Left-sided heart failure can be complicated in the patient suffering with thyrotoxicosis; however, predominantly right heart failure in thyrotoxic patients is a rare condition. We present here a case of reversible right-heart failure with severe tricuspid regurgitation associated with thyrotoxicosis. A 71-year-old woman was admitted to the hospital because of a 10-day history of shortness of breath and indigestion. On echocardiography, there was a normal-sized left ventricle with preserved systolic and diastolic function. However, the right atrium and ventricle were dilated, and there was incomplete systolic coaptation of the tricuspid leaflets, resulted in severe tricuspid regurgitation. The maximal velocity of tricuspid regurgitation was 3.7 m/sec and the estimated pressure gradient between the right two chambers was 55 mmHg. After treatment that included diuretics and antithyroid drug (methimazole), the symptoms of right heart failure resolved. Four weeks later, a second echocardiogram was obtained revealing a normalized right atrium and ventricle, trivial tricuspid regurgitation and the resting pulmonary hypertension had disappeared.
Aged ; Diuretics ; Dyspepsia ; Dyspnea ; Echocardiography ; Female ; Heart Atria ; Heart Failure* ; Heart Ventricles ; Heart* ; Humans ; Hypertension, Pulmonary ; Thyrotoxicosis* ; Tricuspid Valve Insufficiency*

Since the new hypertension guideline published by the American Heart Association/American College Cardiology/American Society of Hypertension in 2017, the Korean Society of Hypertension and the European Society of Hypertension revised and announced new hypertension guidelines. Also the Korean Society of Hypertension published Korea hypertension fact sheet 2018, including prevalence, awareness, management status of hypertension, and their trends in Korea. Herein, I provide information on diagnosis and treatment of hypertension based on the new guidelines of the Korean Society of Hypertension.
Blood Pressure ; Cardiovascular Diseases ; Diagnosis ; Heart ; Hypertension ; Korea ; Prevalence

Cardiac tumors are rare diseases with various imaging findings. However, differentiating cardiac tumors based on imaging findings is challenging because of similarities in imaging features. We present two cases of cardiac tumors, including primary cardiac lymphoma and cardiac metastasis, in which the differential diagnosis was difficult.

Inadvertent left internal mammary artery (LIMA)-great cardiac vein (GCV) anastomosis is a rare complication of coronary artery bypass graft surgery. Patients with iatrogenic aortocoronary fistula (ACF) were usually treated surgical repair, percutaneous embolic occlusion with coil or balloon. We report a case of iatrogenic LIMA to GCV anastomosis successfully treated with coil embolization and protected left main coronary intervention through the percutaneous transfemoral approach.
Arteriovenous Fistula ; Coronary Artery Bypass ; Embolization, Therapeutic ; Fistula ; Humans ; Internal Mammary-Coronary Artery Anastomosis ; Mammary Arteries ; Transplants ; Veins

Inadvertent left internal mammary artery (LIMA)-great cardiac vein (GCV) anastomosis is a rare complication of coronary artery bypass graft surgery. Patients with iatrogenic aortocoronary fistula (ACF) were usually treated surgical repair, percutaneous embolic occlusion with coil or balloon. We report a case of iatrogenic LIMA to GCV anastomosis successfully treated with coil embolization and protected left main coronary intervention through the percutaneous transfemoral approach.
Arteriovenous Fistula ; Coronary Artery Bypass ; Embolization, Therapeutic ; Fistula ; Humans ; Internal Mammary-Coronary Artery Anastomosis ; Mammary Arteries ; Transplants ; Veins

Left atrial wall calcification is frequently observed in patients with rheumatic valvular heart disease. However, massive left atrial wall calcification, so called porcelain or coconut atrium, with left atrium thrombi is very rare. Here, we describe the case of a 67-year-old male patient with porcelain atrium, recurrent left atrial thrombi, and a spontaneous axillary hematoma after mitral valve replacement and surgical thrombectomy due to rheumatic valvular heart disease. The patient underwent two valvular surgeries 20 years prior; therefore, we determined not to perform additional surgeries because of a high risk of morbidity, mortality, and the recurrence of atrial thrombi. The patient has been maintained on daily warfarin as an anti-thrombic therapy for more than 5 years without major embolic complications.
Aged ; Cocos ; Dental Porcelain ; Heart Atria ; Heart Valve Diseases ; Hematoma ; Humans ; Male ; Mitral Valve ; Recurrence ; Thrombectomy ; Thrombosis ; Warfarin

Though nephrotic syndrome is associated with various thromboembolic phenomena, acute pulmonary thromboembolism is a rare complication. We experienced a case with acute pulmonary thromboembolism in a patient with generalized edema and profound proteinuria. Subsequent investigation revealed that the pulmonary thromboembolism was secondary to nephrotic syndrome due to membranous glomerulonephritis. This thromboembolic complication was successfully treated with thrombolysis and anticoagulation.
Edema ; Glomerulonephritis ; Glomerulonephritis, Membranous ; Humans ; Nephrotic Syndrome* ; Proteinuria ; Pulmonary Embolism*

Though nephrotic syndrome is associated with various thromboembolic phenomena, acute pulmonary thromboembolism is a rare complication. We experienced a case with acute pulmonary thromboembolism in a patient with generalized edema and profound proteinuria. Subsequent investigation revealed that the pulmonary thromboembolism was secondary to nephrotic syndrome due to membranous glomerulonephritis. This thromboembolic complication was successfully treated with thrombolysis and anticoagulation.
Edema ; Glomerulonephritis ; Glomerulonephritis, Membranous ; Humans ; Nephrotic Syndrome* ; Proteinuria ; Pulmonary Embolism*

No abstract available.

Left atrial wall calcification is frequently observed in patients with rheumatic valvular heart disease. However, massive left atrial wall calcification, so called porcelain or coconut atrium, with left atrium thrombi is very rare. Here, we describe the case of a 67-year-old male patient with porcelain atrium, recurrent left atrial thrombi, and a spontaneous axillary hematoma after mitral valve replacement and surgical thrombectomy due to rheumatic valvular heart disease. The patient underwent two valvular surgeries 20 years prior; therefore, we determined not to perform additional surgeries because of a high risk of morbidity, mortality, and the recurrence of atrial thrombi. The patient has been maintained on daily warfarin as an anti-thrombic therapy for more than 5 years without major embolic complications.
Aged ; Cocos ; Dental Porcelain ; Heart Atria ; Heart Valve Diseases ; Hematoma ; Humans ; Male ; Mitral Valve ; Recurrence ; Thrombectomy ; Thrombosis ; Warfarin