Delayed left ventricular apical thrombus formation following discontinuation of dual anti-platelet therapy.

Delayed de novo left ventricular apical thrombus following a distant antero-apical myocardial infarction has to our knowledge not been previously reported. Herein we describe a patient who developed an apical thrombus 18 months after his initial infarct following cessation of dual anti-platelet therapy for a traumatic subdural haematoma requiring surgical evacuation.

Giant right atrium in an adult: case report of a rare condition.

We report one of the largest descriptions of the right atrium (RA) in an adult, in absence of Ebstein's anomaly, tricuspid stenosis and other common adult associations of RA enlargement, such as pulmonary hypertension secondary to chronic pulmonary disease or severe mitral valvular pathology and pulmonary embolism. The RA volume was estimated to be over 1400 ml and was notably disproportionate to that of the left atrium and either ventricle.

Marked reduction of effective radiation dose in patients undergoing CT coronary angiography using prospective ECG gating.

Coronary CT angiography (CCTA) is a rapidly evolving technology which can characterise and image sub clinical atherosclerotic plaque and visualise anatomy and quantitate stenosis. Concern about radiation exposure has limited the uptake of this technology. The aim of this study was to review the radiation dose data in 2298 consecutive patients referred to a single centre in an Australian outpatient setting over 27 months using all available radiation dose reduction strategies. Prospective ECG gating ("step and shoot") was used preferentially in 2025 patients with a mean effective dose of 3.39 ± 1.84 mSv (range 0.86-12.6 mSv). For clinical reasons only 273 patients required retrospective ECG gating, mean dose 19.21 ± 5.58 mSv (range 2.4-34.9 mSv) resulting in an 85.7% reduction in dose for the majority of patients with the low dose technique. In conclusion, most patients referred for routine CCTA can be studied with a radiation dose comparable to invasive X-ray angiography and less than radionuclide myocardial perfusion imaging.

An unusual precipitant of tako-tsubo cardiomyopathy.

A 76-year-old woman presents with acute pulmonary oedema and cardiogenic shock 10h after elective electrical cardioversion for atrial fibrillation. Her echocardiogram shows new wall motion abnormalities with akinesis of the apical and mid segments of the left ventricle and her resting ECG contains deep T wave inversion and QTc prolongation. Angiography reveals non-occlusive coronary artery disease. The echocardiogram on day 6 shows resolution of left ventricular wall motion abnormalities and a return to normal systolic function. The diagnosis of tako-tsubo cardiomyopathy was made. This is the first report of this condition precipitated by electrical cardioversion.

Coronary artery stenting in acute coronary syndrome associated with giant cell arteritis.

Coronary vasculitis is a rare but devastating complication of giant cell arteritis, otherwise known as temporal arteritis. Originally named for its propensity to attack the superficial temporal arteries, it is now recognized that it commonly involves a number of medium and large arteries throughout the body. Here we describe two cases of giant cell arteritis affecting the coronary arteries, one discovered at post-mortem and one which was successfully treated with immunosuppressive therapy and drug-eluting coronary stents. .

Ultraviolet digital image correlation (UV-DIC) for high temperature applications.

A method is presented for extending two-dimensional digital image correlation (DIC) to a higher range of temperatures by using ultraviolet (UV) lights and UV optics to minimize the light emitted by specimens at those temperatures. The method, which we refer to as UV-DIC, is compared against DIC using unfiltered white light and DIC using filtered blue light which in the past have been used for high temperature applications. It is shown that at low temperatures for which sample glowing is not an issue all three methods produce the same results. At higher temperatures in our experiments, the unfiltered white light method showed significant glowing between 500 and 600 °C and the blue light between 800 and 900 °C, while the UV-DIC remained minimally affected until the material began nearing its melting point (about 1260 °C). The three methods were then used to obtain the coefficient of thermal expansion as a function of temperature for the nickel superalloy Hastelloy-X. All three methods give similar coefficients at temperatures below which glowing becomes significant, with the values also being comparable to the manufacturers specifications. Similar results were also seen in uniaxial tension tests.