Takotsubo Syndrome – Stress-induced Heart Failure Syndrome

Takotsubo syndrome is an acute reversible heart failure syndrome, which is increasingly recognised by coronary angiography for patients with acute ‘cardiac’ chest pain.1 It is a distinct disease entity from acute coronary syndrome, although the initial presentation has similar features to either ST elevation myocardial infarction (STEMI) or non-ST elevation myocardial infarction (NSTEMI).

Acute Pericarditis Superimposed on Right Bundle Branch Block, Posterior Fascicular Block, and Interatrial Block

An electrocardiogram of a 72-year-old man who developed acute respirophasic pain in the left and central anterior chest plus fever (103 °F) (Figure 1). There are ubiquitous ST segment deviations (labeled ‘J’), right axis deviation (approximately 160 °), indicating posterior fascicular block right bundle branch block, late intrinsic deflection (in V1) with virtual Q waves in lead I and a definite Q wave in lead II as well as a decrease in r wave voltage from V5 to V6 (V6 resembles lead I).

New Developments in Atrial Fibrillation

Atrial fibrillation (AF) is the most common sustained, medically significant, and troublesome arrhythmia encountered in clinical practice. AF has been associated with decreased quality of life (symptoms), serious morbidity (thromboemboli and tachycardia-induced cardiomyopathy), and increased risk of mortality. Several articles have reviewed this arrthymia in depth including its presentations, prognosis and management. This review will focus on new developments in the management of AF.

Where's the Beef? A Case of Left Ventricular Hypertrophy that Isn't

A 35-year-old man is admitted for evaluation of non-ST-elevation myocardial infarction (STEMI) and heart failure. He has a history of leukemia treated with chemotherapy and radiation as a child, but has not had a cardiac evaluation in 10 years. He had been well until he developed dyspnea with exertion that progressed to dyspnea at rest over two days. At presentation, his blood pressure is 80/60mmHg, his heart rate is 110bpm, and his oxygen saturation is 91% in room air.

Symptomatic Calcific Constrictive Pericarditis Presenting Years After Presumed Resolved Inflammatory Heart Disease

Inflammatory heart diseases are characterized as focal, diffuse, or sparse inflammatory processes of the myocardium and its adjacent structures, including pericardium and endocardium.1 Owing to shared etiologies and proximity, myocarditis is often accompanied by pericarditis, known as perimyocarditis or myopericarditis.2 In this article, we present a patient with predominantly right-sided dysfunction from presumed inflammatory heart disease, who became refractory to standard heart failure treatment nine years after initial presentation due to the la

Progression of Low-pressure to Acute Classic Cardiac Tamponade - A Diagnostic Dilemma in the Setting of Spontaneous Left Ventricular Rupture

Cardiac tamponade (CT) is a pathophysiologic continuum where hemodynamic embarrassment occurs as a result of progressive, decreased venous return that impairs diastolic ventricular filling, which in turn, when uncorrected, severely compromises cardiac output.1,2 The overall risk for death depends on the speed of diagnosis, treatment, volume, and rate of fluid accumulation as well as the underlying pathologic process.1 While CT is classically associated with high intrapericardial pressures owing to rapidly accumulating large pericardial effusions, lo