Abbreviations and Acronyms

ASD: atrial septal defects
LAA: left atrial appendage
PFO: patent foramen ovale
TEE: transesophageal echocardiography

Introduction

Real-time concurrent cardiovascular imaging is necessary for 2 categories of cardiovascular structural intervention in the left atrium: closure of interatrial septal defects and left atrial appendage (LAA) exclusion. Intracardiac echocardiography and transesophageal echocardiography (TEE) are the imaging techniques used to direct and optimize transeptal puncture as well as catheter and device placement; they are also used to monitor for cardiac emergencies, such as tamponade and device embolization. Each technique minimizes the use of contrast dye. The key to successful LAA exclusion

Abstract

Myocardial bridging is a frequent anomaly of the heart in humans and other animals. A myocardial bridge is typically characterized by the systolic narrowing seen with traditional catheter angiography, but this abnormality is not by itself a sign of ischemia or the need for intervention. In particular, transient spontaneous angina must be corroborated by reproducible narrowing during acetylcholine testing; this narrowing occurs during resting conditions and is responsive to nitroglycerin administration. Ischemia in myocardial bridging can result from acquired arterial wall disease (coronary artery atherosclerotic disease) or from instances of coronary spasm. Clinical evaluation should seek to identify baseline features such as myocardial bridge thickness (by using computerized axial tomography or intravascular ultrasonography) and the severity of systolic compression or reproducible spasticity (by administering acetylcholine). Nuclear myocardial scintigraphy is usually negative in patients with isolated myocardial bridging. Spastic coronary hyperactivity must be treated initially with antispasmodic medications, such as calcium channel blockers and nitrates, rather than by percutaneous stent placement or bypass surgery. Only exceptionally prolonged and critically severe spasm can induce intraluminal clotting and acute myocardial infarction. Recognizing the exceptionality and variability of ischemic presentations related to myocardial bridging is essential, as is establishing appropriate investigational methods for each of these facets of the condition.

Abstract

The Micra device is a leadless pacemaker implanted in the right ventricle via a femoral vein transcatheter approach. There are several indications for and advantages to using a leadless pacemaker, and the device's role in the field of cardiology will probably continue to increase. This article presents the case of a rare complication probably due to inadvertent placement of the device in the left ventricle across an undiagnosed patent foramen ovale.

Abstract

Platypnea-orthodeoxia syndrome is a rare condition characterized by positional dyspnea and hypoxemia, with symptoms presenting in the upright position and improving when recumbent. Hypoxemia in platypnea-orthodeoxia syndrome is defined as a drop in Pao₂ of more than 4 mm Hg or oxygen saturation greater than 5% when moving from a supine to an upright position. Etiologic mechanisms include intracardiac or pulmonary shunts and ventilation perfusion ratio mismatch. Platypnea-orthodeoxia syndrome has been described as part of COVID-19 pneumonia sequelae, with differing physiologic mechanisms from cardiac pathologies. This report presents the case of a patient with platypnea-orthodeoxia syndrome of multifactorial etiology: intracardiac shunting secondary to a patent foramen ovale and ventilation perfusion ratio mismatch as a sequela of COVID-19 pneumonia.

In the article, Angelini P, Uribe C, Raghuram A. Coronary Myocardial Bridge Updates: Anatomy, Pathophysiology, Clinical Manifestations, Diagnosis, and Treatment Options. Tex Heart Inst J. 2025;52(1):e238300. published 30 January 2025, the following corrections have been made:

1. The MS degree after “Arjun Raghuram,” has been deleted.

2. The keywords list included “ultrasonography, interventional.” “Interventional” has been deleted. The keyword is now “ultrasonography.”

3. Reference #5 has been corrected. Poláček P. Relation of myocardial bridges and loops on the coronary arteries to coronary occlusions. Am Heart J. 1961;61(1):44-52. doi:10.1016/0002-8703(61)90515-4

The online article and PDF have been corrected.

Lyme Carditis and Inflammation-Driven Plaque Erosion Presenting as Sudden Cardiac Arrest

Marco KaldasMD,

Moneal ShahMD,

Diana PashaievaBDS,

Georgios LygourisMD, and

Anita RadhakrishnanMD