Stenting of the superior vena cava and right pulmonary artery in a woman with a mediastinal mass and acute respiratory distress syndrome (ARDS)

The Chest Pain That Never Went Away: A Case of Complex Cardiopulmonary Pathologies in a 64-Year-Old Caucasian Male

Chest pain is a common and complex symptom that can arise from various etiologies, ranging from benign musculoskeletal conditions to life-threatening cardiovascular events. It is a hallmark symptom of myocardial infarction, angina, and other ischemic heart diseases, necessitating prompt and thorough evaluation. Ongoing chest pain post-procedures and medication administration presents a diagnostic challenge, as it may be indicative of an exacerbation of underlying conditions. We present the case of a 64-year-old Caucasian male who initially presented with severe and persistent chest pain suggestive of an anterior wall ST-elevation myocardial infarction (STEMI). He had a history of coronary artery disease and had recently undergone cardiac catheterization. Despite prompt administration of nitroglycerin and aspirin, the patient's symptoms persisted, prompting emergent percutaneous coronary intervention (PCI). Subsequent to PCI, ongoing chest discomfort persisted, prompting further investigation, which revealed a concurrent lung mass and nodules on imaging. Additional interventions, including repeated PCI procedures and thoracentesis, were undertaken. Unfortunately, the patient's clinical course rapidly deteriorated, culminating in cardiac arrest and unsuccessful resuscitative efforts. This case highlights the complexities inherent in managing intricate cardiovascular conditions and emphasizes the critical importance of maintaining vigilance for concomitant pathologies.

An Undifferentiated Primary Mediastinal Carcinoma Compressing the Main Pulmonary Artery: A Rare Cause of Right Ventricular Strain

Undifferentiated carcinoma (or poorly differentiated carcinoma) of the mediastinum is a relatively rare pathological variant of anterior mediastinal tumors. Pathologists usually use the term to describe an epithelial tumor with no histological features that enable the identification of its site of origin. Invasion of adjacent vital cardiopulmonary structures is among the most problematic complications of anterior mediastinal masses. We report a case of a 60-year-old male presenting with easy fatiguability, significant weight loss, and chest pain. A CT scan of the chest revealed a large anterior mediastinal mass, compression of the main pulmonary artery, and a large pericardial effusion. The patient underwent pericardiocentesis, emergent radiotherapy, and platinum-based chemotherapy. His condition dramatically improved, and he was subsequently discharged home for further follow-up.

Endovascular treatment of pulmonary artery aneurysm: Single case experience

A peripheral pulmonary artery aneurysm (PAA) is a dilatation involving all 3-vessel wall layers (the intima, media, and adventitia) of a distal pulmonary artery. It represents a rare but potentially life-threatening condition. There are only some reviews of transcatheter embolization of unruptured idiopathic peripheral PAAs. Association with cardiac diseases, infections, vascular anomalies, pulmonary hypertension, and vasculitis has been noted. We report a case of a 38-year-old woman, with a history of third-degree atrioventricular (AV) block, treated with pacemaker placement, who presented a PAA in the left pulmonary lobe. Transcatheter coil embolization was performed, using a triple coaxial catheter system (a 6F outer, a 5F intermediate, and a 2.4F inner catheter) to prevent rupture and the aneurysm was successfully embolized. Although there is no consensus on the treatment for unruptured idiopathic peripheral PAAs, transcatheter embolization may be a promising treatment option.