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We describe a case of a mass‐like echocardiographic density on a mechanical prosthetic aortic valve. We initially suspected a thrombus vs vegetation on transthoracic echocardiography, but after transesophageal echocardiography, the density was subsequently determined to be cavitation by reviewing the initial images in slow motion. [ABSTRACT FROM AUTHOR]

Aims von Willebrand factor ( VWF) is an independent risk factor for adverse events in patients with non-valvular atrial fibrillation ( NVAF). However, it is unclear if VWF level remains elevated and predictive of stroke during entire course of NVAF. Methods and Results In order to determine if VWF is a time-dependent blood variable, VWF antigen measured by latex immunoassay in 425 NVAF patients and 100 controls with normal sinus rhythm ( NSR) was analyzed according to NVAF duration (<1 month: n = 76, 1-12 months: n = 98, and >12 months: n = 251). The mean VWF antigen level in NVAF patients with <1-month duration (167 ± 59%) was not different compared to those with 1-12 months (157 ± 50%, P = .24) and >12 months duration (156 ± 54%, P = .11) but higher compared to NSR controls (143 ± 48%, P = .003). Higher VWF level correlated with higher CHADS2 scores and with progressing intensity of blood stasis in the left atrium and thrombus formation in all three time periods of atrial fibrillation duration. Patients not treated with warfarin had VWF 30% higher in the first month compared to following months. Conclusions von Willebrand Factor is steadily elevated throughout the course of dysrhythmia in NVAF patients treated with warfarin and in those with higher intensity of left atrium blood stasis. [ABSTRACT FROM AUTHOR]

Among patients undergoing cardioversion for atrial fibrillation, the presence of left ventricular thrombus is a relatively uncommon and challenging clinical dilemma. While left atrial appendage thrombus is a contraindication to cardioversion, there is paucity of data regarding the safety of cardioversion in with the presence of left ventricular apical thrombus. Also, thrombus characteristics such as protrusion and mobility on echocardiography are known risk factors for systemic embolism. In this article, we present a case highlighting the management of atrial fibrillation in the setting of left ventricular dysfunction, acute heart failure, and echocardiographic evidence of acute left ventricular apical thrombus. [ABSTRACT FROM AUTHOR]

The article presents a case study of a 41-year-old woman with premature coronary artery disease and was presented with a non-ST elevation myocardial infarction. Particular focus is given to the placement of an Impella CP left ventricular (LV) assist device in the patient through the right femoral artery to achieve hemodynamic stability for nitrate administration. Also discussed is the utilization of a snare for removal of an Impella device that has entangled around a LV papillary muscle.