Unraveling the Trio of Interrupted Descending Aorta, Aortic Stenosis, and Bicuspid Aortic Valve: A Complex Cardiovascular Conundrum.

Interrupted descending aorta (IDA) is an extremely rare congenital heart defect characterized by a complete loss of connection between the ascending and descending aorta. This condition is typically diagnosed in infancy or early childhood, but there have been very few cases reported in adulthood. Here, we present a unique case of an IDA in a 16-year-old patient with concomitant aortic stenosis (AS) and bicuspid aortic valve (BAV), making it an extremely rare scenario. This case highlights the importance of early diagnosis and appropriate management in patients with an IDA, particularly when in association with other cardiovascular abnormalities.

Congenital Absence of the Left Circumflex Artery Presenting With Inferoposterior Wall Myocardial Infarction Due to Stenosis of the Super Dominant Right Coronary Artery: A Rare Case.

The primary coronary arteries are the right coronary artery (RCA), the left main coronary artery (LMCA), which bifurcate into the left anterior descending artery (LAD), and the left circumflex artery (LCX), arising from the right coronary sinus and left coronary sinus, respectively. The congenital agenesis of LCX is a very unusual anomaly caused by the inability of LCX to form in the atrioventricular (AV) groove. This condition is usually accompanied by the presence of a large, dominant RCA that supplies its own territory and that of LCX, i.e., the inferior, posterior, and lateral walls. This anomaly is generally detected incidentally during coronary angiography. This condition usually does not manifest as a major cardiovascular event and mildly presents as chest pain upon exertion. The chest pain is vastly attributed to ischemia in the RCA territory, as this "super dominant" vessel majorly directs its supply to the LCX territory for compensation. This is known as the steal phenomenon. In this paper, we discuss a case of a 61-year-old female who came to the ED with the chief complaint of acutely radiating chest pain for five hours and was diagnosed as a case of acute myocardial infarction of the inferior and posterior walls. Coronary angiography revealed 90% stenosis of the RCA and a congenital absence of LCX, which has a significantly low prevalence.

An Extremely Rare Case of Isolated Aortic Valve Prolapse Causing Aortic Regurgitation in the Absence of Any Other Pre-existing Cardiovascular or Non-cardiovascular Condition.

In this case report, we present an extremely rare case of isolated aortic valve prolapse causing aortic regurgitation having no association with any comorbid conditions that are commonly seen with aortic valve prolapse. A 27-year-old female patient presented with chief complaints of dyspnea on exertion (New York Heart Association grade III) for 20 days, decreased appetite for 15 days, and a history of significant weight loss for one and a half years. Transthoracic and transesophageal echocardiography revealed a trileaflet floppy aortic valve with prolapsing non-coronary and right coronary cusps, associated with moderate aortic regurgitation. The incidence of aortic valve prolapse is roughly around 1%. Exceptionally, very few cases of isolated aortic valve prolapse with moderate-to-severe aortic regurgitation without any associated pathology have been reported to date.

Experience of Percutaneous Closure of Ventricular Septal Defects in 140 Patients With Different Duct Occluders in a Tertiary Care Rural Hospital in Central India.

Background Ventricular septal defects (VSDs) are the most common type of septal defects in early infants and are very complicated. This has paved the way for the development of new minimally invasive procedures for interventional cardiologists. This study presents our experience using duct occluders instead of conventional ventricular septal devices in the Department of Cardiology at Acharya Vinoba Bhave Rural Hospital (AVBRH) in central rural India. This study aimed to review success and complications and assess safety and its relation to age, sex, size of the VSDs, type of VSD, and types of devices used after transcatheter closure of perimembranous and muscular VSDs using various types of duct occluders. Methodology This retrospective study included patients who underwent percutaneous VSD device closure at the AVBRH between July 2017 and December 2020. We reviewed the patients' medical records to recognize imaging, clinical, and interventional data pre- and post-procedure and at the last follow-up. Results The success rate of VSD closure was 98.6%, one (0.7%) out of 81 females developed a complication due to device dislodgement, and one male aged six years (0.7%) out of 59 developed a post-procedural complication; hence, the total failure rate was 1.4%. The perimembranous type had no complication, and the muscular type had two (14.3%) unsuccessful procedures. Conclusion This study has concluded an impressive percentage of VSD closure, showing no mortality and low morbidity, using a percutaneous approach with different duct occluders. As the type of device used is not correlated with device failure and failure rate, duct occluders will be financially helpful in the closure of VSD in indicated patients.

Persistent Winking Coronary Sign in a Case of Post-myocardial Infarction Ventricular Septal Rupture After Device Closure.

A winking coronary sign refers to the partial collapse of an artery situated over the ventricular septal rupture during systole and refilling of the same during diastole, which is seen as phasic filling and disappearance of the arterial segment during coronary angiography. In this article, we discuss the case of a patient who reported to the emergency department of a tertiary care hospital in central India with myocardial infarction of the anterior wall. Two-dimensional echocardiography and coronary angiography revealed ventricular septal rupture. The patient was promptly managed by a percutaneous coronary angiography and interventricular septal device closure. Even after the defect closure, the winking coronary sign persisted on coronary angiography, and the patient was then discharged in stable condition.

Marfanoid to Mortality: A Case Report on Sudden Cardiac Death Due to Aortic Dissection in a Young Male With Marfanoid Habitus.

This compelling case study unravels a tragic narrative of a 40-year-old male with Marfanoid habitus, navigating the intricate web of Marfan syndrome (MFS) and succumbing to the devastating complications of aortic dissection. The patient's journey underscores the challenges in managing this rare connective tissue disorder, emphasizing the critical interplay between genetic predisposition and cardiovascular pathology. Moreover, the lack of immediate operative intervention due to the critical condition emphasizes the crucial need for timely diagnosis and intervention. The journey from genetic mutation to cardiovascular complications in MFS or related marfanoid habitus is complex and multifaceted. This case study aims to navigate this intricate path, emphasizing the need for a nuanced understanding of the underlying molecular and structural changes. Furthermore, it reinforces the critical role of ongoing cardiovascular monitoring and surgical interventions to prolong survival and enhance the quality of life for individuals grappling with the challenges posed by MFS or related habitus.

Case Report: Multiple atherosclerotic plaques at its extreme in synchrony.

Peripheral artery (PAD) disease in association with renal artery stenosis is an important association which predicts the severity of the disease. An increase in the number of vessels affected by peripheral artery disease increases the chances of renal artery stenosis. In our case, the patient had primarily presented with anginal chest pain with complaints of claudication which on further investigation was diagnosed to be a triple vessel coronary artery disease along with bilateral subclavian and bilateral renal stenosis. On detailed history taking, risk factors like hypertension and chronic smoking was found to be present in our case which predisposed to peripheral artery disease secondary to atherosclerosis which was diagnosed on further investigations. Although the association of renal artery stenosis is not very rare in cases of severe peripheral vascular diseases, the presence of a triple vessel coronary artery disease in synchrony is what makes it unique. Take away lesson from this case report is importance of early diagnosis of dyslipidemia causing atherosclerosis and its complications. Multiple atherosclerotic lesions in synchrony i.e, bilateral renal artery stenosis with bilateral subclavian artery stenosis with coronary artery triple vessel atherosclerotic disease like in our case and its severity should create awareness among health care individuals and early treatment measures including lifestyle modifications should be considered to avoid such drastic events.

A Rare Association of Patent Ductus Arteriosus (PDA) With Persistent Left Superior Vena Cava (PLSVC) and Unroofed Coronary Sinus (UCS) Terminating Into Left Atrium (LA): A Case Report of an Indian Infant.

Unroofed coronary sinus syndrome (UCSS), also named coronary sinus (CS) septal defect, is a rare type of atrial septal defect (ASD) with the incidence less than 1% of the total number of ASDs. It is caused by incomplete formation of left atrial venous folds during embryonic development. There is communication between the CS and left atrium (LA) due to the presence of a left superior vena cava (LSVC) along with an incomplete or complete loss of the CS roof draining into the LA. It usually presents as mild breathlessness on exertion and the appearance of murmurs on auscultation. A case that is diagnosed as an unroofed CS (UCS) related to a continuous LSVC terminating into the CS, which further terminates into LA, along with a large patent ductus arteriosus (PDA) is a rare presentation.

Ellis-Van Creveld Syndrome: A Rare Case Report of an Indian Child With Rare Cardiac Anomalies and Normal Intelligence.

Ellis-Van Creveld syndrome (EVCS) is an abnormal genetic condition of the EVC2 gene located on chromosome 4. In this case, the person presents with bone growth abnormalities, thus having a short stature, short arms and legs (more commonly the forearm and lower leg), a narrow chest with short ribs, polydactyly, spoon-shaped or malformed nails, abnormalities in dentition, and congenital heart defects like atrial septal defects and ventricular septal defects. In this case report, we present a 4.5-year-old female child who presented with cough and cyanosis as signs and tachypnea, tachycardia, facial oedema, cold, and clubbing as symptoms with polydactyly and short stature focuses on a rare presentation of a syndromic disease known as EVCS.

Infective Endocarditis in Patient With Uncorrected Patent Ductus Arteriosus: A Case Report From Rural India.

A congenital cardiac defect with an untreated left-to-right shunt is a risk factor for infective endocarditis (IE), particularly right-sided infective endocarditis, which has a distinct clinical presentation and outcomes in comparison to left-sided IE. With a prevalence of at least 2-4 per 1000 term births, patent ductus arteriosus (PDA) accounts for around 10% of all congenital cardiac diseases. Early diagnosis by transthoracic echocardiography and prompt antimicrobial therapy for IE are advised to minimize multiorgan failure and severe pulmonary embolism. Closure of large, hemodynamically significant PDA could have a minimal level of intervention, and it may be done cautiously and efficiently with either surgical or transcatheter procedures. The elimination or minimization of these malformations has been advised to remove or decrease the possibility of IE. We present a case of a 10 years old female who presented with a history of intermittent fevers over two weeks. Clinical examination revealed a PDA murmur. Transthoracic echocardiology (TTE) revealed a PDA with vegetation suggestive of IE. The patient was treated with antibiotics, and two weeks after the antibiotic therapy, a TTE showed resolution of the vegetation. Thereafter, the patient was advised to undergo surgical correction of the PDA. This case report highlights the importance of the association of IE with congenital heart disease.