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Multimodality Imaging Features of Cardiac Fungal Infection: A Case Report
Talib Norain,Mohammed Yusri,Abas Sharipah Intan S. SY.,Ramli Kama Azira Awang 아시아심장혈관영상의학회 2019 Cardiovascular Imaging Asia Vol.3 No.4
We present a 38-year-old man with hepatitis C and history of intravenous drug use who presented with fever and hemoptysis. Initial chest CT showed bronchiectasis with an intracavitary lesion consistent with invasive lung aspergillosis in the background of a previously treated tuberculosis infection. Subsequently, he developed cardiac failure symptoms, and transthoracic echocardiogram revealed a left ventricle (LV) apical lesion mimicking a thrombus or vegetation. However, cardiac MRI suggested a fungating apical lesion in the LV, which showed gradual enhancement at the peripheral lesion while sparing the central core in the first-pass perfusion sequence. The long inversion time (600 milliseconds) of the late gadolinium sequence confirmed presence of persistent peripheral enhancement suggestive of an infective focus rather than a thrombus. The intracardiac lesion was compatible with a left ventricular fungal lesion or aspergilloma consistent with a positive serum galactomannan assay. The patient refused surgical intervention. Despite a long course of antifungal therapy, he succumbed to death three weeks after completion of treatment due to disease complications.
Norain Talib,Kama Azira Awang Ramli,Yusri Mohammed 아시아심장혈관영상의학회 2021 Cardiovascular Imaging Asia Vol.5 No.3
A 27-year-old pregnant female presented to our clinic for a cardiac murmur that was detected during an antenatal check-up. She had no cyanosis, and she was asymptomatic for heart failure. The echocardiogram revealed an enlarged right coronary sinus with right coronary artery (RCA) dilatation. The electrocardiographic-gated coronary computed tomography angiogram showed aneurysmal RCA dilatation with fistula to the inferobasal region of the right ventricle. A few small thrombi were visualized in the right ventricle and within the fistula. She delivered a healthy baby via caesarean section at 31 weeks of gestation, and fistula correction was planned within one year.
Intravenous Leiomyomatosis Extending from the Uterus to the Heart
Mohd Yusof Mubarak,Awang Ramli Kama Azira,Yahaya Zainab,Ghapar Abd Kahar,Mohamed Dani Noordini,Ismail Hamidah,Muhammad Nor Mohamad Arif,Leman Hamdan,Mohammed Yusri 아시아심장혈관영상의학회 2019 Cardiovascular Imaging Asia Vol.3 No.2
We report a case of intravenous leiomyomatosis with right atrium extension through the left gonadal vein, left renal vein and inferior vena cava. The tumor moved in and out of the right ventricle via the tricuspid valve, which could lead to valve obstruction and sudden death. We illustrate the importance of multimodality cardiac imaging to diagnose this condition by performing echocardiography, cardiac magnetic resonance imaging and computed tomography.
Sharipah Intan Shafina Syed Abas,Kama Azira Awang Ramli,Koh Ghee Tiong,Yusri Mohammed 아시아심장혈관영상의학회 2020 Cardiovascular Imaging Asia Vol.4 No.1
We report the case of a 12-year-old girl who presented with heart failure symptoms that were treated as dilated cardiomyopathy. The echocardiogram showed a dilated left ventricle, poor ejection fraction, and long segment narrowing of the descending thoracic aorta. A cardiac CT further supported this finding; hence, the diagnosis of Takayasu’s arteritis was proposed. The cardiac MRI revealed a non-ischemic pattern in delayed gadolinium enhancement at the lateral left ventricular wall. She was given steroidal therapy due to vasculitis but was later referred for stenting of the stenosed descending thoracic aorta.