Large Right Atrial Myxoma: A Rare Presentation.

We present a case of a 74-year-old female with a large right atrial myxoma who initially presented to her primary care physician with nonspecific constitutional and abdominal symptoms. Her presenting symptoms were initially thought to originate from her gastrointestinal tract, but her workup for a gastrointestinal disorder was nondiagnostic. It was not until this patient developed symptoms of overt right heart failure that a cardiac condition was suspected. Our case highlights the importance of understanding the potential of cardiac myxomas to mimic many diseases, including cardiac, infective, neurologic, immunologic, pulmonary, and malignant diseases. Therefore, clinicians must always maintain a high index of suspicion for cardiac myxomas when evaluating patients with cardiac and non-cardiac-related symptoms that may be due to these tumors.

Cardiovascular adaptation and cardiac disease in the elite athlete.

Cardiovascular diseases are uncommon among trained athletes. Their occurrences mostly depend on the individual's age and fitness levels. Adequate understanding of the cardiovascular adaptations undergone by the competitive athletes' heart is of paramount importance in order to differentiate them from serious cardiovascular conditions. Diagnosing these abnormalities early may prevent rare but devastating potential complications associated with athletic activities and defines appropriate activity restrictions to minimize the risk of sudden cardiac death. This article will review concerns related to competitive athlete's cardiovascular adaptations and diseases, in light of specific recommendations presented in the 36th Bethesda Conference guidelines.

Sudden cardiac death in the elite athlete.

Sudden cardiac death (SCD) is a long -recognized disease that occurs rarely in trained athletes. Most affected athletes have no symptoms before death. Many attempts have been made to detect those at risk for SCD before athletic participation. However, its overall clinical advantages remain questionable in medical literature. This article will review cardiogenic and non-cardiogenic causes of SCD as well as discuss how this entity affects those athletes older than 35 years.

Horner's syndrome: Herald of a ticking bomb.

Horner's syndrome is a clinical syndrome caused by damage to the cervical sympathetic ganglia. We discuss a case with classic signs of Horner's syndrome in an intravenous drug user with a right septic subclavian artery pseudoaneurysm. This case highlights that with the increasing intravenous drug use, this rare presentation of HS may become more common.

Prevalence of anemia in a Hispanic population with decompensated congestive heart failure.

UNLABELLED: Anemia in patients with heart failure (HF is a frequent event, commonly associated with worse prognosis. Despite the high incidence and adverse outcomes associated with anemia no studies have been conducted amongst Hispanics with HF. OBJECTIVE: The study aims to determine the prevalence, predictors and outcomes of anemia in Hispanics admitted to Veteran Affairs Caribbean Healthcare System with diagnosis of Decompensated Congestive Heart Failure (D-CHF). METHODS: Retrospective review of 617 patient medical charts that had been previously discharged with a diagnosis of HF as per International Classification of Diseases-9 code. The clinical, demographic, laboratory and echocardiographic data was assessed for a total of 148 male patient electronic medical records that met the study inclusion criteria. The re-hospitalization and mortality rates were determined from the admission date until April 2010. RESULTS: The burden of anemia with HF is substantial, with anemia present in 68.2% of patients. Anemia was associated with hypoalbuminemia, higher New York Heart Association classification, elevated pro-BNP level at discharge, renal insufficiency and diastolic dysfunction, all of which demonstrated statistical significance. Anemia had 2.18 and 2.95 times likelihood of any-cause mortality (p = 0.003) and cardiovascular deaths (p = 0.02) when compared with HF patients without anemia. CONCLUSIONS: Anemia is a very frequent and serious finding in patients with D-CHF. The study reveals a higher prevalence of anemia in HF patients among Hispanics in comparison with formerly reported studies covering non-Hispanic populations.

Congestive heart failure and renal complications.

Congestive heart failure is the leading cause of hospital admission among patients over the age of 65 years. It affects population within the United States, including Puerto Rico, presenting itself as the leading cause of heart related deaths worldwide. Its management can include pharmacologic agents which will affect neuroendocrine axis mainly but also include novel non-pharmacologic approaches such as ultrafiltration. The coexistence of heart failure and renal dysfunctions are very common within our medical community, especially within the western hemisphere, causing greater concerns amongst the medical field with increased research and investigation activity. This clinical review article will address the theme of congestive heart failure, highlighting the edema formation concept, volume homeostasis, cardio-renal syndrome and neuroendocrine pathways. The management of acute decompensated heart failure is discussed, primarily focusing with available novel non-pharmacologic approaches.

Recurrent syncope episodes in a 33-year-old male patient: case report and review of literature.

Case report and review of literature of a 33-year-old-male patient who was suffering from recurrent events of loss of consciousness (syncope) found to have multiple events of sustained and non sustained left bundle-branch morphology ventricular tachycardia during Holter evaluation. Both, the echocardiographic and magnetic resonance studies demonstrated morphological changes as seen in Arrhythmogenic right ventricular cardiomyopathy. Arrhythmogenic Right Ventricular Dysplasia (ARVD) is a rare cardiomyopathy characterized by life-threatening ventricular arrhythmias in the absence of apparent structural left heart disease, predominantly occurring within the male gender. Though it is mostly a hereditary condition, there are some sporadic cases. It is characterized by progressive degeneration and fibrous-fatty replacement of the right ventricular myocardium. The European Society of Cardiology and the International Society and Federation Task force is useful for the diagnosis of the condition because of the difficulties in as well as inaccuracies in tissue diagnosis. Patients with a diagnosis of ARVD who suffers from recurrent syncope events and ventricular arrhythmias an Implantable Cardiovertor-Defibrillator (ICD) is indicated to decrease their risk of sudden cardiac death events.