We report a case of a 21-year-old male with stage IIIB sigmoid colon adenocarcinoma who experienced atypical chest pain post-adjuvant chemotherapy with Capecitabine (5-FU prodrug). Evaluation revealed an unexpectedly detected interventricular septum hemangioma. Due to the vasospasm effect of chemotherapy presenting with semi-ischemia, conservative management was chosen for atypical presentation.

BACKGROUND: Sinus of Valsalva aneurysm (SVA) is an extremely rare condition, and its rupture causes acute symptoms such as chest pain and dyspnea. Ruptured SVA is frequently associated with other congenital defects.
METHODS: A 37-year-old male presented with SVA originating from the left coronary sinus that ruptured into the interventricular septum. SVA was diagnosed by echocardiography, cardiac computed tomography and magnetic resonance imaging, and confirmed during the operation.
CONCLUSIONS: SVA is a rare cardiac abnormality which can lead to severe clinical symptoms upon rupture. Immediate surgery is necessary to repair the ruptured SVA.

OBJECTIVE: To demonstrate possible functional changes in the frequently affected fetal interventricular septum (IVS) with spectral tissue Doppler imaging (TDI) and M-mode imaging to compare gestational diabetes mellitus (GDM) and control groups.
METHODS: A total of 63 pregnant women with GDM, 30 on diet (A1 GDM) and 33 on treated with insulin (A2 GDM), and 63 healthy pregnant women randomly selected and matched to the case group in the control group were included.
RESULTS: The GDM fetuses had significantly thickened IVS, increased early diastole (E\'), atrial contraction (A\'), systole (S\'), higher myocardial performance index (MPI\'), prolonged isovolumetric relaxation time (IVRT\'), shortened ejection time (ET\'), and decreased septal annular plane systolic excursion (SAPSE) than the controls. The A2 GDM group fetuses had significantly thickened IVS, increased S\' and shortened ET\' than the A1 GDM group. In the GDM group, we found a significantly positive low correlation between glycated hemoglobin levels and maternal serum fasting glucose and one-hour postprandial glucose with fetal IVS thickness. We demonstrated a significantly negative low correlation between maternal serum one-hour postprandial glucose, glycated hemoglobin levels, and gestational weight gain with fetal IVS ET\'.
CONCLUSIONS: Fetal IVS diastolic and systolic functions were altered in the GDM group compared to controls, and systolic functions were altered in A2 GDM compared to A1 GDM. This may alert clinicians to possible cardiovascular diseases in the postnatal life, and early preventive strategies and long-term lifestyle changes may provide protection in fetuses with GDM.

UNASSIGNED: Cardiac hydatidosis is a relatively rare complication of echinococcosis. Understanding the atypical manifestations, potential associated risk factors, and epidemiology leads to optimal and timely management.
UNASSIGNED: Cardiac hydatidosis is a relatively rare complication of echinococcosis, with a potentially life-threatening condition. Here, we reported a large interventricular septal hydatid cyst bulging in the left ventricle accompanied by a huge cervical lamp with recurrent hepatic cysts that underwent cardiac surgery to excise the cyst uneventfully.

BACKGROUND: Human hydatid disease occurs after infection with Echinococcus granulosus, mainly involves liver and lung, while hydatid involves heart is infrequent. A great majority of hydatid diseases could be asymptomatic, and incidentally found through examination. Here, we reported a woman who suffered an isolated cardiac hydatid cyst located at the interventricular septum.
METHODS: A 48-year-old woman presented intermittent chest pain was admitted to the hospital. Imaging examination revealed a cyst located at the interventricular septum near the right ventricular apex. Considering medical history, radiological findings and serological results, cardiac hydatid disease was suspected. The cyst was successfully removed, while pathological biopsy confirmed the diagnosis of infection of Echinococcus granulosus. Postoperative course was uneventful, the patient was discharged from hospital without complications.
CONCLUSIONS: For symptomatic cardiac hydatid cyst, surgical resection is necessary to avoid progression of disease. During surgical procedure, appropriate methods to reduce the potential risk of hydatid cyst metastasis are essential. Besides surgery, combined with regular drug therapy is an effective strategy to prevent reappearance.

Left bundle branch pacing (LBBP) has been widely adopted as a physiological pacing approach. However, LBBP fails to achieve in some cases because it is difficult to maintain the orientation of the lead tip perpendicular to the interventricular septum (IVS). Three-dimensional (3D) printing technology has emerged as a promising tool for modeling and teaching cardiovascular interventions. Seeking confirmation of optimal lead placement relative to the IVS, we used 3D printing technology to generate a 3D printed heart from a selected patient with successful and proven LBBP. Our model successfully illustrated that the lead tip was perpendicular to the IVS. Application of the 3D technology has potential to help the early-operator understand the optimal lead placement relative to IVS and diminish the learning-curve.

Cardiac amyloidosis presented with normal interventricular septum is an extremely rare entity, and diagnosis may be difficult. This report discusses a 44-year-old female who presented with worsening dyspnoea on exertion, orthopnoea, and lower-extremity oedema. Electrocardiogram depicted low voltage in limb leads and a pseudoinfarct pattern. Echocardiogram revealed biatrial dilatation without changes of ventricular chambers and restrictive filling physiology. A diagnosis of cardiac amyloidosis was considered. Cardiac MRI was pursued, showing delayed gadolinium enhancement, and this ultimately led to the myocardial biopsy confirming the diagnosis of cardiac amyloidosis. The case suggests that patients who present with heart failure of uncertain aetiology, amyloidosis could be a cause of cardiomyopathy despite the absence of \"classical\" echocardiographic features of amyloid deposition such as an increased interventricular septum thickness or\"brilliant sparkled\"appearance of the myocardium.

Hydatid disease is a parasitic infection caused by Echinococcus granulosus. Cardiac involvement is rare especially without liver and lungs tissue involvement. We describe a 12-year-old male patient referred to Mofid Children\'s Hospital, Tehran, Iran in Jul 2020 due to chronic pericardial effusion and suspected tuberculosis infection from Afghanistan. Echocardiography revealed a cystic lesion in the interventricular septum. Thoracic and abdominal computed tomography showed no similar cystic lesion in the lungs and liver. The patient underwent open-heart surgery for cystectomy and medical treatment with albendazole. Histological examination confirmed hydatid cyst diagnosis. The patient was discharged in good condition and oral albendazole was continued.

Myocarditis can cause ventricular wall thickening due to myocardial edema. If the condition improves, the ventricular wall thickening should gradually decrease; a persistent thickening of the patient\'s ventricular wall indicates the coexistence of hypertrophic cardiomyopathy (HCM) and myocarditis. A 30-year-old man was referred to our hospital with continuous chest pain accompanied by profuse sweating. He suffered from fever for two days (the maximum body temperature: 38 °C) and the conditions improved following the use of antipyretics as self-administered medication before admission. Electrocardiogram exhibited ST-segment elevation in leads I and avL, and ST-T wave changes in leads II, III, avF, and V1-V6. Marked elevation of cardiac troponin I was found on laboratory testing. Respiratory tract infection testing showed negative results. A TORCH screen revealed positive herpes simplex virus (HSV), rubella virus (RV), and cytomegalovirus (CMV) IgG but all with negative IgM titer. Ultrasonic echocardiography showed thickness of the interventricular septum (17 mm) and diffuse left ventricular (LV) hypokinesia, without LV outflow tract obstruction. After consultation with the cardiology team, a diagnosis of myocarditis with HCM was made. Patients with myocarditis should be alerted to the possibility of HCM when there is persistent ventricular wall thickening.

A 70-year-old woman with symptomatic bradycardia caused by persistent atrial fibrillation and atrioventricular block was referred to our institution for pacemaker implantation. After we failed to obtain adequate His bundle capture thresholds (>2.5 V at 1.0 ms) at three pacing sites, left bundle branch pacing was attempted as an alternative technique. The tip of the 3830 lead was screwed towards the left side of the interventricular septum. Contrast medium was injected through the C315 sheath, which was placed close to the right side of the interventricular septum to determine the exact depth of the 3830 lead inside the septum. Unexpectedly, the vessels in the interventricular septum were revealed by the contrast, which showed that the lead had penetrated one of the septal vessels. To the best of our knowledge, this is the first reported case of a patient in whom injection of a contrast agent through a delivery sheath showed damage to the interventricular septal vessels. Findings from this case suggest that injection of contrast medium through a C315 sheath that is placed close to the interventricular septum is a potential method for excluding damage to interventricular septal vessels.