Adriamycin cardiomyopathy with congestive heart failure, cardiogenic shock and emergency heart transplant: 30-year follow up

Doxorubicin chemotherapeutic agent is widely utilized for many types of cancers since the late 1960s. Cardiomyopathy is a well-known side effect of doxorubicin often limiting its use. In many cases doxorubicin cardiomyopathy can lead to end stage cardiac failure requiring heart transplantation. The quality of life of heart transplant patients is exceptional with most patients being able to continue normal activities following recovery. There has been significant advancement in cardiac transplantation since it was first attempted in 1967 in Cape Town, South Africa. Drugs such as cyclosporine played an important role in preventing graft failure and prolonging patient survival. Cardiac transplant can extend a patients’ life by over a decade. The patient in this case, Mr. Glen Frank Spurling, has survived 30 years following his cardiac transplant surgery. In this article an overview of doxorubicin cardiotoxicity, cardiac transplantation, and an interview with Mr. Glen Frank Spurling is presented

Diagnosis Using CCTA and Management of Anomalous Right Coronary Artery from the Opposite Sinus

Coronary anomalies can be observed in 1–1.2% of all angiograms performed. Majority of coronary anomalies are benign and do not lead to cardiac ischemia; however anomalous coronary arteries from the opposite sinus (ACAOS) are often associated with sudden cardiac deaths, typically in 0.11–0.35% of individuals who participate in vigorous physical activity (Peñalver et al., 2012). Left and right ACAOS have an incidence of 0.15% and 0.92%, respectively. Left ACAOS are often associated with higher incidence of sudden cardiac death; this could be secondary to greater territory of myocardial perfusion by the left coronary artery. ACAOS are often asymptomatic and initially present as sudden death following exertion in young athletes. The management of left ACAOS is clear and surgery is usually indicated. However there is a lack of consensus on the management of certain cases of right ACAOS. In this paper a case of 20 yo M with right coronary artery from left sinus is going to be presented with a discussion on pathophysiology, diagnosis, and management