Ischemia Possibly Associated with High Degree Atrioventricular Block.

Conduction restoration in second- and third-degree atrioventricular (AV) block after revascularization in acute coronary syndrome (ACS) setting is well established, however this is not the case in non-ACS setting. We present a case of a patient referred for permanent pacemaker implantation, due to high degree AV block (HAVB), who restored his conduction possibly due to targeted revascularization. Thus, this case sheds insight in the reversibility potential of HAVB after revascularization in non-ACS patients, which although signified in current literature, is still far from being a recommendation, due to lack of robust scientific confirmation.

A Rare Case of Gastrointestinal Stromal Tumor with a Liver Metastasis Infiltrating the Inferior Vena Cava and Extending to the Right Atrium with an Early Recurrence after Surgical Extraction.

Gastrointestinal stromal tumors (GISTs) are mesenchymal tumors of the gastrointestinal tract. The major cause of GIST is the presence of an abnormal form of tyrosine protein kinase (KIT) protein also known as CD117, which causes uncontrollable growth of the gastrointestinal cells. Most studies report incidences between 10 and 15 cases of GISTs per million. Metastases to the liver and peritoneum are the most frequent. We report a case of advanced GIST with a liver metastasis infiltrating the inferior vena cava (IVC) and extending to the right atrium in the form of a large, floating, isolated intracardiac liver metastasis with diastolic prolapsing through the tricuspid valve. This is a very rare manifestation. One week after heart surgery and removal of a 5 × 6 cm tumor mass from the right atrium and the IVC, echocardiography depicted an early recurrence.

Asymptomatic infection with novel influenza A/H1N1 virus in a heart transplant recipient.

The spectrum of manifestations and management of the novel influenza A/H1N1 virus in transplanted patients is currently of major concern. Asymptomatic infections are less common yet important for spreading of the virus and thus affect containment measures. To our knowledge, there are no reports of asymptomatic infections with influenza A/H1N1 in immunosuppressed patients. We present the first case of a young heart transplant recipient who remained asymptomatic despite positive polymerase chain reaction (PCR) after exposure to individuals with influenza A/H1N1.