Eric Dandes

Reclassification of Patients for Aggressive Cholesterol Treatment: Additive Value of Multislice Coronary Angiography to the National Cholesterol Education Program Guidelines

National Cholesterol Education Program (NCEP) guidelines have been used to define treatment goals in patients with hypercholesterolemia. However, epidemiology‐based guidelines are unable to identify all subjects with coronary artery disease for aggressive lipid intervention.

Postcardiac injury syndrome following transvenous pacer or defibrillator insertion: CT imaging and review of the literature.

Postcardiac injury syndrome (PCIS) is a frequent clinical entity developing as a complication of cardiac procedures. Some of these may be only minor procedures, such as the insertion of permanent pacer or defibrillator devices. The purpose of this article is to review and illustrate its common imaging findings. PCIS is expected to occur in approximately 1%-2% of patients after pacer or defibrillator device placement. The mechanism of pericarditis following implantation is unclear, but it may involve a direct irritation of the pericardium by minimally protruding electrodes, low-grade bleeding with hemorrhagic pericarditis, and a late autoimmune or inflammatory response to those insults. Radiologists may detect findings that in the appropriate clinical setting should raise the possibility of PCIS. On chest x-ray, the findings include the presence of a pericardial or pleural effusion or both. Computed tomography, in addition to having better characterization capabilities of the pericardial or pleural effusion or both, may also accomplish the diagnosis of lead perforation. Although typically rather benign, PCIS may result in significant morbidity and potential mortality due to arrhythmias, noncardiac pulmonary edema, and cardiac tamponade. Therefore, its early detection is of clinical importance.

Congenital rock and a hard place: unicuspid aortic valve with sinus of valsalva aneurysm

Cardiac CT angiography (CTA) is an ideal tool to investigate possible cardiac malformations. In this case, careful planning of the CTA acquisition and reconstruction provided high resolution images of cardiac anatomy revealing 2 extremely rare coexisting congenital defects; a unicuspid aortic valve (UAV) and sinus of Valsalva aneurysm (SVA). Detailed planning of CTA acquisition reconstruction protocols is essential in obtaining necessary information for clinical decision-making strategies and interventions in the patients with suspected cardiac anomalies.

Simultaneous assessment of coronary stenosis, myocardial perfusion, and ventricular function in a patient with acute myocardial infarction

Cardiac CT angiography (CTA) is an ideal tool to investigate cardiac and noncardiac causes of acute chest pain. In this case, careful planning of the CTA acquisition and reconstruction limits permitted not only the exclusion of aortic dissection and provided high resolution images of coronary anatomy but also showed a concordant abnormality in myocardial perfusion and ventricular function in the setting of an acute coronary syndrome. Detailed planning of every CTA acquisition reconstruction protocol is essential to obtain the information necessary for clinical decision-making strategies and interventions in the patient with chest pain.

Five years of ThePreparedMinds.com

The last decade has seen an explosion of published information in our field. A significant amount of new journals have surfaced over the past few years which, in addition to the established journals, are giving way to a new age of cardiovascular imaging information overload. It has become incredibly difficult to stay up to date with the state of research and, with the constant advances in technology and the different available modalities, this task has become nearly impossible. The North American Society of Cardiovascular Imaging (NASCI) is celebrating the 5th anniversary of its online journal club. It was Louis Pasteur who in an 1854 dissertation at the University of Lille said: ‘‘Dans les champs de l’observation le hasard ne favorise que les esprits préparés’’ (In the fields of observation chance favors only the prepared mind), a favorite quote among radiologists and the inspiration for the title of our website, ThePreparedMinds.com. Our goal was to bring together a team of imagers, both radiologists and cardiologists, who review and curate the vast amount of published material to bring you a few reading suggestions. Readers are invited to engage in conversation and to discuss how the research would affect their practice. Many times, the authors of the papers decide to join in as well, making this an even more beneficial site. During 2013, we had a total of 165 posts, which is a 7 % decrease in the number of posts when compared with 2012 (178 posts). By modality, publications on computed tomography (CT) represented 35 % of posts, magnetic resonance 29 %, and echocardiography 14 %. ThePreparedMinds. com has over 1,100 unique tag identifiers which correspond to the keywords assigned by the authors to their manuscripts for publication. It is not surprising that the two most prevalent keywords are ‘‘coronary artery disease’’ 23 % and ‘‘risk stratification’’ 18 %. To see a graphic representation of the most common keywords during 2013, visit the website and click on the ‘word cloud’ icon located on the right-sided column. We take this opportunity to thank and recognize our editorial board for the time, dedication, and expertise they have devoted to ThePreparedMinds.com and NASCI. Craig Asher, MD Juan Batlle, MD Michael Bolen, MD Erasmo de la Peña-Almaguer, MD Thomas A Foley, MD Brian Ghoshhajra, MD Subodh B. Joshi, MD Matthew W. Martinez MD Gian M. Novaro, MD Tarun Pandey MD Liu, Qianqian MD Ronen Rubinshtein, MD Paul Schoenhagen, MD Phillip M. Young, MD Daniel Vargas, MD Eric E. Williamson, MD