Immunocytochemical localization of muscarinic receptors as an autoantigen in heart tissue

Juvenile pulmonary hypertension associated with fibromuscular dysplasia

A 20-year-old female diagnosed as idiopathic pulmonary arterial hypertension at 7 years of age was referred with worsening dyspnea and chest pain. Several imaging studies and right cardiac catheterization showed multiple stenoses in the peripheral pulmonary arteries with severe pulmonary hypertension and multiple systemic arterial stenoses lacking in systemic hypertension. No evidence of inflammatory or autoimmune disease was detected. Fibromuscular dysplasia was clinically diagnosed because of the narrowed systemic and pulmonary arterial stenoses which included dilatation and aneurysms that appeared similar to a string of beads. Treatment with sildenafil yielded a temporary improvement in her disease state.

Multi-detector row CT of hemoptysis

Hemoptysis is symptomatic of a potentially life-threatening condition and warrants urgent and comprehensive evaluation of the lung parenchyma, airways, and thoracic vasculature. Multi-detector row computed tomographic (CT) angiography is a very useful noninvasive imaging modality for initial assessment of hemoptysis. The combined use of thin-section axial scans and more complex reformatted images allows clear depiction of the origins and trajectories of abnormally dilated systemic arteries that may be the source of hemorrhage and that may require embolization. Conditions such as bronchiectasis, chronic bronchitis, lung malignancy, tuberculosis, and chronic fungal infection are some of the most common underlying causes of hemoptysis and are easily detected with CT. "Cryptogenic" hemoptysis is common among smokers and warrants subsequent follow-up imaging to exclude possible underlying malignancy. The bronchial arteries are the source of bleeding in most cases of hemoptysis. Contributions from the non-bronchial systemic arterial system represent an important cause of recurrent hemoptysis following apparently successful bronchial artery embolization. Vascular anomalies such as pulmonary arteriovenous malformations and bronchial artery aneurysms are other important causes of hemoptysis. Multi-detector row CT angiography permits noninvasive, rapid, and accurate assessment of the cause and consequences of hemorrhage into the airways and helps guide subsequent management.

Pulmonary infarction as the initial manifestation of Takayasu's arteritis

A 50-year-old woman reporting sudden-onset chest pain was diagnosed as having pulmonary infarction associated with Takayasus arteritis. She had experienced moderate malaise and cough for 3 months. Computed tomography (CT) and magnetic resonance imaging (MRI) showed wedge-shaped infiltrative shadows typical of pulmonary infarction in the right lung. Although pulmonary artery involvement in Takayasus arteritis is well documented, most patients show only signs of mild to moderate pulmonary hypertension. Few reports discuss patients with symptoms due to pulmonary infarction as the initial manifestation. Takayasus arteritis should therefore be considered a differential diagnosis in pulmonary infarction.