Primary Cardiac T Cell Lymphoma Mimicking ST-Elevation Myocardial Infarction.

Primary cardiac T cell lymphoma is an extremely rare condition with only a handful of biopsy-proven cases worldwide. We present a 62-year-old female presenting with nonspecific chest discomfort, shortness of breath, and anterolateral ST-elevation on electrocardiogram mimicking a ST-elevation myocardial infarction. Imaging revealed a cardiac mass and cardiac catheterization showed diffuse noncritical coronary disease with an occluded 2nd diagonal branch. Biopsy via minimally invasive cardiac surgery showed a pathologically proven diagnosis of primary cardiac T cell lymphoma. To our knowledge, this is the first documented case worldwide of primary cardiac T cell lymphoma that has resulted in ST-elevation mimicking a myocardial infarction.

Massive left ventricular pseudoaneurysm presenting as dysphagia: a case report.

Background: Left ventricular pseudoaneurysm is a recognized, however, uncommon presentation of acute myocardial infarction in the current era. This is due to early reperfusion therapy for acute myocardial infarction. Left ventricular pseudoaneurysm after myocardial infarction can present in a variety of ways, including heart failure, chest pain, and dyspnoea. Case summary: We present a case of a 61-year-old male who presented with extremely atypical symptoms of dysphagia and weight loss due to a massive left ventricular pseudoaneurysm. Transthoracic echocardiogram and computed tomography revealed a large pseudoaneurysm causing mass effect on multiple gastrointestinal organs. Organic causes for dysphagia and weight loss were ruled out by gastroscopy. Surgical management was carried out but was ultimately unsuccessful. Discussion: Despite the heterogeneity in presentation for patients with left ventricular pseudoaneurysm, rapid diagnosis is important for management and prognosis. Diagnostic tools include transthoracic echocardiography, computed tomography, and cardiac magnetic resonance imaging. Management is usually surgical; however, there is some debate in the literature regarding conservative vs. surgical management for chronic pseudoaneurysms. More data are needed to determine optimal management strategies and prognosis for patients with left ventricular pseudoaneurysms.

Blown Wide Open: An Unusual Case of Torrential Mitral Regurgitation Resolving With a Cough.

Mitral regurgitation can have varying hemodynamic parameters dependent on factors such as pressure gradients, exercise, and/or provocative maneuvers. We present a case of unusual dynamic mitral regurgitation resolved by coughing in a patient with hypertrophic cardiomyopathy. (Level of Difficulty: Intermediate.).

COVID-19 and Myocarditis: What Do We Know So Far?

COVID-19 has been declared a global pandemic by the World Health Organization and is responsible for hundreds of thousands of deaths worldwide. COVID-19 is caused by SARS-CoV-2, and common clinical symptoms include fever, cough, sore throat, headache, and fatigue. Myocardial injury is relatively common in patients with COVID-19, accounting for 7%-23% of cases, and is associated with a higher rate of morbidity and mortality. There is a discrepancy in the literature about myocarditis as the etiology of myocardial injury in patients with COVID-19; although many anecdotal reports of myocarditis have been noted, there are only a handful of case reports in the literature about myocarditis related to COVID-19. In this review we summarize the most up to date literature around the association between COVID-19 and myocarditis and provide clinicians a practical framework about the clinical manifestations, diagnostic tools, and treatment options currently available. Importantly, this review will heighten suspicion for myocarditis as an etiology of myocardial injury in COVID-19 patients, therefore improving clinical outcomes and encouraging shared clinical decision-making. This will also open the door for further research to build around this review. Emergent treatment options for COVID-19 are in clinical trials and might be of benefit to COVID-19 patients with myocarditis in addition to current guideline-based recommendations.

La COVID-19 a été déclarée pandémie mondiale par l'Organisation Mondiale de la Santé et elle est responsable de centaines de milliers de décès dans le monde. La COVID-19 est causée par le SARS-CoV-2, et les symptômes cliniques courants sont la fièvre, la toux, le mal de gorge, les maux de tête et la fatigue. Les lésions myocardiques sont relativement fréquentes chez les patients atteints de la COVID-19, représentant 7 à 23 % des cas, et sont associées à un taux de morbidité et de mortalité plus élevé. Il existe des divergences dans la littérature décrivant la myocardite en tant qu'étiologie de lésions myocardiques chez les patients atteints de la COVID-19; bien que de nombreux rapports anecdotiques de myocardite aient été rapportés, il n'y a qu'un nombre limité de rapports de cas dans la littérature concernant des myocardites liées à la COVID-19. Dans cette revue de littérature, nous résumons la bibliographie la plus récente sur l'association entre COVID-19 et myocardite et fournissons aux cliniciens un cadre pratique sur les signes cliniques, les outils de diagnostic et les options de traitement actuellement disponibles. Il est important de noter que cette revue augmentera la suspicion de myocardite comme étiologie de lésions myocardiques chez les patients atteints de la COVID-19, améliorant ainsi le pronostic clinique et encourageant une prise de décision clinique partagée. Cela ouvrira également la voie à d'autres recherches qui pourront s'appuyer sur cette étude. De nouvelles options de traitement de la COVID-19 sont en cours d'essais cliniques et pourraient être bénéfiques aux patients atteints de la COVID-19 qui présentent une myocardite, tout en étant considérées pour les recommandations actuelles basées sur les lignes directrices.