A: H&E, 40x, Well circumscribed tumor with compressed peripheral adrenal parenchyma (black arrow). 2b: H&E, 100x, Nests of tumor cells with circumscribed margin and adjacent normal adrenal parenchyma (black arrow). 2c: H&E 100x Nests and trabecular pattern of tumor cells, separated by thin fibrovascular septae. 2d: H&E, 400x, Tumor cells having moderate amount of granular eosinophilic cytoplasm, centrally placed round nucleus with fine granular chromatin and inconspicuous nucleoli. Scattered sustentacular cells (black arrow) are also noted.


(A) Magnetic resonance imaging shows 1.6 cm-sized mass in anterior wall of the cervix (white arrow indicates the cervical mass).


(B) Gross finding shows the tumor confirmed as poorly differentiated squamous cell carcinoma with clear resection margin (measuring 3.3 x 3.0 x 0.5 cm) (white arrow indicates the cervical mass).


The needle attached to semen containing syringe was put into the posterior cul-de-sac along the biopsy guide.


A; Right anterior oblique (RAO) lateral view. Manipulation of Gaia second guidewire with Crusade catheter during dilation for the right ventricular (RV) branch true lumen by 1.5 mm balloon.


B; While the tip of Gaia second guidewire was facing on the balloon through the strut, immediately balloon deflation was applied. The Gaia second guidewire could pass to the RV branch true lumen in the same space of the first protection guidewire.


C; Kissing balloon inflation at the right coronary artery main vessel and RV branch with 4.0 mm and 2.0 mm balloon, respectively.


D; Final angiogram. The RV branch was restored; the main coronary vessel also showed optimal result.


Transthoracic echocardiography on admission and four days later after percutaneous coronary intervention (PCI). Echocardiography on admission showing global hypokinesia, mild mitral regurgitation (MR) and left atrium (LA) enlargement (LA volume, 54 mL) (A, B).


Transthoracic echocardiography on admission and four days later after percutaneous coronary intervention (PCI). Four days later after PCI, left ventricular contraction and LA enlargement have improved (LA volume, 34 mL), and MR has resolved (C, D).


Coronary artery angiography during the primary percutaneous coronary intervention. (A) Left coronary angiography showing significant stenosis from the distal left main coronary artery to the mid left anterior descending artery with thrombolysis in myocardial infarction (TIMI) 2 flow and total occlusion at the ostium of the left circumflex artery with TIMI 0 flow.


Coronary artery angiography during the primary percutaneous coronary intervention. (B) Final coronary angiography showing successful revascularization without periprocedural complications.


Computed tomography scan revealing consolidation and ground-glass opacity in the dependent portion of the right lung, with pleural effusion limited to the right lung.


(A-C) depict the axial, coronal, and sagittal panel of the preoperative CTA, respectively. The white arrows indicated the fistula and RCAA.


(D-F) depict the axial, coronal, and sagittal panel of the 6-months follow-up CTA, respectively. The white arrows indicate the mild dilated RCA.


(G,H) show the preoperative and postoperative echocardiography images of the patient. A large fistula and RCCA to RV shunt was indicated by the arrow. RCA, right coronary artery; RCAA, right coronary artery aneurysm; LV, left ventricle; RV, right ventricle.


(A,B) depicted the reconstructed image of the heart and dilated right coronary artery.


(C-F) depicted the surgical repair process. RCA, right coronary artery; RCAA, right coronary artery aneurysm; AO, aorta.


The 5-chamber view of the heart at 25.3 weeks showing the fistula between the left coronary artery and coronary sinus (arrow, A).


Power Doppler imaging confirming the communication between the left coronary artery and coronary sinus (B).


The 4-chamber view of the heart at 29.6 weeks showing the dilated coronary sinus (arrow) with the collapsed left atrium (C). . Ao, aorta; CS, coronary sinus; LA, left atrium; LV, left ventricle; RA, right atrium; RV, right ventricle.


Postnatal computed tomography showing the dilated left circumflex artery draining into the enlarged coronary sinus on the axial image (arrow.


The 3-dimensional volume rendering image (arrow,. . Ao, aorta; CS, coronary sinus; LAA, left atrial appendage; LCX, left circumflex coronary artery; LMA, left main coronary artery; PA, pulmonary artery.


Clinical fundus photo of a 44-year-old male presenting with diminution of vision following dengue fever. (A) Right eye. (A) Right eye showing additional retinal whitening exclusively inferior to the right macula.


Clinical fundus photo of a 44-year-old male presenting with diminution of vision following dengue fever. (B) Left eye. Both eyes depicting perivascular exudates, intraretinal hemorrhages, cotton wool spots and macular edema.


Fundus fluorescein angiography of a 44-year-old male presenting with diminution of vision following dengue fever. (A) Right eye.


Fundus fluorescein angiography of a 44-year-old male presenting with diminution of vision following dengue fever. (B) Left eye. Both eye showing disc and perivascular leakage limited to posterior pole indicative of vasculitis. In addition, there is capillary nonperfusion due to occlusion of multiple small arterioles supplying the macula of right eye confirming macular ischemia.


Electrocardiogram of the patient before admission.


At discharge.


Real-time monitoring of the patient's vital signs during hospitalization.


Level of cholinesterase.


Cardiac troponin I. Before admission and at discharge.


(A) Pedigree analysis of the family of patient 1. The arrow points out the proband. Circles correspond to female. Squares correspond to male. The mutation was indicated -/- if negative and ?/? if untested.


(B) Genetic testing of patient 1 showed a guanine deletion at position 973 (c.973delG) in exon 8 of the LAMP2 gene.


The echocardiogram of patient 1: substantial left ventricular hypertrophy with a maximal thickness in the posterior wall of the left ventricle of 10 mm and a ventricular septal thickness of 15 mm, and obstruction in the left ventricular outflow tract.


Right coronary artery-right ventricle (RV) fistula. A
Arrow showed the dilated right coronary artery. B
Arrow showed the aneurismal dilatation of right coronary artery. C
Arrow showed fistula ostium. D; The spectrum of fistula was continuous. Ao aorta, LA left atrium, LV left ventricle, RA right atrium, RV right ventricle.


Left anterior descending-pulmonary artery fistula. A
Arrow showed the abnormal blood flow in the pulmonary artery. B
Arrow showed the origin of the fistula is left anterior descending. C; The spectrum of fistula showed only in diastole.


Left circumflex (LCX)-coronary sinus (CS) fistula. A LCX was dilated and connected with CS. B; CS was connected with right atrium (RA). CS coronary sinus, LCX left circumflex, LV left ventricle, RA right atrium, RV right ventricle.


EKG with ST elevations in anterior leads.


Echocardiogram with severe hypokinesis of anterior, anteroseptal walls, and apex.


Chest X-ray showing dilated cardiomyopathy.


Tilt test registration. The figure shows the recording of systolic blood pressure, diastolic blood pressure, and heart rate in clinostatic and sitting position (passive orthostatic position not performable because of severe presyncopal symptoms) during a tilt test. In sitting position, an immediate reduction in systolic blood pressure to 55 mmHg and diastolic blood pressure to 28 mmHg is evident, without any change in the heart rate, which remains stable at 76 beats/min.


Electrocardiogram ,cardiac ultrasound.


The figure shows the 12-lead electrocardiogram pointing out the first-degree atrioventricular blockage (panel A). In panel B, cardiac ultrasound (parasternal long-axis view) depicts left ventricle wall thickness, diffuse myocardial hyperechogenicity, and mild pericardial effusion.


Four-chamber view in a transthoracic echocardiogram showing enlargement of
the left ventricle (LV) (The LV apical structure was unclear in this view).


Cine cardiac magnetic resonance imaging (MRI) image in a four-chamber view
shows bulging of the interventricular septum (IVS) toward the right ventricle (white
arrow) and invagination of fatty material (black arrow).


A T1-weighted image shows bright tissue replaced in the left ventricle (LV)
apical position (white arrow), which could suggest the presence of fat replacement.


A late gadolinium enhancement (LGE) image performed 10 minutes after the
contrast media injection showed no intramyocardial hyperenhancement area but indicated
the presence of myocardial tissue in the out pouching; this confirmed the congenital
nature of the diverticulum.


Medical image.


Admission head computed tomography demonstrates a metallic foreign body projecting in the region of the right transverse sinus (arrow). The bullet previously seen in the right transverse sinus is no longer evident on the follow-up head computed tomography angiography.


Chest radiograph obtained at admission (a) demonstrates no cardiopulmonary abnormality.


A follow-up chest radiograph (b) shows a 5 mm round metallic foreign body projecting over the left hilum (open arrow) with interval development of a wedge shaped pulmonary opacity a the left lung base (arrow head).


Case 1: left CAG showed a huge aneurysm with calcification of the proximal left coronary artery, and the LAD is obstructed at the outflow of the aneurysm (red arrowhead), and the blood is supplied by the collateral circulation tract from the right coronary artery. LAD, left anterior descending artery; LCX, left circumflex artery.


Case 1: macrofindings of the LAD aneurysm during surgery. A giant coronary aneurysm prior to resection is observed. A hard and calcified mass >40 mm in diameter is present. The mass was filled with a red blood clot. LAD, left anterior descending artery.


Case 2: right CAG at 1 year after CABG. The blood flow supply from the GEA to the distal site of RCA was adequate. CAG, coronary artery angiogram; CABG, coronary artery bypass graft surgery; GEA, gastroepiploic artery; RCA, right coronary artery.


Coronary angiogram in the right anterior oblique cranial view (A), showing the left circumflex artery (LCx) (arrow) and the left anterior descending artery (LAD) originating from the left main coronary artery.


When the right coronary ostium was cannulated (B), another circumflex artery (RCx) (arrow) was noticed in addition to a right coronary artery (RCA) in the left anterior oblique cranial view.


Preoperative left internal carotid angiograms showing anomalous arteries arising from the internal carotid arteries, which and run anteromedially along the frontal base and making a hairpin-pin bend, and a saccular aneurysm is seen on the hairpin-pin bend, lateral view.


Oblique view.


Preoperative angiograms revealing an aneurysm with oblique view. Postoperative angiograms showing no filling of the aneurysm.


(A) Plasma glucose trend in case 1.


(B) Plasma glucose trend in case 2.


Duplex ultrasound demonstrating retrograde flow through the right external carotid artery that supplies antegrade flow to the right internal carotid artery.


Intraoperative photo of the opened common carotid artery revealing a hard calcific plaque with soft thrombus.


Excised ruptured hydatid cyst wall.


(A) MDCT image of the LAD in an enhancement scan.


(B) MDCT image of the LAD in a plain scan. LAD, left anterior descending coronary artery; MDCT, multidetector computed tomography.


Visualization of the coronary angiography. (A) Intraoperative open-heart coronary angiography shows no significant stenosis in the left coronary artery.


Visualization of the coronary angiography. (B) Intraoperative open-heart coronary angiography shows no significant stenosis in the right coronary artery. LAD, left anterior descending coronary artery; LCX, left circumflex coronary artery.


Treatment course of maggot therapy. (a) Before maggot therapy. Necrotic tissue is seen on the surface of the wound.


Treatment course of maggot therapy. (b) After one session (48 h) of treatment, the reduction of necrotic tissues is seen.


Treatment course of maggot therapy. (c) Maggots growing from second to third instar larvae.


Treatment course of maggot therapy. (d) After six sessions of treatment, debridement was conducted to the deep portion from the ulcerated base, and favourable granulation can be seen on the amputated surface.


Intra-/post-operative view. (a) Intra-operative. Additional debridement is done.


Intra-/post-operative view. (b) Three post-operative weeks. Approximately 70% of the skin graft was taken. After conducting partial simple reefing, split thickness skin graft of 20/1000 inches was used.


Short LAD arises from the left sinus of Valsalva and gives rise to one septal branch, little intermedius branch, and one diagonal branch.


Circumflex artery (LCX) is aplastic, as shown in the left caudal angiographic projection.


Right coronary artery (RCA) is normal in its origin and course.


Long LAD arises from the right sinus of Valsalva with a separate ostium, different from RCA. This LAD is longer than the first, runs on the right ventricle, and gives rise to septal and diagonal branches, supplying the mid and distal territories of septal, anterior, lateral wall, and apex.


Overlapping Figures 1 and 5, we can see the entire course of LAD along interventricular sulcus to the apex.


A 55-year-old male with confirmed IgG4 vasculopathy. Axial maximum intensity projection (MIP) image of CT coronary angiography shows partially thrombosed aneurysm of the left anterior descending artery (arrows).


A 55-year-old male with confirmed IgG4 vasculopathy. Volume rendered image shows the aneurysm of the left anterior descending artery (in pink).


A 55-year-old male with confirmed IgG4 vasculopathy. The right anterior oblique caudal view of conventional angiography shows aneurysmal dilatation of the left anterior descending artery with contrast blush (*).


A 55-year-old male with confirmed IgG4 vasculopathy. Coronal maximum intensity projection images of CT abdominal angiography in arterial.


A 55-year-old male with confirmed IgG4 vasculopathy. Venous. Phases show partially thrombosed aneurysm in the proximal part of 8th right intercostal artery (*). Enhancing nodular paravertebral soft-tissue thickening is noted adjacent to the proximal right intercostal arteries above and below this level.


A 55-year-old male with confirmed IgG4 vasculopathy. Axial image of CT abdominal angiography in the arterial phase shows a partially thrombosed aneurysm in relation to the common hepatic artery. Artifacts are seen in relation to the aneurysm (post-injection in the gastroduodenal artery). The aortic stent graft is also seen in situ.


A 55-year-old male with confirmed IgG4 vasculopathy. Coronal maximum intensity projection image of CT abdominal angiography shows multiple visceral artery aneurysms - in relation to the common hepatic artery (black arrow), inferior pancreaticoduodenal artery (white curved arrow), and the jejunal branch of superior mesenteric artery (white arrow). Artifacts are noted in relation to the gastroduodenal artery, aorta, and the superior mesenteric artery - representing stent grafts and post-procedural changes. Cholecystectomy clips are also seen.


Clinical course and IgG index. MMT, manual muscle testing; CSF, cerebrospinal fluid; IVMP, intravenous methylprednisolone pulse therapy; M, magnetic resonance imaging; N, Nerve conduction study.


Initial electrocardiography revealing ST segment elevation in leads V1-V3.


Transesophageal echocardiography image revealing spongy appearance of the right ventricle with trabeculations forming deep fissures and grooves, located in the right ventricle apical wall.


Transesophageal echocardiography contrast echo demonstrating flow from right ventricular cavity into the trabecular recesses.


Fluorescein angiography showed profound macular and peripheral ischemia in the early phase.


In the middle phase.


In the late phase. Composite view).


Follow-up fluorescein angiography showed profound macular and peripheral ischemia in the early phase.


Four-chamber transthoracic echocardiography.


Cardiac magnetic resonance (CMR) images. Reveal concentric hypertrophy with moderately impaired left ventricular function and multiple cystic structures in the septal, mediolateral and anterior parts of the left ventricle.


Medical image.


Late gadolinium enhancement (LGE) demonstrated high signal intensity of the cystic lesions indicating fibrotic tissue , Short axes of the corresponding sequences: transthoracic echocardiography.


Late gadolinium enhancement (LGE) demonstrated high signal intensity of the cystic lesions indicating fibrotic tissue , Cine-CMR.


Late gadolinium enhancement (LGE) demonstrated high signal intensity of the cystic lesions indicating fibrotic tissue. And LGE.


Cardiovascular magnetic resonance mapping of T1 ,. T1 Mapping (1425 +- 144).


T2 . T2 Mapping (60.5 +- 8.2).


Extracellular volume. At 32 months post-transplant FU revealed increased values. Extracellular volume (32.7 +- 9.6).


Timeline of postoperative course after heart transplantation. ATG, Antithymocyte globulin; CMR, Cardiac magnetic resonance tomography; HLA-AB, Human leukocyte antigen antibodies; ICU, Intensive care unit; IgG, Immunoglobulin G; IMC, Intermediate care unit; LV, Left Ventricle; LVEF, Left ventricular ejection fraction; LVAD, Left ventricular assist device; MELAS, Mitochondrial encephalomyopathy, lactic acidosis and stroke-like episodes; MMF, Mycophenolate Mofetil; nsVT, Non sustained ventricular tachycardia: pAMR, Pathologic Antibody mediated rejection; RV, Right ventricle; RVEF, Right ventricular ejection fraction; TDI-Sm, Tissue Doppler Imaging Systolic peak velocities (radial/longitudinal); TTE, Transthoracic echocardiography.


Electrocardiogram and Chest X-ray. (A) ECG showed sinus rhythm, 60 bpm, normal axis, fragmented QRS in the inferior leads (III, aVF) and flat T waves in III, aVF and V6. When compared to previous ECGs, no new abnormalities were observed.


Electrocardiogram and Chest X-ray. (B) Chest X-ray with a single lead ICD, normal heart size and no signs of pulmonary congestion.


Echocardiography. Parasternal long axis view showed mild left ventricular enlargement, both left ventricular end-diastolic.


Echocardiography. End-systolic. Diameters. Right ventricle, ascending aorta and left atrium were of normal size. Interventricular septum and posterior left ventricular wall had normal thickness. No pericardial effusion was observed.


Dynamic of high sensitivity cardiac troponin I levels. Hs-cTnI levels peaked at admission. Three days later, with ongoing recurrent episodes of chest pain, a further increase in hs-cTnI value was observed. After starting aspirin and colchicine, chest pain resolved and hs-cTnI levels progressively decreased. At discharge, hs-cTnI value was almost normal (normal range 0-58.05 ng/l).


Electrocardiogram at admission. Atrial fibrillation, mild ST segment depression in leads V 3-6. T wave inversion.


Diagnosis and treatment of the patient.


Electrocardiogram after resuscitation. Still atrial fibrillation, ST segment depression was significantly deepened and ST segment elevation in aVR lead.


Coronary angiography. Sub occlusive thrombus in the proximal, medial and distal part of the right coronary artery (TIMI 2).


Coronary angiography. Normal flow through the right coronary artery.


RAO caudal view shows a mild lesion in the middle of the LCX artery.


LAO view demonstrates no RCA in the right sinus of Valsalva.


(C) Reconstructed three-dimensional image obtained by the volume-rendering technique shows the anomalous RCA with an interarterial course.


(D) Similarly, the anomalous RCA between the aorta and pulmonary trunk can be seen. . Abbreviations: LAO, left anterior oblique; LCX, left circumflex coronary artery; RAO, right anterior oblique; RCA, right coronary artery.


(A) Reconstructed three-dimensional image obtained using the volume-rendering technique shows the anomalous RCA with an interarterial course.


(B) The origin of the anomalous RCA is evident. . Abbreviation: RCA, right coronary artery.


(A) LAO cranial view shows an anomalous RCA arising from the left sinus of Valsalva.


(B) LAO cranial view shows a high-grade 90% stenosis in the proximal RCA.


(C) LAO cranial view shows a final good angiographic result after PCI procedure.


(D) Reconstructed three-dimensional image obtained by the volume-rendering technique shows the anomalous RCA with an interarterial course.


(E) The anomalous RCA originates from the left sinus of Valsalva. . Abbreviations: LAO, left anterior oblique; PCI, percutaneous coronary intervention; RCA, right coronary artery.


Coronary angiography: Total occlusion of right coronary artery (RCA) and left circumflex artery. Left anterior descending artery originating from RCA.


Computed tomography coronary angiography: Common ostium for right coronary artery (RCA) and left anterior descending artery; absent left main artery. Left circumflex artery short in length and significantly narrow in caliber; completely blocked RCA in proximal segment due to dense calcification.


Angiographic image of this patient. (A) (AP + CRA30 ) the left anterior descending branch.


Angiographic image of this patient. (B) (RAO30. + CAU20 ) the circumflex branch.


Angiographic image of this patient. (C) (AP + CRA20 ) the right coronary artery.


CT angiography volume rendered reformation image. The right coronary artery (RCA) is enormously dilated and tortuous with a large number of collateral vessels. Normal course of a very large right coronary artery is seen.


CT angiography multiplanar reformatted image. The dilated right coronary artery is emerging from the right aortic sinus.


CT angiography volume rendered image. Right coronary artery is dilated and tortious with a large number of collaterals feeding the left coronary system. Left coronary artery is emerging from pulmonary artery trunk. The left anterior descending artery and their diagonal branches are also dilated and tortuous.


Magnetic resonance imaging of the chest. . Notes: Increased signal is seen on T2-weighted images in subcutaneous fat in the anterior abdominal wall at the midline. Increased signal is also noted in anterior mediastinum fat posterior to the sternum. There is periosteum enhancement of the sternum manubrium and at the upper part of the body of the sternum after contrast administration. There is also increased signal in the bone marrow noted on T2-weighted images in the sternum manubrium and in the upper part of the body of the sternum, suggesting bone marrow edema. No evidence of fracture is noted. Findings are consistent with osteomyelitis involving the manubrium and the upper part of the sternum body. Arrows indicate the area of osteomyelitis.


Twelve-lead electrocardiogram showing complete left bundle branch block.


Four-chamber echocardiogram showing a dilated left ventricle.


The constantly deficient secretion of cortisol.


Contrast-enhanced computed tomography revealing atrophic bilateral adrenal glands (red arrows).


MRI showing the posterobasal left ventricular aneurysm (arrows).


A picture of PET scan showing viability of myocardium.


Aneurysm showing thrombus (arrows).


Mitral valve excised and replaced with #29 C. E. Bioprosthesis via left ventricle (arrows).


Completed linear closure of ventriculotomy buttressed with Teflon strips (arrows).


Non-contrast enhanced.


Contrast-enhanced. Black-blood thrombus images of the head in Case 1. The red arrow indicates the focal stenosis of the internal jugular vein and cerebral vein sinus.


(A-D) Magnetic resonance arthrography images of the head in Case 2. The red arrow indicates partial filling defects.


Magnetic resonance venography images of the head.


Neck. In Case 2.


Flow diagram of the study selection process on cyclosporine-A (CsA)-induced thrombosis.


The 3-dimensional (3D) volume rendered image demonstrates both of the left anterior descending arteries (LAD), one originating from the left main coronary artery and the second anomalous one from the right side and spreading to the anterior wall of the left ventricle toward the left ventricular apex.


The segmented 3D image demonstrates both the left anterior descending arteries (LAD), their origin and course.


Coronary angiogram images of the second primary angioplasty:
A and
B show the intrastent thrombus with mycotic aneurysm of the right coronary artery. C and
D show the right coronary artery angioplasty with an overlapping bare metal stent.


Parasternal short-axis view showing the classical windsock appearance of the ruptured sinus of Valsalva arising from the noncoronary sinus.


Communicating with the right atrium.


Electrocardiography on presentation shows a sinus rhythm of 65 beats/minute and ST elevation in V3, II and III.


The CAG. Shows the compression of the LAD coronary artery during the systole resulting in narrowing.


Performed after the second chest pain attack demonstrating a dissection in the distal left anterior descending coronary artery.


Parasternal short axis view at the level of the papillary muscles during the acute phase, demonstrating a small posterior pericardial effusion. The left ventricular contractile function is normal.


Parasternal short axis view at follow-up, demonstrating normal left ventricular contractility and resolution of pericardial effusion.


Parasternal short axis view at the aortic annulus demonstrating giant aneurysms in the right coronary artery, left anterior descending artery, and another giant aneurysm posteriorly in the left circumflex artery region.


Apical four chamber view with anterior angulation demonstrating all three giant aneurysms. The right coronary aneurysm lies at the atrioventricular groove (AV) and the left sided aneurysms are noted along the interventricular septum and the left AV groove.


Still frame image showing the diameter of the right coronary artery aneurysm.


Still frame image showing size of the coronary artery aneurysms of the left anterior descending artery and circumflex artery.


Aneurysm in the region of the circumflex branch of left coronary artery with an area of increased echogenecity along the aneurysmal wall, suspicious of a thrombus.


Selective left coronary artery angiogram in slight left anterior oblique view with caudal angulation. The left main coronary artery appears normal and trifurcates into the left anterior descending (LAD), ramus and circumflex branches. The giant aneurysm in the LAD appears globular in this view and is densely opacified. The ramus aneurysm is long and saccular, located inferior to LAD. There is ectasia of the circumflex branch.


AP view of the same demonstrating overlapping of ramus and LAD aneurysms.


Straight lateral view of a selective right coronary artery angiogram demonstrating a giant aneurysm just distal to the coronary ostium. Multiple small aneurysms are noted throughout the course of the right coronary artery and posterior descending.


showed QS patter with T-wave inversion in III and a VF.


CT angiogram showing bilateral pulmonary emboli.


CT scan Head without Contrast.


MRI Brain without contrast.


MRA Brain.


Troponin trend.


Echocardiographic features of myocardial crypts. Transthoracic
echocardiogram two-chamber view showing diastolic features of a myocardial crypt:
penetration perpendicular to myocardial wall, and ,contention by thin sub epicardial layer
(white arrow).


Echocardiographic features of myocardial crypts. Systolic sub-total obliteration on transthoracic
echocardiogram two-chamber view.


Echocardiographic features of myocardial crypts. Modified two-chamber view
demonstrates the presence of second, more apical crypt parallel of the previous one
(white arrow).


Optimal delineation of the two crypts in cardiac magnetic
resonance two-chamber view sequence (black arrows).


Obvious
hyperenhancement in the inferior wall (white arrows) with adjacent myocardial crypt
(open arrow) on the cardiac magnetic resonance-late gadolinium enhancement short-axis
sequence.


ECG upon arrival (March 2018).


ECG upon review 4 months later (July 2018).


Serial electrocardiograms, lead II strips. (a): normal, 5 months prior to admission.


Serial electrocardiograms, lead II strips. (b): Complete third-degree atrioventricular (AV) block, at primary office 12 h before admission.


Serial electrocardiograms, lead II strips. (c): Type I second-degree AV block, 2 h after admission and antibiotic therapy.


Serial electrocardiograms, lead II strips. (d): first-degree AV block, 12 h after admission and antibiotic therapy.


Serial electrocardiograms, lead II strips. (e): normal, at discharge.


The electrocardiogram recorded in emergency room (ER).


The electrocardiogram prior to antiarrhythmic treatment. The electrocardiogram shows a short PR interval, a delta wave, wide QRS complex, and ST depression.


Electrocardiograms with the sacral neuromodulation device in both on and off modes. (A) An electrocardiogram performed with the sacral neuromodulation implant in "off" mode shows no changes and a sinus rhythm in a patient on antiarrhythmic medication.


Electrocardiograms with the sacral neuromodulation device in both on and off modes. (B) An electrocardiogram performed with the sacral neuromodulation implant in "on" mode shows no changes and a sinus rhythm in a patient on antiarrhythmic medication.


ECG on admission demonstrating anterior ST-segment elevation.


Diagnostic coronary angiography of left coronary artery system . Views:. PA cranial.


Diagnostic coronary angiography of left coronary artery system . PA caudal.


Diagnostic coronary angiography of left coronary artery system . LAO Caudal.


RCA. LAO.


RCA. RAO.


Views of the RCA before.


After. Drug eluting balloon treatment. Markers indicate the RV branch which was occluded and subsequently recanalized following intervention.


Schematic drawing of the anomalous arteries and steno-occlusive changes found in this patient, showing the blood flow in the right internal carotid artery angiography.


The left vertebral artery angiography. As seen on Figures 2 and 3.


Echocardiogram in apical four chamber view. Left: Severe RV and RA dilatation. Right: Mild RV and RA dilatation in recovery.


Straight left upper border of heart.


Left ventricular (LV) apical aneurysm.


Echocardiography showing coronary sinus type of interatrial communication measuring 10 mm x 16 mm with left to right shunting.


Intraoperative finding of a pure coronary sinus type of interatrial communication measuring 1.5 cm in size and a normal coronary sinus ostium.


Resting ECG reveals delayed R wave progression.


Exercise ECG reveals significant ST elevation in lead V3.


Stanford type A DeBakey type II aortic dissection showing enlarged ascending aorta with an approximate diameter of 4.5 cm and dark reddish in color along its length. Extent of the aortic dissection reaches nearly 7 cm high.


(A) Section of the dissected ascending aorta showing the intramural hematoma that was found behind the brachiocephalic trunk.


(B) Section of the dissected ascending aorta revealing calcified left coronary cusp of the aortic valve and dissection entry, measuring around 5 mm, which was situated at the intima of the anterior wall of the ascending aorta, near the sinotubular junction.


(A) Supracoronary aortic tube graft 28 mm, 7 cm in length, placed directly at the sinotubular junction.


(B) Saphenous vein graft taken from the left lower extremity placed between the grafted ascending aorta and the LCX.


Admission electrocardiogram showing sinus rhythm and complete right bundle branch block.


Admission chest X-ray showing evidence of previous sternotomy (repaired tetralogy of Fallot), cardiomegaly and implanted cardioverter defibrillator in left pectoral region.


Right anterior oblique coronary angiography view of the patient. The arrows point to the stenotic sites, including the distal stenosis of the left main coronary artery, severe ostial stenosis of the left anterior descending artery, ramus intermedius artery, and left circumflex artery.


Left anterior oblique coronary angiography view of the patient, showing multiple stenosis at mid and distal parts of the right coronary artery (arrows).


(a) Left ventriculography (right anterior oblique view) showing a left ventricular cleft (white arrow) at the basal inferior wall in diastole.


(b) Transthoracic echocardiogram (apical 2-chamber view). Left ventricular cleft (white arrow) in the basal inferior wall in diastole.


(c) Transthoracic echocardiogram (apical 2-chamber view). More prominent demonstration of left ventricular cleft (white arrow) with contrast echocardiography in diastole.


(d) Cardiac magnetic resonance imaging (left ventricular long-axis view). Myocardial cleft (white arrow) in the basal inferior segment.


Left ventricular cleft narrowed in systole in (a) left ventriculography (right anterior oblique view).


(b) Transthoracic echocardiogram (apical 2-chamber view) with contrast.


(c) Cardiac magnetic resonance imaging (left ventricular long-axis view).


Two-dimensional echo apical four-chamber view.


X-ray image postimplantable cardioverter defibrillator placement.


Prominent 'q' wave, ST segment elevation and 'T' wave inversion in lead II, III and aVF with ST segment depression seen in lead I and aVL. Right sided chest leads (V4R-V6R) showed <1 mm ST segment elevation.


Chest radiograph showing cardiomegaly and pulmonary congestion upon admission.


Chest radiograph showing resolution of cardiomegaly with marked improvement of pulmonary congestion by day nine of hospitalization.


Free thyroxine (FT4) serum concentrations during hospitalization before and after therapeutic plasma exchange (TPE).


An 12-lead electrocardiogram showing acute ST-segment changes in leads II, III, and VF (shaded in light blue).


Follow-up cardiac catheterization demonstrates complete resolution of the right coronary artery dissection (areas corresponding to acute abnormalities noted on the initial cardiac catheterization - see Figure 2 - are circled).


Electrocardiographic examination shows left ventricular hypertrophy and T wave inversion.


Echocardiographic examination shows that the left ventricle cavity is smaller than normal and there is a significant hypertrophy in the septum.


Telecardiography shows epicardial ICD implantation.


Multiple metastasis. Although the ovary carcinoma was resected, liver, and bone metastasis (arrow) was detected. Multiple lymph nodes are swelling (arrowhead), indicating metastasis.


Sagittal computed tomography image of the brain demonstrates a posterior fossa anomaly with vermian hypoplasia, expansile arachnoid cyst, and hydrocephalus.


(a) Maximum intensity projections of computed tomography (CT) angiography demonstrate stenosis of the basilar artery and aplasia of the right common carotid artery.


(b) Multiplanar reconstruction of CT angiography of the neck demonstrates aplasia of the right internal carotid artery.


(c) Skull base CT scanning demonstrates an absence of the right carotid canal.


(d) Abnormal origin and course of the left subclavian vessels are demonstrated. Bilateral common carotid arteries have arisen from the distal side of the left subclavian artery.


(a) Single-photon emission computed tomography demonstrates reduced cerebral blood flow in the border zones between the middle and posterior cerebral artery territories in the right hemisphere.


(b) After extracranial-intracranial bypass, cerebral blood flow of the right hemisphere improves to the normal level.


The dysmorphic facies with hypertelorism and low-set ears.


Cerebral angiography of the left internal carotid artery (ICA) demonstrating severe stenosis of the left ICA at the distal cavernous-infraclinoid portion. The ocular artery was not confirmed (a).


Cerebral angiography of the left internal carotid artery (ICA) demonstrating severe stenosis of the left ICA at the distal cavernous-infraclinoid portion. Cerebral angiography of the left common carotid artery before stent placement demonstrating the ocular artery (arrows) was depicted by a collateral blood flow from the external carotid system (b).


Cerebral angiography of the left internal carotid artery (ICA) demonstrating severe stenosis of the left ICA at the distal cavernous-infraclinoid portion. Cerebral angiography of the left ICA after stent placement demonstrating the ocular artery (arrowhead) was depicted by a directed blood flow from the ICA (c).


Preoperative.


Postoperative. Fluorescent fundus angiography demonstrating the visualization of the retinal artery which improved markedly after the treatment.


A; Preoperative transesophageal echocardiography. Severe calcification was observed in all leaflets and aortic annulus (arrowheads).


B; Preoperative transesophageal echocardiography. The left coronary ostium was intact; there was no significant stenosis (dotted circle).


Preoperative coronary angiography. Left coronary ostium did not show significant stenosis (dotted circle).


Anesthetic record. start/end of surgery. PAP pulmonary artery pressure, CVP central venous pressure, AP arterial pressure, (1) start of CPB, (2) AVR, (3) withdrawal of CPB, (4) signs of left heart failure and appearance of left ventricular wall motion abnormality, (5) second run of CPB, (6) second withdrawal of CPB.


Electrocardiogram on admission and after stent implantation. . Notes:. Showing ST segment slope-down depression, and ,T-wave inversion in leads II, III, aVF, and ,V4-V6. T-wave amplitudes in leads II, III, aVF were decreased, compared with (A). . Abbreviation: ECG, electrocardiogram.


Electrocardiogram on admission and after stent implantation. ECG after stent implantation.


Colon under colonoscopy. . Notes: (A, B) Colonoscopy showing tumor with dirty white-yellow furs in the transverse colon.


Colon under colonoscopy. (C, D) Repeat colonoscopy showing normal colon 10 months after the operation.


ECG during stent thrombosis. . Notes: (A) ECG before recurrent chest pain.


ECG during stent thrombosis. (B) Inverted T-waves in leads II, III, and aVF. Increased T-wave amplitudes in leads III, aVF, and V1-V6, compared with.


ECG during stent thrombosis. ECG after PTCA, decreased T-wave amplitudes in leads II, III, and aVF, compared with . Abbreviations: ECG, electrocardiogram; PTCA, percutaneous transluminal coronary angioplasty.


ECG during stent thrombosis.


ECG changes of acute inferior wall myocardial infarction post-operation. . Notes:. Obvious elevation of ST segment in leads II and III, aVF compared with . Abbreviation: ECG, electrocardiogram.


ECG changes of acute inferior wall myocardial infarction post-operation. ECG 1 day before surgery.


Left anterior oblique caudal view in the coronary angiogram, showing a giant left coronary aneurysm.


Left anterior oblique cranial view in the coronary angiogram, showing a giant left coronary aneurysm (arrow).


Three-dimensional volume-rendering computed tomography, showing a giant aneurysm of the left main coronary artery.


Another view of the giant aneurysm with three-dimensional volume-rendering computed tomography.


CT chest on admission showed SVC thrombus that extended to involve the brachiocephalic vein.


Self-captured photo for prior oral ulcer.


Photo of psudo-folliculitis lesion.


Multiple Sections through CMR revealing normal myocardium with no evidence of endomyocardial fibrosis or scarring.


Diffuse thyroid hypervascularity.


Multiple nodules shown by 'x'.


Upsloping ST depression at J point in the inferior lead (de Winter sign) (red arrow) with positive T wave (yellow arrow) along with minimal ST elevation in aVR (black arrow).


(a) 99% thrombotic occlusion seen in the mid right coronary artery.


(b) After placement of drug-eluting stent.


ST elevation was not noted in serial electrocardiography. Post-post angioplasty resolution of De Winter pattern in inferior leads.


(A) Ischemia-free kidney transplant procedure. The diagram shows procurement, preservation, and implantation of the donor kidney without cessation of blood supply using normothermic machine perfusion.


(B) Normothermic machine perfusion device, Liver Assist (Organ Assist, Groningen, the Netherlands).


(C) Donor kidney circuit on the organ reservoir of the NMP device.


Normothermic machine perfusion and allograft viability. (A) Arterial flow rates and pressure.


Normothermic machine perfusion and allograft viability. (B) Creatinine (Crea) and urea concentration in the perfusate.


Normothermic machine perfusion and allograft viability. (C) Volume of urine production during machine perfusion.


Normothermic machine perfusion and allograft viability. (D) pH values and specific gravity levels of the urine produced before procurement, during machine perfusion, and post-reperfusion.


Initial presenting electrocardiogram: sinus rhythm with premature atrial and ventricular contractions, ST Elevation and Q waves in II, III, and aVF and tall R wave in V2 consistent with infero-post wall MI, STEMI.


Right coronary artery (RCA) pre-intervention revealing 90% occlusion of the mid RCA with thrombus formation.


Right coronary artery (RCA) after bare metal implantation in the mid RCA.


Computed tomography of a 77-year-old man with nonocclusive mesenteric ischemia, carried out at 5 h postadmission with contrast enhancement. A, Spreading of hepatic portal venous gas in the left lobe (white arrows) compared with the initial scan.


Computed tomography of a 77-year-old man with nonocclusive mesenteric ischemia, carried out at 5 h postadmission with contrast enhancement. B, Remarkable bowel dilatation and pneumatosis intestinalis (white arrows) in the absence of contrast-induced bowel wall enhancement.


Computed tomography without contrast undertaken on admission of a 77-year-old man with nonocclusive mesenteric ischemia. A, A small amount of hepatic portal venous gas in the left lobe (white arrows).


Computed tomography without contrast undertaken on admission of a 77-year-old man with nonocclusive mesenteric ischemia. B, Computed tomography did not reveal remarkable acute mesenteric ischemia findings, such as bowel wall thickening, a hyperattenuating bowel wall, and paper-thin bowel wall (white arrows).


Emergency laparotomy carried out in a 77-year-old man with nonocclusive mesenteric ischemia. The small bowel appears necrotic, with segmental and skip lesions visible at the initial operation.


Optical coherence tomography angiography (OCTA) with the right eye represented by the right column.


The left eye by the left column The structural slabs a, b of the lesions in both eyes were obtained using an RPE-RPE fit segmentation.


Optical coherence tomography angiography (OCTA) with the right eye represented by the right column En face OCTA with customized segmentation between RPE and Bruch's membrane shows a type 1 neovascular network with evident aneurysmal dilatation, as demarcated by the crossing blue and green lines (c, d). Dense B-scan with angiographic flow overlay e, f demonstrates the corresponding cross-sectional view and the customized segmentation of the respective lesions.


The left eye by the left column The structural slabs a, b of the lesions in both eyes were obtained using an RPE-RPE fit segmentation. En face OCTA with customized segmentation between RPE and Bruch's membrane shows a type 1 neovascular network with evident aneurysmal dilatation, as demarcated by the crossing blue and green lines (c, d). Dense B-scan with angiographic flow overlay e, f demonstrates the corresponding cross-sectional view and the customized segmentation of the respective lesions.


Polymorphous rash on the infant's inferior limbs.


Cross-sectional view at the level of the great arteries: left anterior descending (LAD) artery (at 3 o'clock).


(A) Cross-sectional view at the level of the great arteries: left anterior descending (LAD) with an aneurysm (diameter > 6 mm, Z score + 16.45).


(B) The same image as 3A with color Doppler.


Chest X-ray posteroanterior view, arrow showing asymmetrical cardiomegaly.


Two-dimensional transthoracic echocardiography image (parasternal short-axis view) showing cystic mass over lateral wall of left ventricle extending into inferior side.


Computed tomography angiogram showing relation of the cyst with the major epicardial vessels and relation of cyst with left ventricle cavity.


White pale daughter cysts after thoracotomy on the lateral wall of the left ventricle.


Daughter cysts after delivery.


(A-D) Case presentation of 65-year-old male patient with COVID-19, 5 days after tocilizumab (TCZ), non-contrast abdominal CT. Axial.


(A-D) Case presentation of 65-year-old male patient with COVID-19, 5 days after tocilizumab (TCZ), non-contrast abdominal CT. Coronal.


(A-D) Case presentation of 65-year-old male patient with COVID-19, 5 days after tocilizumab (TCZ), non-contrast abdominal CT. 3D reconstruction, pneumatosis intestinalis (PI) involving ascending colon (yellow arrows), with dilated multiple right lower quadrant small bowel loops with mesenteric and portal venous gas (yellow arrowheads).


Chordoid glioma in 34-year-old man. . A. Axial unenhanced CT showing hyperattenuated mass compressing frontal horn of right lateral ventricle. Note small calcification (arrow) in periphery of mass.


Chordoid glioma in 34-year-old man. B. Sagittal T1-weighted (upper left panel) and axial T2-weighted (upper central panel) images showing isointense lobulated mass (arrows) relative to cerebral cortex in anterior third ventricle. Axial susceptibility-weighted image (upper right panel) showing no evidence of intratumoral hemorrhage. Sagittal (lower left panel), axial (lower central panel), and coronal (lower right panel) post-contrast T1-weighted images showing strong enhancing main tumor with lobulated margin (arrows) in anterior part of third ventricle and smaller enhancing masses (arrowheads) along wall of lateral ventricles and fourth ventricle.


Chordoid glioma in 34-year-old man. C. CBV map of perfusion MRI showing elevated CBV within tumor (arrows) in third ventricle.


Chordoid glioma in 34-year-old man. D. Photomicrograph of hematoxylin and eosin stained slide showing solid cellular components composed of clusters and cords of epithelioid tumor cells (arrows) within variable mucinous stroma (original magnification x 400).


Chordoid glioma in 34-year-old man. Photomicrographs of immunostained slides for GFAP.


Chordoid glioma in 34-year-old man. CBV = cerebral blood volume E, F. CD 34. Showing diffuse and strong expression in tumor cells (dark yellow and brown colors) (original magnification x 400). GFAP = glial-fibrillary acid protein.


Coronary angiography with a catheter located in the coronary artery. The dotted circle shows the ruptured distal fragment of the catheter, before it detached.


Skull radiography, anteroposterior view. The dotted white circle shows the catheter fragment lodged in the right middle cerebral artery.


Right internal carotid artery angiography, left anterior oblique view. The dotted white circle shows a double-lumen balloon inflated within the fragment of the catheter, the latter lodged in a branch of the right middle cerebral artery.


Skull radiography, right anterior oblique view. Note inside the white circle the balloon inflated displacing the fragment distally.


(a) Skull radiography. Continued white arrow shows the inflated balloon half inside the catheter fragment and half distal to it. Dotted white arrow shows the catheter fragment.


(b) Skull radiography. Dotted white circle shows the inflated balloon pushing the catheter fragment at M1 segment of cerebral media artery.


(c) Facial bones radiography. Dotted white circle shows the catheter fragment near the tip of the guide catheter at cervical segment of carotid artery.


(d) Chest radiography centered on the clavicle. Inside the dotted white circle, note the inflated balloon and catheter fragment at the level of the right common carotid's origin. White arrow shows the tip of the guide catheter at the level of the right brachiocephalic trunk.


Postprocedural computed tomography of the brain, showing a subarachnoid hemorrhage.


Follow-up angiography with no evidence of vascular lesions or residual intravascular evidence of the retrieved catheter fragment.


Follow-up computed tomography of the brain, without secular lesions.


60-year-old male with ACS-inferior wall MI, post thrombolysis and post MI angina. Coronary angiography-AP view fluoroscopy shows blunt left sinus (arrow) with no coronary origin.


60-year-old male with ACS-inferior wall MI, post thrombolysis and post MI angina. Coronary angiography-AP view fluoroscopy shows blunt left sinus with no coronary origin.


60-year-old male with ACS-inferior wall MI, post thrombolysis and post MI angina. Coronary angiography-right anterior oblique angiographic view shows both right and left coronaries originating from the right sinus (arrow).


60-year-old male with ACS-inferior wall MI, post thrombolysis and post MI angina. Coronary angiography-lateral angiographic view shows both RCA and LCA originating from same ostium (arrow).


60-year-old male with ACS-inferior wall MI, post thrombolysis and post MI angina. Coronary angiography-right anterior oblique angiographic view shows both right and left coronaries originating from the right sinus.


60-year-old male with ACS-inferior wall MI, post thrombolysis and post MI angina. Coronary angiography-lateral angiographic view shows both RCA and LCA originating from same ostium.


60-year-old male with ACS-inferior wall MI, post thrombolysis and post MI angina. CT coronary angiography-CT image with 3D reconstruction shows retroaortic course of LCA (arrow).


60-year-old male with ACS-inferior wall MI, post thrombolysis and post MI angina. CT coronary angiography-CT axial image shows all three coronary arteries.


Bedside chest X ray showing diffuse and bilateral lung infiltrates, cephalization of the pulmonary vessels, bronchial wall thickening giving the aspect or railway track in the upper right lung field and blunting of the right costophrenic angle. The cardiac silhouette is not interpretable (not standing chest x ray).


(A-D) High Resolution Computed Tomography showing scattered ground glass opacities, with predominant bilateral postero-basal and central distribution. It is associated occasionally with a septal thickening giving the aspect of crazy paving.


Bedside chest X ray showing diffuse interstitial lung disease, affecting predominantly the right upper lobe. The right scissure is well visible. We remark also the blunting of the right costophrenic angle. The mediastinum is not interpretable.


(A-D) Computed Tomography Scan showing Crazy paving with ground glass opacities and bilateral thickening of the interlobular septa, located predominantly in the right upper lobe, the middle lobe and the basal segments of the right lower lobe, the apical segment of the left upper lobe and the upper segment of the left lower lobe.


An electrocardiogram showing the ST segment elevation in DII, DIII, and aVF, as well as the ST segment depression in V1-V5.


A coronary angiographic image showing the total occlusion of the LCx (RAO 12. - Caudal 36 ).


An aortic root angiographic image revealing the left main coronary artery arising from the left Valsalva sinus and an absent right coronary ostium (LAO 36. - Caudal 7 ) (Video 1).


A post-stent angiographic image revealing that the RCA originated from the LCx (RAO 10. - Caudal 39 ) (Video 3).


A; CT angiographic image showing a single coronary artery arising from aorta.


Twelve-lead electrocardiography on admission showed atrial fibrillation with a heart rate of 78 beats/min and ST elevation at II, III, and aVF and ST depression at V2-V6.


The head computed tomography (CT) image showed no intracranial hemorrhages.


But the hyper-dense arterial sign was observed at the basilar artery. Arrowhead), which suggested the basilar artery occlusion.


The contrast-enhanced chest CT did not indicate aortic dissection nor cardiac tamponade (c).


The coronary angiography revealed distal occlusion in the posterior descending branch of the right coronary artery (d, arrow).


Mild stenotic lesions suggestive of atherosclerotic pathology were observed in some parts (e and f).


The diffusion-weighted image showed hyper-intense lesions in the region of the posterior inferior cerebellar artery (g and h).


Magnetic resonance angiography did not reveal the flow of the basilar artery, and severe stenotic lesions of the major arteries were scarcely observed (i).


After 38 h from the onset, his consciousness level was depressed as Japan coma scale I-3. The head computed tomography (CT) 38 h after the onset showed hydrocephalus.


After 38 h from the onset, his consciousness level was depressed as Japan coma scale I-3. Due to cerebellar edema and hemorrhagic infarction of the ischemic cerebellum, which compressed the aqueduct.


After 38 h from the onset, his consciousness level was depressed as Japan coma scale I-3. The head CT after cerebral ventricular drainage showed improvement in hydrocephalus (c).


After 38 h from the onset, his consciousness level was depressed as Japan coma scale I-3. The chest CT showed cardiac tamponade (d). Emergency pericardiotomy was immediately performed to allow the fluid to drain. A left mural and atrial appendage thrombi were observed.


After 38 h from the onset, his consciousness level was depressed as Japan coma scale I-3. There were no apparent bleeding sources, aortic dissections, nor myocardial ruptures intraoperatively (e).


12 lead electrocardiogram (ECG) of the patient at the time of presentation. ECG showing T wave inversion in precordial leads from V1 to V6. There is no shift of ST segments.


Coronary angiogram in the left anterior oblique caudal view showing eccentric narrowing the proximal left anterior descending coronary artery with 75% stenosis.


Coronary angiogram showing successful result of angioplasty and stenting to proximal left anterior descending coronary artery.


12-lead ECG showing normalization of the ischemic changes on follow up.


Twelve-lead electrocardiogram on admission. The electrocardiogram demonstrates hyperacute T waves in V2-4.


Left coronary angiography. A; Initial left coronary angiography of cranial view revealing embolic obstruction straddling the bifurcation in the left anterior descending artery and diagonal branch (arrow).


Left coronary angiography. B; Left coronary angiography after aspiration showing the restoration of blood flow.


Contrast-enhanced computed tomography showed that tumor invading the left renal vein (arrow).


Transesophageal echocardiography showing a patent foramen ovale and shunt flow (arrow). LA: left atrium, RA: right atrium.


Transthoracic echocardiography on readmission showing right ventricular dilatation and a mobile mass attached to the tricuspid valve (arrow). RV: right ventricle, LV: left ventricle, RA: right atrium.


Electrocardiogram 4 h post-presentation, with recurrence of chest pain showing ST-elevation in leads V1-V2.


Slit lamp biomicroscopy of the anterior segment of the left eye shows marginal (arrow) and peripheral (arrowheads) circumferential neovascularization of the iris.


MRA extracranial showing severe narrowing of the origin of the right brachiocephalic artery (yellow arrow) and complete occlusion of the left common carotid artery with distal reconstitution of flow near the bifurcation (red arrow).


52-year-old male with atypical chest pain. Coronary computed tomography angiography curved planar reformation image of the mid left anterior descending coronary artery. The white arrow marks an area suspicious for significant stenosis (>70%).


52-year-old male with atypical chest pain. And rest perfusion Images were acquired 150 s after injection of 1110 MBq Rb82. Total acquisition time was 270 s.


52-year-old male with atypical chest pain. Static rubidium-82 perfusion images (17 segment polar maps) demonstrates no difference between stress.


53-year-old male presenting with severe chest pain and cardiac arrest, which was successfully treated with resuscitation and cardioversion. 12-lead electrocardiogram shows massive ST-elevation consistent with anterior ST-elevation myocardial infarction.


52-year-old male with atypical chest pain. Fractional flow reserve (FFRCT = 0.52) derived from coronary computed tomography images and based on a physiologic model of coronary blood flow using three principles: (1) The total resting coronary blood flow can be quantified relative to the myocardial mass, (2) The microcirculatory vascular resistance at rest is inversely proportional to the size of the supplying coronary arteries, and (3) The vasodilatory response of the coronary microcirculation to adenosine can be predicted, allowing computational modeling of maximal hyperemia. The integration of the physiological model into 3-dimensional computational models allows computation of coronary flow and pressure under hyperemic conditions.


(a) Echo showed RV diameter 31.8 mm, the wall of the RV became thinner.


(b) CMRI showed foci of fat in right ventricular free wall.


Peripheral angiogram shows right common iliac artery stenosis of 90% at proximal and distal edges of the stent.


Right femoropolpiteal graft is thrombosed, left common iliac artery shows multifocal areas of narrowing and occlusion of 90.


Terumo wire (0.035) and exteriorized through left femoral artery (a). Right femoral artery approach was used for deploying right common iliac artery stent.


8 mm x 55 mm peripheral balloon was used and serial predilatation done (b).


8 mm x 120 mm medtronic self-. expanding stent was deployed in the right common iliac artery and 7 mm x 150 mm medtronic self-expanding stent deployed in the left common iliac artery. Postdilatation with simultaneous kissing at aortoiliac junction was done using 8 mm x 55 mm balloon in right common iliac artery and 7 mm x 40 mm balloon in left common iliac artery. Postprocedure showed good distal flow.


Computed tomography peripheral angiogram shows patent stent seen in relation to distal aorta, left common iliac artery, external right common iliac artery.


The occupational processes and tools at workplace. A. The charcoal recycler.


The occupational processes and tools at workplace. B. The on/off button of the charcoal recycler.


The occupational processes and tools at workplace. C. Handling the charcoal bowl.


The occupational processes and tools at workplace. D. Moving the charcoal to the grid pan.


The occupational processes and tools at workplace. E. After a fire is started in the charcoal with the grid pan, the burning charcoal is moved from the pan to the bowl.


The occupational processes and tools at workplace. F. Placing and stirring the burning charcoal beneath the duct for aeration.


The occupational processes and tools at workplace. G. Moving the charcoal bowl to a metal container for delivery to tables.


A hypoechoic mass with irregular borders concurrent with a thrombus based on the apical two-chamber view.


Two-dimensional.


Three-dimensional. Tomography scan with volume rendering showed large ventricular thrombus.


Computed tomography angiography preoperatively showing that there is an interruption between right sinus of Valsalva and the enlarged and tortuous right main coronary artery.


Arrow), a single left coronary ostium with a giant coronary trunk.


Arrow), a 7-mm fistula into the right ventricle (Red).


Arrow), the left and right coronary artery were connected with each other and formed a closed loop at the base of the heart.


Ascending aortic angiography preoperatively showing that the left and right coronary artery were enlarged and tortuous.


Right coronary artery was detected secondly to the left one , confirming the diagnosis of coronary artery ring with single left coronary ostium and fistula.


Intraoperative view showing that the fistula was ligated with off-pump strategy.


Transthoracic echocardiography showing that a 6.28-mm coronary fistula into the right ventricle.


Arrow) was detected preoperatively, and undetectable 1 week post-surgical ligation.


Pedigree of the family. The arrow indicates the proband. Circles indicate females, squares indicate males. The diagonal line indicates a deceased family member. Black squares/circles indicate a carrier of the FHM3 (c.4495T>C) mutation with hemiplegic migraine. White squares/circles indicate subjects that are neither patients nor mutation carriers.


Electrocardiograms before and after admission. . Notes: (A) An electrocardiogram shows bradycardia with Mobitz type II second-degree atrioventricular block and complete left bundle branch block 1 month before admission.


Electrocardiograms before and after admission. (B) An electrocardiogram shows third-degree atrioventricular block on admission.


An electrocardiogram shows biventricular pacing after CRT-D implantation. . Abbreviation: CRT-D, cardiac resynchronization therapy-defibrillator.


A: Twelve-lead ECG showing constant fusion during right ventricular apex (RVA) overdrive pacing (cycle length [CL] = 360 ms) of the ventricular tachycardia (VT; CL = 370 ms).


B: ECG showing progressive fusion during RVA overdrive pacing (CL = 340 ms) of the VT.


A: Intracardiac electrogram showing overdrive pacing from the LCC/RCC commissure during ventricular tachycardia (cycle length = 360 ms) at a paced cycle length of 340 ms.


B: Catheter position under fluoroscopy.


C: Catheter position under intracardiac ultrasonography (Soundstar, Biosense Webster, Diamond Bar, CA). The tip of the ablation catheter is positioned in the LCC/RCC commissure. ABL = ablation catheter; CS = coronary sinus; HB = His bundle; LAO = left anterior oblique; LCC = left coronary cusp; NCC = noncoronary cusp; RCC = right coronary cusp; RVOT = right ventricular outflow tract; US = ultrasonography.


Intracardiac electrogram showing that the single extrastimulus terminated the ventricular tachycardia (VT). A potential in the mid-diastolic phase during the VT is observed that persisted even after the VT terminated. However, this mid-diastolic potential more likely is a mechanical valve artifact as a result of a tiny potential, such as the mid-diastolic potential recorded, after the last QRS complex (asterisk).


Oxygen pulse (VO2/HR) at the time of the diagnosis. x-axis: VO2; left y-axis: heart rate (HR) represented by red dots; right y-axis: VO2/HR represented by blue dots.


Oxygen pulse (VO2/HR) after cardiac therapy. x-axis: VO2; left y-axis: heart rate (HR) represented by red dots; right y-axis: VO2/HR represented by blue dots.


Electrocardiography: sinus rhythm, ST-segment elevation on leads V2-V5.


Echocardiography: Four chamber view showing evidence of classic takotsubo cardiomyopathy, the apical type. Represents systole.


Echocardiography: Four chamber view showing evidence of classic takotsubo cardiomyopathy, the apical type. Represents diastole.


Petechial rash found in the distal third of the legs and the feet.


Petechial rash on buccal mucosa.


Demonstrating nail ridging.


EKG showing ST segment elevations in leads II, III, and aVF.


Four chamber(a) view shows dilated right atrium and right ventricle, dilated coronary sinus.


The terminal unroofing of the coronary sinus is demonstrated by arrow in the subxiphoid image, (b) RA-right atrium, LA-left atrium, CS-coronary sinus, RV-right ventricle, LV-left ventricle.


Chest X-ray revealing mild cardiomegaly, dilated right descending pulmonary artery, and oligemia in the right lung.


Dilation of right ventricle and pulmonary arteries (arrow).


Obstruction of pulmonary arteries from proximal portion (arrow).


Decrease in the right ventricle size (arrow).


(a) Echocardiogram, parasternal long axis view. Dilated coronary sinus is demonstrated (arrow), along with descending Aorta (head arrow). Long and short axes of CS are shown.


(b) Modified parasternal short axis. CS (arrow) and PLSVC (head arrow) are shown.


(c) Modified four chamber view. Cs (arrow) is seen entering RA (star), postero superiorly to left ventricle (triangle).


(a) CMR, cine sequence, vertical long axis (equivalent to apical two chamber echographic view), diastolic frame. The dilated CS (arrow) is shown. 1 left atrium (LA), 2 left ventricle (LV), 3 main pulmonary artery, 4 aortic arch.


(b) axial view (similar to Figure 1c). CS (arrow) is seen entering RA (star), postero superiorly to left ventricle (triangle); inferior vena cava inlet in RA is shown (point arrow).


CMR, cine sequence, coronal view, diastolic frame. Slice width 8 mm. Arrow points to the site where superior vena cava, if present, should be seen entering upper RA. PLSVC is seen forming the left mediastinal border and draining into the very dilated CS, in turn connecting to RA. 1 PLSVC, 2 dilated CS, 3 RA, 4 LA, 5 ascending aorta, 6 left pulmonary artery, 7 right innominate vein and overlapping innominate artery and common carotid artery, 8 left innominate vein, 9 inferior vena cava.


(A) Pre-operative 3D reconstruction (3Mentio Medical Imaging B. V. , Bilthoven, The Netherlands) of the 7.5-cm abdominal aortic aneurysm.


The aneurysm contains no intraluminal thrombus at all, as can be seen in the coronal.


Axial plane. Of the computed-tomography angiography.


Volume-rendering reconstruction of the aneurysm after the implantation of a modular nitinol-based endograft (Bolton Medical, Barcelona, Spain).


Coronary angiogram showing 95% stenosis in right coronary artery. (A higher resolution / colour version of this figure is available in the electronic copy of the article).


Two-dimensional transthoracic echocardiographic images. (A) Long-axis view of the left ventricle showing an echo-lucent cavity in the left-ventricular myocardium with abnormal blood flow on color Doppler (arrow).


Two-dimensional transthoracic echocardiographic images. (B) Short-axis view at the MV (mitral valve) level also showing the echo-lucent cavity with partitions in the left-ventricular myocardium and abnormal blood flow on color Doppler. AO, aorta; LA, left atrium; LV, left ventricle; RA, right atrium; RV, right ventricle; RVOT, right ventricular outflow tract.


(A,B) CT angiogram images showing the anatomical profile of IPA (white arrow) and perforation (black arrow).


(C,D) CMR LGE images showing the high signal intensity of the IPA with a distal low signal intensity ( ), and a linear high signal intensity (white arrow) of the IPA wall and partitions. LCS, left coronary sinus.


Post-operation two-dimensional transthoracic echocardiographic images. Short-axis view at the aortic valve level showing the perforation of the left sinus of Valsalva repair.


Post-operation two-dimensional transthoracic echocardiographic images. Non-standard short-axis view showing the cessation of abnormal blood flow on color Doppler.


Erythema and swelling around CRT-P insertion site.


TEE revealing vegetation at the anterior leaflet of the mitral valve.


Non-compacted myocardium measures 11.9-12.9 mm, and the compacted myocardium measures 3.7-4.2 mm in the sagittal plane.


3D image.


Printing. Of non-compaction cardiomyopathy.


Increased trabeculation in the left ventricle, particularly in the midsections and apex with a non-compacted to compacted ratio of 2.5.


Timeline of Case 1 and Case 2.


Intraoperative transesophageal echocardiogram images with color flow doppler of the main pulmonary artery (MPA), left pulmonary artery (LPA) and right pulmonary artery (RPA) prior to surgical pulmonary embolectomy. The images reveal significant flow acceleration across a dilated MPA (Panel A) and minimal to no antegrade flow into the LPA (panel B) and RPA (panel C). (For interpretation of the references to color in this figure legend, the reader is referred to the Web version of this article. ).


Intraoperative transesophageal echocardiogram images with color flow doppler showing the main pulmonary artery (MPA), left pulmonary artery (LPA) and right pulmonary artery (RPA) after surgical pulmonary embolectomy. The images reveal reduced flow acceleration across the MPA (Panel A) and significantly improved flow in the LPA (Panel B) and RPA (Panel C). (For interpretation of the references to color in this figure legend, the reader is referred to the Web version of this article. ).


Intraoperative transesophageal echocardiogram images showing a significantly dilated right ventricle (Panel A) that normalized (Panel B) after surgical embolectomy.


Chest radiography showing bilateral pulmonary infiltrates.


Initial ECG demonstrating ST-segment elevation in multiple leads.


Transthoracic echocardiogram showing a calcified apical thrombus and global hypokinesis.


Computed tomography imaging showing hyperdense hemorrhagic lesion in the left temporal horn of lateral ventricle with hemorrhage in left lateral ventricle.


Contrast-enhanced angiography showing evidence of well-defined, strongly homogenous, enhancing polypoidal intraventricular mass lesion both in arterial phase and venous phase with hemorrhage in left lateral ventricle.


A cauliflower-like vascular mass in the temporal horn of lateral ventricle with an attachment to the choroid plexus.


Noncontrast computed tomography showing dilated both lateral, third and fourth ventricles suggestive of moderate communicating hydrocephalus.


(a) Papillary fronds lined by single layer of cells (H and E, x40). (b) Delicate fibrovascular connective tissue fronds covered by single layer of uniform cuboidal to columnar epithelial cells with round to oval, basally situated nuclei (H and E, x200).


Electrocardiogram (ECG) of the proband. (A) The ECG of the proband showed ventricular tachycardia onset at a cycle length of 280ms.


Electrocardiogram (ECG) of the proband. (B) Baseline ECG for proband showing a saddle-shaped ST elevation in leads V1-V3.


Prenatal US at 33 weeks' gestational age with red arrow showing dilation of the left ventricle directly under the mitral valve. Given echocardiogram and magnetic resonance imaging in the 1st week of life, this was likely aneurysmal dilation. The left atrial aneurysm is not visualized here or during prenatal US.


Echocardiogram imaging: (a) Four chamber view, day 1 of life, showing large left ventricle submitral free wall aneurysm.


(b) Parasternal short axis view, day 7 of life, showing left atrial aneurysm with hyperechoic mass at apex (arrow), presumed to be a blood clot.


(a) Sagittal plane T2 cardiac magnetic resonance imaging, day 7 of life, showing left atrial appendage aneurysm and hypoechoic blood clot at the ventral aspect. The left ventricular free wall aneurysm can be seen directly below left atrial.


(b) Sagittal oblique cardiac magnetic resonance imaging with free wall left ventricular aneurysm with free communication to the left ventricle.


Postoperative apical view echocardiogram with and without Doppler flow showing the development of new left ventricular apical pseudoaneurysm. Arrow shows apical pseudoaneurysm and color flow study shows flow into the pseudoaneurysm during cardiac systole.


Apical 4 chamber view echocardiogram performed at 6 years of age showing persistent large submitral left ventricular aneurysm marked by red arrow.


The ECG with Q waves in DII, DIII and AVF, negative T waves in VI V2 and V3 without alteration of the ST segment.


The CT scan showed the Amyand's hernia.


Electrocardiograph analysis showed mild ST-segment elevation and abnormal Q waves in III and aVF; sinus tachycardia and complete right bundle branch block.


Pulmonary computed tomographic angiography (CTA) showed bilateral pleural effusion and inflammation (pulmonary window and mediastinal window).


Changes in temperature and blood pressures during hospitalization.


Changes in inflammatory markers during hospitalization.


Changes in myocardial injury markers during hospitalization.


Immediate postoperative chest AP radiograph shows increased opacity in bilateral perihilar areas.


Postoperative electrocardiogram shows ST segment elevation in leads V2-4 and T-wave inversion in leads I, aVL, V2-6.


Chest X-ray of the patient, taken on the February 12, 2021.


Admission electrocardiogram shows anteroseptal and lateral ST segment elevation.


Inpatient electrocardiogram shows inferior ST segment elevation.


Inpatient electrocardiogram shows lateral ST segment elevation.


The illustration of CT angiography of acute embolism in right iliofemoral artery (arrow).


The illustration of echocardiogram of huge thrombi in left ventricle apex (arrow). LV, left ventricle; LA, left atrium.


The illustration of coronary arteriography with left anterior descending dissection (arrows).


A 35-year-old woman with recurrent attacks of palpitation since childhood. A) Transthoracic color Doppler echocardiography shows the dilated left circumflex artery (arrow) emptying into the big coronary sinus.


A 35-year-old woman with recurrent attacks of palpitation since childhood. B) Continuous turbulence flow on color Doppler at the level of coronary artery-coronary sinus connection as well as in the coronary sinus indicating a left-to-right shunts flow.


Coronary angiography (anteroposterior view) demonstrates contrast opacified left circumflex artery that is markedly dilated. CS = Coronary sinus, LCX = Left circumflex artery, LM = Left main coronary artery.


The TE echocardiogram:. X-plane vision showing a thrombus inside the appendage of the LA, and ,a limited image that comes from the posterolateral wall to the mitral valve plane without any communication with the atrial chamber.


Increased velocity of the color Doppler at the level of the mitral inflow. LV = left ventricle, LA = left atrium; Ao = ascending aorta; TE = Transesophageal.


Angio-CT: capsuled lesion of the posterolateral left atrial wall to mitral annulus with clear margins, but no contrast enhancement both in the arterial.


The late phases LV = left ventricle, LA = left atrium, CT = Computed tomography.


Cardiac MR: the intramural formation in the context of the lower lateral wall of the LA, occupying the chamber, by causing obstruction to ventricular filling but in the absence of signs of local invasiveness (a).


It was characterized by a marked hyperintensity on T2-weighted images (b). LV = left ventricle, LA = left atrium, RV = right ventricle, MR = Magnetic resonance.


Histological examination: a hematoxylin and eosin stain confirmed the presence of histiocytes, crenated red blood cells, and crystals, which are typical findings of a chronic hematoma.


Right Foot edema with peripheral Cyanosis.


Right Forefoot Gangrene.


Invasive angiogram showing right coronary artery (Blue Arrow), left circumflex artery (Yellow Arrow), left anterior descending artery (Red Arrow).


Crops of small, red-yellow dome-shaped papules of approx. 6 mm with well-defined borders located on the anterior medial thigh.


Appearance of venous blood following phlebotomy, exhibiting a thick, milky supernatant.


The main milestones of the proband's medical history. Reconstructed by the patient's reports and medical records.


The endomyocardial biopsy of the right ventricle (10-50 micron scale). Hematoxylin eosin staining showed: the endocardium is thin. Cardiomyocytes with foci of enlightenment in the perinuclear zone, disarray, with homogenization of the cytoplasm. In individual cardiomyocytes, there are foci of myolysis with the formation of voids in the cytoplasm. Microvessels with red blood cell sludge phenomenon, sclerosed walls, proliferation of endothelial cells, stenosis of the lumen and single perivascular lymphohistiocytic cells. There are minor hemorrhages, mild sclerosis. Staining of congo red (in non-polarized and polarized light), Perls reaction, the PAS reaction are a negative.


Interoperative image of arteriovenous fistula involving the radial artery and the cephalic vein in the wrist.


Coronary angiography of an essential thrombocythemia case with acute myocardial infarction. Examination results of the. First.


Coronary angiography of an essential thrombocythemia case with acute myocardial infarction. Second time admissions.


Electrocardiogram showing ST segment elevation in leads V3 and V4.


Coronary angiography showing a large thrombus in the left anterior descending artery.


Coronary angiography status post-thrombectomy with no residual lesions in the left anterior descending artery.


Echocardiography on admission. . Notes: Echocardiography showed muscular VSD of approximately 2 cm size. Ventricular septal defect (arrow).


Echocardiography on admission. . Notes: Echocardiography showed muscular VSD of approximately 2 cm size. Further delineation with use of color-flow Doppler. . Abbreviations: LV, left ventricular; RV, right ventricular; VSD, ventricular septal defect.


Coronary angiogram. . Note: Selective left coronary injection shows mid-left anterior descending total occlusion without any collateral vessels (arrow).


Emergent operation for ventricular septal defect repair by two patch technique. . Note: A ventricular septal defect (arrow).


Percutaneous transcatheter AMPLATZER. Muscular VSD Occluder device inserted across ventricular septal defect. . Note: AMPLATZER. 16 mm muscular VSD device was placed appropriately across the ventricular septal defect (arrow). . Abbreviations: VSD, ventricular septal defect; LV, left ventricular; RV, right ventricular.


Proximal left main coronary artery 99% occlusion in Case 1.


Left main coronary artery 99% occlusion in Case 2.


A 46-year-old male presented with chest pain for 1 month. Frontal chest radiograph shows a homogenous radio-opacity in the left upper zone, broad based toward aortic knuckle (large white arrow) causing superior mediastinal widening.


(a-c) A 46-year-old male presented with chest pain for 1 month. Multidetector computed tomography thoracic aortography (axial, sagittal, and coronal sections in mediastinal window) shows focal intense enhancing saccular outpouching (pseudoaneurysm) in the inferolateral wall of aortic isthmus, mushroom shaped (*) just distal to origin of the left subclavian artery (small white arrow) with periaortic hypoattenuating prominent inflammatory soft tissue (large white arrow) causing subsegmental passive collapse of the left upper lobe (white arrowhead).


(a) A 46-year-old male presented with chest pain for 1 month. Multidetector computed tomography (MDCT) thoracic aortography - three-dimensional (3D) volume rendered (VR) image (axial) shows focal saccular outpouching (pseudoaneurysm) in the inferolateral wall of aortic isthmus, mushroom shaped (white arrow) just distal to origin of the left subclavian artery.


(b) A 46-year-old male presented with chest pain for 1 month. MDCT thoracic aortography - 3D VR image (sagittal) shows focal saccular outpouching (pseudoaneurysm) in the inferolateral wall of aortic isthmus, mushroom shaped (large white arrow) just distal to origin of the left subclavian artery (small white arrow).


(c) A 46-year-old male presented with chest pain for 1 month. MDCT thoracic aortography - 3D multidetector computed tomography image (coronal) shows focal saccular outpouching (pseudoaneurysm) in the inferolateral wall of aortic isthmus, mushroom shaped (large white arrow) just distal to origin of the left subclavian artery (small white arrow).


(a and b) A 46-year-old male presented with chest pain for 1 month. Multidetector computed tomography thoracic aortography, (axial sections in mediastinal window) shows few para-aortic necrotic lymph nodes (white arrowhead), few left lower paratracheal partially necrotic lymph nodes (small white arrow), and few aortopulmonary or subaortic partially necrotic lymph nodes (large white arrow).


A 75-year-old male presented with dyspnea, right-sided chest pain, massive hemoptysis, and fever. Frontal chest radiograph shows a fairly defined inhomogeneous radio-opacity in the right upper and mid zones lung fields (large white arrow).


(a) A 75-year-old male presented with dyspnea, right-sided chest pain, massive hemoptysis, and fever. Multidetector computed tomography (MDCT) pulmonary arteriography - three-dimensional (3D) volume rendered (VR) image (axial) shows focal saccular outpouching (pseudoaneurysm) arising from the feeding posterior segmental branch of the right pulmonary artery (white arrow).


(b) A 75-year-old male presented with dyspnea, right-sided chest pain, massive hemoptysis, and fever. MDCT pulmonary arteriography - 3D VR image (coronal) shows focal saccular outpouching (pseudoaneurysm) arising from the feeding posterior segmental branch of the right pulmonary artery (white arrow).


(c) A 75-year-old male presented with dyspnea, right-sided chest pain, massive hemoptysis, and fever. MDCT pulmonary arteriography - 3D VR image (sagittal) shows focal saccular outpouching (pseudoaneurysm) arising from the feeding posterior segmental branch of the right pulmonary artery (white arrow).


(a) A 75-year-old male presented with dyspnea, right-sided chest pain, massive hemoptysis, and fever. Immediate postoperative follow-up frontal chest radiograph shows coils filling the pseudoaneurysm sac (small white arrow) with minimal resolution of inhomogeneous radio-opacity (white arrowhead).


(b) A 75-year-old male presented with dyspnea, right-sided chest pain, massive hemoptysis, and fever. Post-operative day 3 follow-up frontal chest radiograph shows coils filling the pseudoaneurysm sac (small white arrow) with partial resolution of inhomogeneous radio-opacity (white arrowhead).


(c) A 75-year-old male presented with dyspnea, right-sided chest pain, massive hemoptysis, and fever. Four weeks post-operative follow-up frontal chest radiograph shows coils filling the pseudoaneurysm sac (small white arrow) with near-complete resolution of inhomogeneous radio-opacity (white arrowhead).


A 43-year-old male presented fever, pain, and localized swelling in the right upper anterior chest wall for 1 month. Frontal chest radiograph shows no significant abnormality.


(a-c) A 43-year-old male presented fever, pain, and localized swelling in the right upper anterior chest wall for 1 month. Contrast-enhanced computed tomography chest (axial, coronal, and sagittal sections in mediastinal window) shows a fairly defined peripherally enhancing collection in the right upper anterior chest wall epicentered in 1st costochondral junction and sternocostal joint (small white arrow). Adjacent encasement of the right internal mammary artery with pseudoaneurysm of the artery is seen (large white arrow).


(a) A 43-year-old male presented fever, pain, and localized swelling in the right upper anterior chest wall for 1 month. Contrast-enhanced computed tomography (CT) chest - three-dimensional (3D) volume rendered (VR) image (axial) shows focal saccular outpouching (pseudoaneurysm) of the right internal mammary artery (large white arrow).


(b) A 43-year-old male presented fever, pain, and localized swelling in the right upper anterior chest wall for 1 month. Contrast-enhanced CT chest - 3D VR image (coronal) shows focal saccular outpouching (pseudoaneurysm) of the right internal mammary artery (large white arrow).


(c) A 43-year-old male presented fever, pain, and localized swelling in the right upper anterior chest wall for 1 month. Contrast-enhanced CT chest - 3D VR image (sagittal) shows focal saccular outpouching (pseudoaneurysm) of the right internal mammary artery (large white arrow).


A; Sagittal computed tomography angiography showing a left cerebellar hemisphere hemorrhage.


B; Thrombin generation curves obtained with 5pM tissue factor and 4 muM phospholipids (final concentration) in platelet-poor plasma using calibrated automated thrombin generation assay (Stago, Asnieres, France). The area under the thrombin generation curve (or endogenous thrombin potential) is significantly higher in the patient (red) compared to another subject with afibrinogenemia (blue) or a representative normal control (grey). In this patient with combined inherited antithrombin and fibrinogen deficiency, increased thrombin generation is due to insufficient inhibition of thrombin. Thrombin generation is decreased after infusion of 30 U/kg antithrombin concentrate (pink).


C; Visualization of the left coronary artery with computed tomography coronary angiogram showing 80% stenosis in the common trunk.


D; Visualization of the left coronary artery with computed tomography coronary angiogram showing 50% stenosis in the anterior interventricular branch of left coronary artery.


This figure shows transition of blood sugar (BS) and sodium. Corrected sodium is calculated using the formula; sodium+{(BS-100)/100*1.65}. Left bar is for BS level and right bar is for sodium concentration.


Brain magnetic resonance imaging consistent with CPM. High signal intensity lesions in the posterior central pons on T2WI (arrow head).


Low signal intensity lesion on T1WI.


High signal intensity lesion and a lesion without a decrease in the apparent diffusion coefficient on DWI.


Apple watch record of the patient's heart rate.


EKG showing supraventricular tachycardia.


EKG showing normal sinus rhythm following electrical cardioversion.


The surface electrocardiogram during the onset of atrial tachycardia.


The surface electrocardiogram showing sinus rhythm after surgical ablation.


The adventitia scar after ablation of the right atrial appendage under thoracoscopic clamping.


Echocardiography of patient 1: Coronary flow pattern arising from the right-facing sinus and continuing between aorta and pulmonary artery (PA) suggesting an interarterial/intramural course of the left coronary artery.


Surgical unroofing of the left coronary artery (LCA): Identification of the slit-like ostium of the LCA in the right- facing sinus and its intramural course toward the left-facing sinus (A).


Unroofing of the LCA with a longitudinal incision into the intima from its ostium up to its off-spring from the aortic root (B).


By this, enlarging the ostium and eliminating the dynamic obstruction of the proximal main stem of the LCA (C).


Echocardiography of patient 2: Origin of the right coronary artery (RCA) from the left-facing sinus with an interarterial and intramural course between the aorta and the pulmonary artery (PA). Normal origin of the left coronary artery from the left-facing sinus.


Coronary computed tomography angiography of patient 3: AAOCA with an anomalous origin of the left coronary artery arising from the non-facing sinus without an interarterial course, but with a short intramural course. ECMO, Extracorporeal membrane oxygenation; PA, pulmonary artery.


A-D. Arteriography. Occlusion of right iliac artery.


A-D. Arteriography. ; Occlusion and aneurisms in terminal abdominal aorta and branches.


A-D. Arteriography. ; Occlusion of right subclavian artery.


A-D. Arteriography. ; Occlusion of left subclavian artery.


17-year-old boy with unruptured right sinus of Valsalva aneurysm, contrast-enhanced CT (a) Coronal image shows aneurysm (An) compressing the RVOT (arrow) with dilatation of RA and RV.


(b) Axial image shows the aneurysm extending along right atrio-ventricular groove (arrow).


(c) Oblique coronal image shows dilated right cardiac chambers, intrahepatic IVC, and hepatic veins (arrow). An = Aneurysm, LA = Left atrium, LV = Left ventricle, RA = Right atrium, RV = Right ventricle, RVOT = Right ventricular outflow tract, IVC = Inferior vena cava.


(a) Check left coronary artery angiogram done through right radial access with Tiger catheter. Left anterior descending stent is patent.


(b) Final result of transfemoral right coronary artery percutaneous coronary intervention.


(c) Check aortogram after percutaneous coronary intervention showing no major dissection or perforation.


(a) Transthoracic echo apical four-chamber view showing hematoma (arrowhead) compressing the left atrium (arrow).


(b) Transthoracic echo showing resolution of hematoma (red arrow) behind the left atrium (green arrowhead).


(a) Computed tomography thorax axial section showing posterior mediastinal hematoma (blue star) extending behind the left atrium (red asterisk).


(b) Repeat computed tomography showing resolving hematoma in the posterior mediastinum (thick arrow) with no hematoma behind the left atrium (thin arrow).


(A) Pre-hospital ECG showed ventricular tachycardia with a heart rate of 250 beats/min.


(B) Admission ECG.


(A) The left ventricular long-axis four-chamber view showed localized wall thinning of the RV apex (bold arrow) and abnormal echo in the posterior basal segment (thin arrow).


(B) The short-axis two-chamber view of the left ventricle indicated abnormal wall motion and localized dilation during diastole in RV, similar to a mini ventricular aneurysm (black arrow).


Intracardiac electrophysiological studies of right ventricular stimulation easily induced rapid ventricular tachycardia with a heart rate of 250-280 beats/min originating from the RV with various forms. (A) Body surface electrocardiogram, paper speed 25mm/s.


Intracardiac electrophysiological studies of right ventricular stimulation easily induced rapid ventricular tachycardia with a heart rate of 250-280 beats/min originating from the RV with various forms. (B) Intracardiac electrogram, paper speed 100mm/s.


Myocardial MRI showed that the segmental RV wall was locally thinned, and the abnormal signal indicated fat infiltration (bold arrow). (A) Left ventricular long-axis four-chamber view, bright blood FIESTA sequence.


Myocardial MRI showed that the segmental RV wall was locally thinned, and the abnormal signal indicated fat infiltration (bold arrow). (B) Short axis section of the left ventricle, black blood Double IR sequence.


Sequencing results of the DSG2 mutation. (A) The father of the proband did not carry the pathogenic gene.


Sequencing results of the DSG2 mutation. (B) The proband, his mother and sister carried a mutation in the DSG2 gene. Sequence chromatogram indicated a G to A transition of nucleotide 445.


Sequencing results of the PRRT2 mutation. (A) The proband and his father carried a mutation in the PRRT2 gene.


Sequencing results of the PRRT2 mutation. (B) The mother and sister of the proband did not carry the pathogenic gene. Sequence chromatogram indicated a C loss of nucleotide 641.


The pedigrees of the proband's family affected by PKD and ARVC in our study. Symbols with a slash through them indicate deceased individuals.


MR brain images showing the mismatch between positive DWI.


Negative FLAIR , consistent with hyperacute stroke of the AOP vascular territory.


Thrombus in left atrium and left ventricle.


Thrombus in right atrium, left atrium, and left ventricle.


Doppler ultrasonography with peak systolic velocities (PSV) of the right proximal.


Left proximal.


Right distal.


Left distal. Renal arteries [Normal PSV < 180 cm/s.


Computerized tomography of the right.


Left. Proximal renal arteries (arrows). Approximately 50% stenosis of the left renal artery is noted.


Percutaneous renal angiography showing the proximal left renal artery (arrows) with 50% stenosis prior to stent placement.


Improved flow post stent placement.


Left coronary angiogram showing stenotic left anterior descending coronary artery with first diagonal branch (D1) and absent left circumflex artery.


Right coronary angiogram showing a superdominant right coronary artery with double posterior descending arteries.


ECG during outpatient clinic cardiologist's consulting: inverted T waves in precordial leads (V1, V2, V3, V4, V5) and the presence of complete right bundle-branch block - minor criteria according to the 2010 revised Task Force criteria (2). . ECG - electrocardiogram.


ECG performed in emergency room: VT with right ventricular (RV) outflow configuration, left bundle-branch block morphology with inferior axis (positive QRS in leads II, III, and aVF and negative in lead aVL) - minor criterion according 2010 revised Task Force criteria (2). . ECG - electrocardiogram, RV - right ventricular, VT - ventricular tachycardia.


4 chamber LGE image. The RV local aneurysms has been reported in CMR. . CMR - cardiac magnetic resonance, LGE - late gadolinium enhancement, RV - right ventricle.


4 chamber LGE in the right and left ventricles. . LGE - late gadolinium enhancement.


Short axis LGE in the right and left ventricles. . LGE - late gadolinium enhancement.


Supraventricular tachycardia (SVT) with a long RP interval was recorded on electrocardiogram (ECG). Positive P-waves are seen in V1.


Electrocardiogram on second day post-right craniotomy for evacuation of hemorrhage and clipping of right middle cerebral artery aneurysm showing deep negative T waves in almost all leads with prolonged QTc interval (580 ms).


Left ventriculogram showing systolic anterior wall aneurysm.


Two-dimensional transthoracic echocardiography in the apical long-axis view showing anteroseptal wall aneurysm with nearly normal motion of the other segments in a) end diastole and b) mid-systole.


ECG demonstrating normal sinus rhythm at 86 bpm. No other significant abnormalities were noted.


Eletrocardiographic recordings before ventricular fibrillation in this case. The ECG shows ST segment elevation in lead V3-V5.


Coronary angiogram showing marked systolic narrowing of the left anterior descending artery. Diastole.


Systole).


ECG of the patient during hypoglycemic coma.


ECG showing ST elevation in II, I, aVL, V5, V6 with concavity upward and PR segment elevation in aVR and PR segment depression in other leads.


Electrocardiogram showing normal sinus rhythm and occasional premature ventricular complexes, right bundle branch block, and ST-segment depressions of 0.5-1 mm in leads V4-V6.


Cardiac catheterization, right anterior oblique projection with 25 degrees of caudal angulation; showing 100% left anterior descending occlusion, 90% occlusion of the circumflex, and 95% occlusion of the obtuse marginals 1 and 2.


Aneurysm of coronary artery.


Coronary angiogram done from 2010 demonstrating 2 aneuryms in the right coronary artery.


Coronary angiogram done in 2008 demonstrating aneurysms in the Right coronary artery.


Abdominal and pelvic non-contrast CT revealing a 36 x 31-mm, well-demarcated, ellipsoid and hypodense mass with a CT value of about 27 Hounsfield units (HU) in the external branch of the right adrenal region. Hypodense lesions with a diameter of 15 mm.


Abdominal and pelvic non-contrast CT revealing a 36 x 31-mm, well-demarcated, ellipsoid and hypodense mass with a CT value of about 27 Hounsfield units (HU) in the external branch of the right adrenal region. 39 mm discovered in the upper.


Abdominal and pelvic non-contrast CT revealing a 36 x 31-mm, well-demarcated, ellipsoid and hypodense mass with a CT value of about 27 Hounsfield units (HU) in the external branch of the right adrenal region. Lower. Poles of the right kidney, respectively.


Abdominal and pelvic non-contrast CT revealing a 36 x 31-mm, well-demarcated, ellipsoid and hypodense mass with a CT value of about 27 Hounsfield units (HU) in the external branch of the right adrenal region. Non-contract CT of the chest suggesting lung metastasis: multiple nodules in both lungs, the largest one being located in middle lobe of the right lung (D).


TTE revealing a 23.9 x 13.4-mm, hyperechoic mass with a smooth surface in the left atrium, close to the posterior leaflet of the mitral valve, and moving without extension to the outflow tract during the cardiac cycle; the mass was suspected to be a myxoma (A).


Repeat TTE showing a 27.7 x 16-mm isoechoic mass attached to the posterior leaflet annulus of the mitral valve in the enlarged left atrium (B).


Immunohistochemical staining showing positivity for CAIX, CD10, and Vimentin. (A) CAIX (x200).


Immunohistochemical staining showing positivity for CAIX, CD10, and Vimentin. (B) CD10 (x200).


Immunohistochemical staining showing positivity for CAIX, CD10, and Vimentin. (C) Vimentin (x200).


Immunohistochemical staining showing positivity for CAIX, CD10, and Vimentin. (D) Histological examination of the tumor using Hematoxylin & Eosin stain.


Genetic results for case 2.


ECG shows concave ST elevation over lead I, II, V2, V5 and V6.


CT Brain shows subacute infarct of right corona radiata.


Penal A and B show the diastolic and systolic phase of ventriculogram which showing ventricular apical ballooning.


Case 1. (A) Digital subtraction angiography (DSA) oblique view demonstrating small unruptured aneurysm (red arrow) in the transition between the cavernous and clinoidal segments of the right internal carotid artery (ICA).


Case 1. (B) Intraoperative photograph of direct injection of fibrin glue into the cavernous sinus posterior to the ICA.


Case 1. Indocyanine green (ICG) videoangiography demonstrating patency of the right ICA, darkened by the presence of atheroma in the center of the vessel, and ,patency of the right posterior communicating artery (PCoA).


Case 1. Companion intraoperative photograph.


Case 1. Postoperative axial computed tomography angiography (CTA).


Case 1. 3-dimensional CTA, superior skull base view, obtained 2 h after surgery, demonstrating complete occlusion of the right ICA.


Case 1. (G) Postoperative oblique-lateral DSA after several thrombectomies showing patency of the right ICA and contrast stagnation caused by poor collateral flow. Used with permission from Henan Provincial People's Hospital, Juha Hernesniemi International Center for Neurosurgery.


Case 2. Intraoperative photographs demonstrating. Direct injection of fibrin glue into the cavernous sinus.


Case 2. Subsequent visualization of the patent internal carotid artery (ICA) during resection.


Case 2. 90 min later, the thrombosed middle cerebral artery, which has turned blue.


Case 2. (D) Postoperative posteroanterior angiography via the right common carotid artery demonstrating occlusion of the distal ICA.


Case 2. (E) Postoperative axial computed tomography of the head after decompressive hemicraniectomy and resection of ischemic territory. Used with permission from Barrow Neurological Institute, Phoenix, Arizona.


(a) Diastolic flow from the pulmonary trunk directed upward.


(b) Pulsed-wave Doppler confirming typical coronary flow pattern.


(c) Coronary-pulmonary fistula from the mid segment of the left anterior descending coronary artery (arrow).


(d) Coronary-pulmonary fistula from the right coronary artery (arrow).


Right ventricular systolic phase.


Right ventricular diastolic phase.


Left ventricular systolic phase.


Left ventricular diastolic phase.


A 76-year-old man with dyspnea subsequently diagnosed with coronary artery disease. Coronary computed tomography (CT) angiography curved multiprojection reconstructions of the right (right coronary artery), the left anterior descending, the left circumflex, and the left main coronary arteries as well as the ramus. Red arrow: Coronary stenosis; blue arrow: CT-derived fractional flow reserve reading [cf. Figure 2].