Ajit Pal Singh

Transjugular approach for successful recanalization and stenting for inferior vena cava stenosis

Budd-Chiari syndrome is a rare disease characterized by obstruction of outflow in the hepatic vein and/or the inferior vena cava (IVC). Percutaneous transluminal angioplasty and stent placement is nowadays considered to be the first-line treatment for central venous disease because of its minimal-invasive approach. IVC reconstruction by surgical approach is not preferred due to increased morbidity and disappointing patency rates. We describe a case of a long-segment, thrombotic, chronic total occlusion of the IVC that was dilated and stented using a recanalization technique involving the use of Brokenborough septal puncture needle, Mullin dilator and Accura balloon from the jugular approach.

Idiopathic dilatation of the pulmonary artery-a case report.

Idiopathic dilatation of the pulmonary artery (IDPA) is a rare anomaly presenting with enlargement of the pulmonary artery in the absence of an identifiable cause. The natural history of this silent but potentially life‐threatening disease can be unpredictable. We report a case of IDPA in an 80‐year‐old female with a massively dilated pulmonary artery.

A patient with Marfan's syndrome presented with severe rheumatic mitral stenosis and successfully treated with percutaneous transmitral balloon commissurotomy – Report of first case

Marfans syndrome (MFS) is an inherited autosomal dominant disorder of connective tissue with mutation on the fibrillin-1 gene encoding for fibrillin. This frequently involves the cardiovascular system with prevalence is 1:5000-10,000. The clinical major criteria involve the skeletal and ocular apparatus and the cardiovascular and central nervous system. In Marfans syndrome mitral valve prolapse and aortic dilation are the main cardiovascular manifestations. According to the literature database the prevalence of aortic dilatation is 76%, 62% for mitral valve prolapse, 29% for mitral valve regurgitation and 26% for aortic regurgitation, in adult patients with Marfans syndrome. We are reporting a case who presented with severe rheumatic mitral stenosis & later on examination found to be a case of Marfans syndrome. This patient was successfully treated with percutaneous transmitral balloon commissurotomy. In medline search, so far there is no other case of Marfans syndrome reported to have rheumatic mitral stenosis.

Cisplatin-etoposide induced myocardial infarction in a patient with small cell carcinoma

© 2018 Srija Katta et al. This is an open access article distributed under the terms of the Creative Commons Attribution License -NonCommercialShareAlikeUnported License (http://creativecommons.org/licenses/by-nc-sa/3.0/). *Corresponding Author Ajit Singh, Department of Cardiology, Kasturba Medical College and Hospital, Manipal Academy of Higher Education, Manipal-576104, India. E-mail: ajitjsingh.mcops @ gmail.com Cisplatin-Etoposide Induced Myocardial Infarction in a Patient with Small Cell Carcinoma

Atorvastatin-induced hepatotoxicity, increased by clopidogrel stress on CYP450 Enzyme: Understanding the mechanism through a case

© 2018 Sahithi Thotakura et al. This is an open access article distributed under the terms of the Creative Commons Attribution License -NonCommercial-ShareAlikeUnported License (http://creativecommons.org/licenses/by-nc-sa/3.0/). *Corresponding Author Kanav Khera, Department of Pharmacy Practice, Manipal College of Pharmaceutical Sciences, Manipal Academy of Higher Education, Manipal-576104, India. E-mail: kanavworld @ gmail.com Atorvastatin-Induced Hepatotoxicity, Increased by Clopidogrel Stress on CYP450 Enzyme: Understanding the Mechanism through a Case

Successful Primary Percutaneous Intervention with Stenting in Anomalous Right Coronary Artery Arising from left Coronary sinus in case of Acute Inferior wall Myocardial Infarction Complicated by Cardiac Tamponade.

Anomalous origin of the right coronary artery (RCA) from the left sinus of valsalva is a rare congenital abnormality. The unusual location and noncircular orifice of this anomaly poses a great technical challenge for selective catheterization and percutaneous coronary intervention (PCI). Hemopericardium leading to tamponade complicating acute MI is rare and leads to hemodynamic instability. We report a case of acute inferior wall MI with a moderate pericardial effusion in cardiac tamponade who was treated with immediate pericardiocentesis followed by PCI and stenting of an anomalously arising RCA from the left sinus. Key words: Anomalous coronary artery, Primary PCI, Tamponade, Hemopericardium, Inferior wall MI.

Adenocarcinoma—a rare intruder into the superior vena cava and the right atrium

A 60-year-old woman presented with breathlessness for 6 months. On examination, she had dilated veins in the neck and chest with direction of blood flow downwards suggesting superior vena cava (SVC) obstruction (figure 1A). Chest auscultation revealed diminished breath sounds on the right side. Chest X-ray showed mediastinal widening with soft-tissue density lesion in upper-right hemithorax (figure 1B). Transthoracic echocardiogram showed globular mass in right atrium (RA) obstructing the tricuspid valve (figure 1C and online supplementary video 1). Transoesophageal echocardiogram revealed the mass extending from SVC and filling the RA (figure 1D,E-asterix …

Biatrial enlargement: an unusual cause of massive cardiomegaly.

A 50-year-old woman presented with complaints of progressive breathlessness and easy fatiguability over the past 2 years. Jugular venous pressure was raised with absence of a wave. Cardiac auscultation revealed two distinct mid-diastolic murmurs at the apex and a left lower sternal border with an ejection systolic murmur at the right second intercostal space. The ECG performed showed atrial fibrillation with a fast ventricular rate. Rate control was achieved with amiodarone infusion and intravenous diuretic therapy was instituted. Chest radiograph (figure 1 …

UFO in the heart: revealed during balloon mitral valvuloplasty for severe mitral stenosis

A 39-year-old man presented with worsening dyspnoea on exertion of 1-year duration. Cardiac auscultation revealed a loud first heart sound with a soft, rumbling mid-diastolic murmur. ECG showed P mitrale with tall R wave in V1. Chest roentgenogram revealed cardiomegaly with straightening of the left heart border suggestive of left atrial (LA) appendage enlargement, dilation of the right and left pulmonary arteries (horizontal arrows) and prominence of the both upper lobe …

Congenitally corrected transposition of the great vessels associated with morphological right ventricular non-compaction presenting with supraventricular tachycardia.

A 25-year-old man presented to the emergency department with acute onset palpitation. He had a history of four to five similar episodes in the past 2 months, which had resolved on their own. ECG showed supraventricular tachycardia (SVT) with a rate of 170/min (figure 1). He was treated with intravenous adenosine which reverted the tachycardia. Transthoracic echocardiogram was attempted but an adequate window could not be obtained as the patient was obese. Only the spatial relationship of the two great vessels …