Number 17-12: A "Swinging Heart"
A 71-year-old male with a previous history of working-exposure to glass components was admitted to our hospital with persistent complaints of chest tightness, shortness of breath and edema in the lower limbs that started 3 months prior to his admission. An echocardiogram from a local hospital identified a nodule on the right-sided of the pericardium and large pericardial and pleural effusions. Percutaneous drainage was performed and 30 mL were obtained from the pericardium and 500 mL from the pleurae, both of hemorrhagic appearance. Biochemical analysis of pericardial and pleural fluids was not performed and cytological analysis was negative for malignant cells. Medical treatment was initiated and the patient remained asymptomatic for the following 3 days. The patient's symptoms recurred and rapidly worsened so he was admitted to our institution for further examination and treatment.
Number 17-11: The Ventral Cardiac 'Flop' - A CMR Sign in Congenital Absence of the Pericardium
A 64-year old Caucasian lady was seen at the rapid access chest pain clinic with a 6-month history of atypical chest pain. Her risk factors for cardiovascular disease were smoking, hypertension and familial risk. She was referred for coronary angiography that revealed moderate right coronary artery/posterior descending artery stenosis while left ventriculography
suggested an unusual cardiac orientation with a laterally displaced and vertically oriented heart. She was referred to us for stress perfusion cardiovascular magnetic resonance (CMR) imaging.