Anand Iyer

Recurrent left ventricular thrombus in Crohn's disease: a rare presentation.

A 40-year-old man with Crohn’s disease was found to have recurrence of a large left ventricular mass on echocardiography during workup for stricturoplasty. He presented with left limb emboli. He had been diagnosed with a left ventricular thrombus 2 years earlier, with multiple cerebral and peripheral emboli, and underwent surgery. We carried out redo surgery, and histology revealed organized thrombus. We discuss the management of this complex case.

Contained myocardial abscess following a myocardial infarction

Myocardial abscesses are usually associated with endocarditis or septic emboli. Myocardial abscesses developing at the site of a myocardial infarction are rare and are thought to occur as a result of a supra-infection at the site of necrotic tissue and are associated with an increased risk of ventricular wall rupture. We present images of a ventricular abscess following an acutemyocardial infarction associated with severe mitral regurgitation (MR).

Delayed presentation with cardiac tamponade due to blunt thoracic trauma and ruptured left atrial appendage

Delayed survival due to cardiac chamber rupture in the setting of blunt thoracic trauma is rare. Delay can occur due to transport from a remote location as reported herein when patient was operated upon 5xa0h later following left atrial rupture causing cardiac tamponade. We emphasize the need for high index of suspicion of cardiac tamponade in patients who show hemodynamic instability. Cardiopulmonary bypass may be required when there is uncontrolled bleeding following opening of the pericardium.

Ruptured Sinus of Valsalva Aneurysm Causing Acute Right Heart and Hepatorenal Failure Requiring Urgent Surgery

A sinus of Valsalva aneurysm is a rare cardiac anomaly that may be congenital or acquired. Very rarely, they present with acute symptoms as a result of rupture into the cardiac chamber. If left untreated, they almost always result in deteriorating cardiac function. We report a patient presenting with acute right heart failure and hepatorenal syndrome requiring urgent surgery and double patch repair.

Thoracic melioidosis: A diagnostic dilemma

The diagnosis of melioidosis can be difficult, and it is frequently described as “the great mimicker”. We report a case of thoracic melioidosis presenting as a mediastinal mass with impending superior vena cava obstruction. With the presumptive diagnosis of mediastinal tumor, the patient underwent surgery for tissue sampling, and a purulent collection was found. The clinical syndromes of melioidosis and the diagnostic dilemma are discussed.