Smonporn Boonyaratavej

Right Ventricular Myxoma

![Figure][1] [![Graphic][3] ][3][![Graphic][4] ][4] A 14-year-old girl presented with a 2-month history of dyspnea on exertion. A physical examination revealed a giant A-wave on jugular venous pulse. Echocardiography revealed a huge mobile heterogenous mass (A to D, asterisks) ,

Undetected Large Aortopulmonary Window in an Adult: A Confluence of Great Vessels

ology, Department of Medicine, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand; yCardiac Center, King Chulalongkorn Memorial Hospital, Thai Red Cross Society, Bangkok, Thailand; and the zDivision of Cardiothoracic Surgery, Department of Surgery, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand. Manuscript received May 1, 2013; accepted May 7, 2013. Journal of the American College of Cardiology Vol. 62, No. 19, 2013 2013 by the American College of Cardiology Foundation ISSN 0735-1097/

Intracardiac and intravenous leiomyomatosis.

36.00 Published by Elsevier Inc. http://dx.doi.org/10.1016/j.jacc.2013.05.097

Pneumohydropericardium with cardiac tamponade after pericardiocentesis

![Figure][1] [![Graphic][3] ][3][![Graphic][4] ][4][![Graphic][5] ][5] A 43-year-old woman with a history of syncope was referred for open heart surgery for right atrial (RA) myxoma removal. On examination, she had a grade 2/6 systolic ejection murmur. Intraoperative

Rare angiographic and echocardiographic findings of an aortic arch interruption in a patient with differential cyanosis

A 69-year-old woman developed dyspnoea 1 day after percutaneous pericardiocentesis for idiopathic pericardial effusion. On the exam, she had a pulsus paradoxus of 12 mm Hg and an elevated jugular venous pulse. The chest radiograph showed air separating the pericardium from the heart,

A rare cause of pulsus paradoxus: acute tension hydrothorax

A 23-year-old lady with a 3-year history of undiagnosed murmur and progressive dyspnoea was referred to our institution for a percutaneous patent ductus arteriosus (PDA) closure. Physical examination revealed differential cyanosis with an oxygen saturation in the upper and lower extremity of 95 and 86%, respectively. A loud P2 with a grade 3/6 systolic murmur …

Images in CardiologyScimitar Sign in a Patient With an Atrial Septal Defect: A Comprehensive Noninvasive Assessment With Transthoracic Echocardiography and Computed Tomography

A 63-year-old man with advanced lung cancer, suffered from increasing dyspnoea for 1 week. Physical findings included tachypnoea, decreased breath sound in the entire left chest. Chest film revealed complete ‘white out’ of left hemithorax with rightward shift of mediastinum (figure 1A) while previous study last 2 months showed no effusion. Initial blood pressure was 90/50 mm Hg and exhibiting pulsus paradoxus of 25 mm Hg (figure 1B, from continuous, non-invasive haemodynamic monitoring). Transthoracic echocardiography revealed large left pleural effusion with …

Scimitar Sign in a Patient With an Atrial Septal Defect: A Comprehensive Noninvasive Assessment With Transthoracic Echocardiography and Computed Tomography

![Figure][1] [![Graphic][3] ][3][![Graphic][4] ][4] A 30-year-old woman was referred for a percutaneous atrial septal defect (ASD) closure. She was acyanotic. She had a systolic ejection murmur and a wide-fixed split S2. The chest radiograph showed cardiomegaly; pulmonary

Very late presentation of anomalous origin of the left coronary artery from the pulmonary artery: case report

![Figure][1] [![Graphic][3] ][3][![Graphic][4] ][4] A 30-year-old woman was referred for a percutaneous atrial septal defect (ASD) closure. She was acyanotic. She had a systolic ejection murmur and a wide-fixed split S2. The chest radiograph showed cardiomegaly; pulmonary

Calcium sign of thoracic aortic dissection in Takayasu’s arteritis

BackgroundAnomalous origin of the left coronary artery from the pulmonary artery (ALCAPA) is a rare congenital coronary anomaly. The enlarged right coronary artery provides retrograde collaterals to supply the left ventricle then preferentially directs into the lower pressure pulmonary artery system causing coronary steal phenomenon. Few patients who survive through adulthood without surgery must have abundant, well-formed functioning collaterals with adequate perfusion of the left ventricle. We present the oldest reported patient with ALCAPA to undergo corrective surgery.Case presentationA 79-year-old woman presented with a 3-months history of worsening shortness of breath and orthopnea. Physical examination discovered a soft continuous murmur at the left upper chest. Transthoracic echocardiography demonstrated an unusual, tubular-like structure inside the interventricular septum with a turbulent flow from color Doppler. Moreover, there was a severe mitral regurgitation from posterior mitral leaflet restriction associated with ventricular remodeling in combination with mitral annular dilatation. Coronary angiography and coronary computed tomography angiography established the diagnostic hallmark of ALCAPA syndrome. Stress cardiovascular magnetic resonance perfusion imaging demonstrated no myocardial ischemia suggesting adequate collateral circulation. Remarkably, there was a left coronary ostial stenosis, which served as a protective mechanism against myocardia ischemia by limiting the steal effect. The patient successfully underwent the ligation of anomalous artery at its origin in combination with bioprosthetic mitral valve replacement. Her postoperative course was uneventful.ConclusionsThis case utilized multimodality imaging for delineating the course of abnormal vessels and helping to formulate therapeutic decision.