Methodist Journal

FEATURED GUEST EDITOR

ISSUE INTRO

The Burgeoning Field of Cardio-Oncology

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RECOGNITIONS

Barry H. Trachtenberg Leads Issue on Cardio-Oncology

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REVIEW ARTICLES See More

Heart Failure in Relation to Anthracyclines and Other Chemotherapies

Heart Failure in Relation to Tumor-Targeted Therapies and Immunotherapies

The Role of Cardiovascular Imaging and Serum Biomarkers in Identifying Cardiotoxicity Related to Cancer Therapeutics

Prevention and Treatment of Chemotherapy-Induced Cardiotoxicity

Cardiovascular Toxicities of Radiation Therapy

Electrophysiologic Complications in Cancer Patients

Vascular Toxicity in Patients with Cancer: Is There a Recipe to Clarify Treatment?

Future Directions in Cardio-Oncology

CASE REPORTS See More

A Rare Case of Pancreatitis-Induced Thrombosis of the Aorta and Superior Mesenteric Artery

Anomalous Origin of the Right Coronary Artery from the Left Main Coronary Artery in the Setting of Critical Bicuspid Aortic Valve Stenosis

Simultaneous Transfemoral Mitral and Tricuspid Valve in Ring Implantation: First Case Report with Edwards Sapien 3 Valve

Uneventful Follow-Up 2 Years after Endovascular Treatment of a High Flow Iatrogenic Aortocaval Fistula Causing Pulmonary Hypertension and Right Heart Failure

MUSEUM OF HMH MULTIMODALITY IMAGING CENTER See More

Do Not Pass Flow: Microvascular Obstruction on Cardiac Magnetic Resonance After Reinfarction Following Primary Percutaneous Coronary Intervention

CLINICAL PERSPECTIVES See More

EXCERPTA

Cardio-Oncology, Then and Now: An Interview with Barry Trachtenberg

POINTS TO REMEMBER

Onconephrology: An Evolving Field

POINTS TO REMEMBER

Herbal Nephropathy

EXCERPTA

Rolling the Dice on Red Yeast Rice

EDITORIALS

Letter to the Editor in Response to “Cardiac Autonomic Neuropathy in Diabetes Mellitus”

Vol 11, Issue 4 (2015)

Article Full Text

MUSEUM OF HMH MULTIMODALITY IMAGING CENTER

Complications of Cardiac Contusion Diagnosed Using Multimodality Imaging

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Article Citation:

Lakshmi Chebrolu, Joshua McKay, Jeffrey Parker, and Karla Kurrelmeyer. Complications of Cardiac Contusion Diagnosed Using Multimodality Imaging. Methodist DeBakey Cardiovascular Journal. October 2015, Vol. 11, No. 4, pp. 253-253.

doi: https://doi.org/10.14797/mdcj-11-4-253

Keywords
cardiac contusion , tricuspid leaflet , echocardiography , hematoma

A 32-year-old male with a history of end-stage renal disease on hemodialysis presented to Houston Methodist Hospital with chest pain and hypotension following a motor vehicle accident. Echocardiography revealed severe right ventricular (RV) enlargement with akinesis of the RV free wall and a pericardial mass (Image 1: arrow). He had severe restriction of the posterior tricuspid leaflet and no coaptation of the tricuspid leaflets, resulting in severe tricuspid regurgitation (Image 2: dashed arrow demonstrating V wave cut-off sign). Cardiac computed tomography angiography revealed a 2 cm × 7 cm intrapericardial loculated nonenhancing fluid collection (HU 15–25 likely exudative) located anteriorly and extending superiorly to the level of the aortic arch (Image 3: H).

The patient was taken to the operating room, and the fluid collection was evacuated and sent to pathology. A 37-mm St. Jude Attune™ adjustable tricuspid annular ring (St. Jude Medical, Sylmar, CA) was placed. Pathology was consistent with a subacute hematoma (Image 4: HE sections demonstrating cardiac myocytes with myxoid change, fibrosis, chronic inflammation, fibrin deposition, and hemosiderin laden-macrophages). Patient did well and was discharged home. Follow-up imaging revealed persistent significant tricuspid regurgitation, small residual pericardial hematoma (RH), and significant dilation of the right atrium (RA) and RV (Image 5, 6: arrow points out 37-mm St. Jude Attune adjustable tricuspid annular ring).

https://journal.houstonmethodist.org/na101/home/literatum/publisher/pinnacle/journals/content/mdcj/2015/19476094-11.4/mdcj-11-4-253/20151228/images/large/i1947-6094-11-4-253-f01.jpeg

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