No abstract

The efficacy and safety of the BADFORM technique might be acceptable. © 2017 Wiley Periodicals, Inc.

Whether a cardiac tumor is primary or metastatic strongly influences the therapeutic strategy. We herein present a case of a cardiac tumor that occupied most of the right atrium which required immediate treatment in a patient with breast cancer. Multiple imaging modalities, especially computed tomography and cardiac magnetic resonance imaging, provided a precise preoperative diagnosis. We performed cardiac surgery prior to breast cancer surgery because the cardiac tumor was thought to be a myxoma rather than a metastatic cancer.

DESCRIPTIONAn 85-year-old woman reported sudden onset dyspnoea and subsequent vomiting after eating a large meal. She had normal blood pressure (124/ 60 mm Hg) but was tachypnoeic (28/min). Coarse crackles were heard in all the lung fields, and chest radiography showed congestion. ECG showed a non-specific ST-T change, and the brain natriuretic peptide level was 35.2 pg/mL. Transthoracic echocardiography demonstrated extrinsic left atrial (LA) compression (figure 1), and the tricuspid regurgitation pressure gradient was 42 mm Hg. Subsequently, contrast-enhanced CT revealed oesophageal dilation compressing the LA (figure 2).

Anomalous origin of the right coronary artery (ARCA) from the main pulmonary artery is a rare congenital anomaly, unlike the well-known anomalous origin of the left coronary artery (Bland-White-Garland syndrome) from the pulmonary artery. Since most ARCA cases are diagnosed during childhood, few adult cases have been reported. We describe the case of a patient who demonstrated ventricular arrhythmia and low cardiac function due to ischemic heart disease and an ARCA. Coronary angiography revealed flow from the left coronary artery to the pulmonary artery via an epicardial collateral artery and the right coronary artery. Multidetector-row computed tomography provided a definitive diagnosis of ARCA; the patient underwent surgical revascularization.