Eosinophilic granulomatosis with polyangiitis (EGPA), historically known as the Churg-Strauss disease, is a small- to medium-sized vessel multi-organ vasculitis with a propensity to involve the heart. EGPA is a rare condition with an estimated annual incidence of one to 4.2 people per million. The cardiac involvement causes significant morbidity and mortality in EGPA patients. Approximately 50% of the deaths in EGPA are related to cardiac disease and occur within the first few months since diagnosis. The current recommendations support evaluation of cardiac involvement by using history, physical exam and multimodality imaging including echocardiogram and cardiac magnetic resonance imaging (CMR). Here, we report a rare case of eosinophilic myocarditis in a 19-year-old patient with EGPA seen on CMR. Pertinent literature is also reviewed. We highlighted the importance of CMR in diagnosing and follow up of EGPA patients.

Echocardiography is the most common imaging modality for the assessment of cardiovascular tumors, followed by more advanced imaging modalities, such as cardiac computed tomography or cardiac magnetic resonance imaging. Non-neoplastic lesions that may simulate a true neoplasm on imaging are termed "cardiac pseudotumors." As echocardiography is the initial imaging modality where pseudotumors are identified, it is imperative to have a fundamental understanding of pseudotumors evaluation using echocardiography. There is paucity of the literature describing the different kinds of pseudotumors. This review is an attempt to describe common cardiac pseudotumors and to classify them based on their origin. The tumors arising from cardiac structures, such as epicardium, endocardium, or myocardium, were termed as "intrinsic" while the pseudotumors with no cardiac origin were termed as "extrinsic." The more common pseudotumors are described in detail with pertinent echocardiographic features and examples.

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Subcutaneous immunotherapy (SCIT) is a widely used therapy for allergic rhinitis and asthma. It is a useful adjunct to standard medical management of these conditions that can lead to long-term benefits and possible resolution of symptoms. The benefits of SCIT, particularly for children, include avoiding prolonged use and side effects from medications, preventing new aeroallergen sensitizations, and reducing the risk of developing asthma. The primary risks of SCIT include local and systemic reactions. Standard schedules for SCIT include advancing through multiple doses usually in four vials (diluted to 1:1000) on a weekly basis; however, there are benefits of using accelerated schedules, especially for children who need to coordinate school and parent work schedules. Special considerations for pediatric patients include fear of needles, avoiding discomfort with injections, consent, optimal injection scheduling, and difficulty communicating about symptoms during reactions in very young children. Overall, SCIT can be a safe and beneficial therapy for children.

Background: Though heart disease is the leading killer of women in the United States, many of them are unaware of their individual risks. Studies have shown that awareness of cardiovascular disease risk correlates with positive behavior changes, including increased physical activity and weight loss, leading to a heart-healthy lifestyle. The purpose of this study was to assess women’s awareness of their heart disease risk and barriers to starting heart healthy behaviors, such as improved diet and exercise. Methods: The Change of Heart (COH) Program at the University of Kansas Hospital conducted a self-reported assessment on women’s perceived barriers to leading heart-healthy lifestyle. Participants (N = 157) of this study were recruited from Mid-America Cardiology and their age ranged from 29 to 78 years (M = 53 years). Additionally, participants had an average education level of college and above and the median income was greater than $60,000. The assessment included questions regarding family and other care giving responsibilities, personal perception of heart disease risk, availability of indoor exercise facilities, and community access to fresh fruit and vegetables. Results: The three most common personal barriers amongst this population were family and other care giving obligations (87%), not perceiving oneself to be at risk for heart disease (63%), and feeling too stressed to accomplish one’s tasks (51%). Additionally, the three most common community barriers were a lack of nutritional information posted on restaurant menus (32%), not having access to indoor exercising facilities (17%), and not having access to support groups, such as weight management, smoking cessation (13%). When participants were asked what their intentions to make lifestyle changes to lower heart disease risk, 66% answered either an 8 or 9 on a scale of 0 (no intention) to 10 (most intention); however, 21% of women did not or occasionally did not believe they had control over their health conditions. The majority of participants had access to fresh fruits and vegetables (66%), to smoke free restaurants and public facilities (75%), and to safe, outside, public exercises areas (61%). Conclusion: In this well-educated cohort of women, the most common barrier to leading a heart-healthy lifestyle was lack of time due to family obligations. Most women were aware that women in general needed to make healthy changes in their lives, but they did not personalize their risk. This study suggests that women, even with available resources, need to be assessed, reminded, and encouraged to develop behavioral skills and strategies (e.g. time management) to incorporate heart healthy behaviors into their lifestyle.