The latest issue of CASE is now available with intriguing reports, including “Emotional Stress Triggered Severe Mitral Regurgitation: The Multifactorial Interplay of the Mitral Valve.” CASE Editor-in-Chief Vincent Sorrell, MD, FASE, remarked, “Aker et al. provide readers with an intriguing manuscript on the transient nature of MR. In their report, a 77-year-old woman (HFpEF from hypertensive heart disease) demonstrated severe MR with normal LV systolic function during a routine serial TTE. There was malcoaptation of normal-appearing MV leaflets in the setting of patient distress and complaints of feeling ‘emotional’ and ‘overwhelmed.’ Through counseling, the patient became calmer and within 10 minutes, a repeat TTE demonstrated dramatic changes: mild MR, smaller LA, lower RVSP, and improved semi-quantitative findings of MR. These changes occurred without detectable changes in LV global or LV regional function and without significant changes in BP or HR. This report should serve as an important reminder on the transient nature of MR and the need to document the clinical setting (including BP) on all reports. To quote these authors’ conclusions: ‘Physicians should be encouraged to consider psychological factors and routine preassessment of BP before and during echocardiography when evaluating patients for [MR] given the highly dynamic characteristics of the MV.’”
The remainder of this issue tackles a variety of topics in the Multimodality Imaging, Coronary Artery Disease, Infections in the Heart, and Valvular Heart Disease categories. Cianci et al. report on a potential association of cardiac sarcoidosis with ulcerative colitis, presenting a variety of CV images and a summary of existing literature. Torres-Valencia et al. describe a missed myocardial infarction due to coexisting symptoms of COVID-19. With the use of TTE, TEE, and CCT imaging, Sahebjam et al. find a vegetation within a coronary artery fistula, a rare location for endocarditis. Rounding out this issue is Valvular Heart Disease with a report from Corsi et al. demonstrating the vast variation in clinical presentations of patients with QAV.
Be sure to check out the latest Unlock the CASE on the CASE homepage, which was the winning entry from the Cardio-oncology SIG Case Competition.
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