07 ± 0.18 arbitrary units; p < 0.001). Acute exercise failed to increase Nampt levels in skeletal muscle and liver tissues (p > 0.05) despite increased activation of the AMPK target acetyl‐CoA carboxylase in soleus muscle (≈ 32 %; p < 0.05). Neither acute exercise nor EGCG treatment had direct or immediate effects on Nampt concentrations in the tested tissues. Support: American Physiological Society (D.M.U.), Mellon Foundation (K.E.M).