記述言語：英語   掲載種別：研究論文（学術雑誌）  

DOI： 10.1097/MCA.0000000000001654

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記述言語：英語   掲載種別：研究論文（学術雑誌）  

Spontaneous coronary artery dissection (SCAD) is an important non-atherosclerotic cause of acute coronary syndrome, predominantly affecting younger women without traditional cardiovascular risk factors. In hemodynamically stable patients, accumulating evidence supports a conservative management strategy owing to the high rate of spontaneous vessel healing, while technically challenging invasive interventions should be reserved for selected high-risk cases. Despite growing evidence regarding acute management, recurrent SCAD and other adverse cardiovascular events have been reported during follow-up, underscoring the need for surveillance. However, optimal strategies for post-acute follow-up and for assessing the appropriateness of treatment decisions remain insufficiently established. This review focuses on clinical decision-making in the management of SCAD, with particular emphasis on follow-up assessment. We summarize the existing evidence regarding indications for conservative versus invasive treatment and discuss the clinical rationale for longitudinal imaging surveillance. Special attention is given to the role of non-invasive follow-up using coronary computed tomography angiography, including confirmation of vessel healing, evaluation of residual intramural hematoma, and assessment of distal coronary flow. Given the heterogeneity of SCAD and the risk of recurrence, individualized treatment decisions and structured follow-up strategies are essential to optimize management, avoid unnecessary invasive procedures, and support care and risk stratification in patients with SCAD.

DOI： 10.3390/jcdd13050190

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記述言語：英語   掲載種別：研究論文（学術雑誌）  

DOI： 10.1097/MCA.0000000000001559

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記述言語：英語   掲載種別：研究論文（学術雑誌）  

BACKGROUND: Primary cardiac myxofibrosarcoma is an exceptionally rare malignant tumour, often asymptomatic until local invasion or distant metastasis occurs. Early diagnosis is challenging, and the prognosis is generally poor owing to high local recurrence and metastasis rates. CASE SUMMARY: We report the case of a 79-year-old woman who presented with neurological symptoms and multiple brain metastases. Imaging showed a broad-based exophytic mass obstructing the left pulmonary vein and extending into the left atrium. Surgical resection was conducted, and the diagnosis of myxofibrosarcoma was confirmed from histology. Despite surgery, the tumour recurred locally within days, and the brain metastases progressed. Considering the patient's deteriorating condition, no further treatment was initiated. She was then transferred to hospice care and died shortly thereafter. DISCUSSION: Primary cardiac myxofibrosarcoma is an extremely rare malignancy with non-specific symptoms and poor prognosis owing to its aggressive biological behaviour. In this case, multimodal imaging showed features suggestive of malignancy, including an exophytic mass with a broad attachment base and heterogeneous signal intensity. Despite surgical resection, the tumour recurred rapidly, and brain metastases progressed. The tumour size, high histological grade, and delayed intervention are likely to contribute to poor clinical outcomes. Owing to their rarity, there are no standardized treatment guidelines for primary cardiac sarcomas. In this case, we reconfirmed the high-grade malignancy of the cardiac sarcoma through multiple computerized tomography scans conducted over a short period. Currently, the only method for prompt evaluation using multiple imaging modalities involves early surgical resection combined with adjuvant therapy to improve clinical outcomes.

DOI： 10.1093/ehjcr/ytaf447

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記述言語：英語   掲載種別：研究論文（学術雑誌）  

DOI： 10.26599/1671-5411.2025.02.002

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