Another new one for me.
Young body builder with large muscle mass and supplement use.

Kidney Biopsy:
Focal and segmental glomerulosclerosis (FSGS)
+
Many platelet thrombi within glomerular capillary loops, rupturing the capillary walls and extending into Bowman’s space. microscopy)

Thrombi = likely related to supplements.

This is a 24-year-old man presenting with rise in creatinine (1.8) and minimal proteinuria.

Welcome to our OCTOBER 28 issue of #JACCCaseReports @JACCJournals
jacc.org/journal/case-r….

Full PDF here:
jacc.org/doi/10.1016/S2…

@minnowalsh
@hmkyale

Coronary Peripheral and Structural Interventions:
Extraction of Protruding Ostial Stents to Enable Percutaneous Coronary Interventions: The EXPOSE Technique
jacc.org/doi/10.1016/j.…

The RASE Technique for Extraction of a Protruding Aorto-Ostial Coronary Stent
jacc.org/doi/10.1016/j.…

Aorto-Ostial Stenting: Dealing With the Illusion of Precision
jacc.org/doi/10.1016/j.…

Anomalous Retro-Aortic Left Circumflex Artery Identified During Transcatheter Patent Foramen Ovale Closure: Procedural Implications
jacc.org/doi/10.1016/j.…

Look Before You Leap?: Coronary Assessment Before PFO and ASD Device Closure
jacc.org/doi/10.1016/j.…

Inoperable Retroatrial Hematoma Causing Shock After PCI: A Life-Saving Epicardial Bailout
jacc.org/doi/10.1016/j.…

Percutaneous Thrombectomy of a Thrombus in Transit Through a Patent Foramen Ovale: A Novel Approach
jacc.org/doi/10.1016/j.…

Improvement in Recurrent Ascites From Multilevel Venous Obstruction With Transcatheter Caval and Iliac Vein Recanalization
jacc.org/doi/10.1016/j.…

IVUS-Guided Exclusion of Right Coronary Artery Aneurysm in Multivessel Coronary Artery Disease Using Hybrid Stenting
jacc.org/doi/10.1016/j.…

Multivessel Spontaneous Coronary Artery Dissection in Non-ST-Segment Elevation Myocardial Infarction: Compassion Instead of Stenting
jacc.org/doi/10.1016/j.…

Caseous Peripheral Medial Arterial Calcification With Inflammation and Luminal Occlusion
jacc.org/doi/10.1016/j.…

Successful Mechanical Thrombectomy Using a Stent-Retriever Device for STEMI of the Left Main Coronary Artery
jacc.org/doi/10.1016/j.…

Acute Coronary Syndrome After High-Voltage Electrocution: A Shocking Diagnosis
jacc.org/doi/10.1016/j.…

Seventy Seconds of Asystole: Delayed Atrioventricular Block Post-TAVR From His-Bundle Injury and Phase 4 Block
jacc.org/doi/10.1016/j.…

Renal Denervation for Uncontrolled Hypertension in a Patient With Mast Cell Activation Syndrome
jacc.org/doi/10.1016/j.…

A2VF Technique: Venous-Puncture–Free Foot Arteriovenous Fistula Creation in Chronic Limb-Threatening Ischemia
jacc.org/doi/10.1016/j.…

Superficial Femoral Artery Stent Fracture With Pseudoaneurysm Evaluated by Angioscopy
jacc.org/doi/10.1016/j.…

Transjugular Patent Foramen Ovale Closure in the Setting of Inferior Vena Cava Interruption
jacc.org/doi/10.1016/j.…

Rhythm Disorders and Electrophysiology:
Acute Postcardioversion Left Atrial Appendage Stasis During Left Atrial Appendage Closure Procedures
jacc.org/doi/10.1016/j.…

Should We Pay More Attention to Left Atrial Appendage Physiology During Rhythm Restoration?
jacc.org/doi/10.1016/j.…

Immediate Cardioversion During Left Atrial Appendage Occlusion in Three Patients With Left Atrial Appendage Thrombus
jacc.org/doi/10.1016/j.…

Malignant Arrhythmias Caused by Pericardial Lipomas: Benign, Yet Deadly
jacc.org/doi/10.1016/j.…

Fluoroless PVC Ablation Via the Internal Jugular Vein in Interrupted Inferior Vena Cava
jacc.org/doi/10.1016/j.…

Choosing the Best Route: Arrhythmia Transcatheter Ablation in Patients With Interruption of Inferior Vena Cava
jacc.org/doi/10.1016/j.…

Recurrent Torsades de Pointes Precipitated by Berberine Supplement
jacc.org/doi/10.1016/j.…

Subacute Apical RV Lead Microperforation in CRT Implantation: An Electrical Diagnosis
jacc.org/doi/10.1016/j.…

Utility of Small Dose Pilsicainide in Suppressing Atrial Fibrillation and Inducing a Target Slow-Fast AVNRT
jacc.org/doi/10.1016/j.…

Bradycardia-Dependent Loss of Atrial Capture After Single-Chamber Leadless Atrial Pacemaker Implantation
jacc.org/doi/10.1016/j.…

Hemophagocytic Lymphohistiocytosis Complicated With Reversible Cardiomyopathy and Severe Sinus Node Dysfunction
jacc.org/doi/10.1016/j.…

V-on-A Tachycardia Misclassified as Ventricular Tachycardia by Atrial Blanking: A 4-Question Electrogram Approach
jacc.org/doi/10.1016/j.…

Retrieving Dislodged Leadless Pacemaker With Percutaneous Coronary Angioplasty Balloon-Assisted Snaring: A Novel Technique
jacc.org/doi/10.1016/j.…

Contrast-Free Dual-Chamber Leadless Pacemaker Implantation Using Intracardiac Echocardiography and 3-Dimensional Electroanatomical Mapping
jacc.org/doi/10.1016/j.…

No Leads, No Dye, No Problem?
jacc.org/doi/10.1016/j.…

Loss of Biventricular Capture After CRT-D Implantation: Device Malfunction or Something Else?
jacc.org/doi/10.1016/j.…

A Curious Change in QRS Width: Timing Is Everything
jacc.org/doi/10.1016/j.…

Heart Failure and Cardiomyopathies:
Chagas Cardiomyopathy: New-Onset Biventricular Failure and Refractory Ventricular Arrhythmias
jacc.org/doi/10.1016/j.…

Septal Myocarditis Mimicking Proximal Left Anterior Descending Artery Occlusion
jacc.org/doi/10.1016/j.…

Depressed LV Contractility as a Sentinel of Fulminant Systemic Scleroderma
jacc.org/doi/10.1016/j.…

Fall of the Titans: Anabolic-Androgenic Steroid Use in a Patient With a TTN Truncating Variant
jacc.org/doi/10.1016/j.…

Microaxial Flow Pump and Ivabradine for Tachycardia-Induced Cardiogenic Shock Caused by Automatic Atrial Tachycardia
jacc.org/doi/10.1016/j.…

Critical Care Cardiology: Key Tenets of Clinical Management
jacc.org/doi/10.1016/j.…

Improving Iron Deficiency Screening in Veterans With Heart Failure
jacc.org/doi/10.1016/j.…

Congenital Heart Disease:
Transcatheter Superior SVASD With PAPVR Repair Using Custom 8-cm Covered Stent and Superior Locking Technique
jacc.org/doi/10.1016/j.…

Left Bundle Branch Area Pacing in Repaired Tetralogy of Fallot Evaluated by Advanced Echo Parameters
jacc.org/doi/10.1016/j.…

Staged Biventricular Conversion in an Older Adolescent Patient With a Hypoplastic Left Ventricle
jacc.org/doi/10.1016/j.…

Left Ventricle Hypoplasia in an Adolescent Patient
jacc.org/doi/10.1016/j.…

Adolescent Survival in Thoracoabdominal Ectopia Cordis With Complex Single Ventricle Physiology and Complete Atrioventricular Block
jacc.org/doi/10.1016/j.…

@NAkhterMD
@aroniskn
@CraigBasman
@JACabreraCardio
@MiChen__
@aabha_divya
@MarcEngels7
@sarano_maurice
@Miho_Fukui_
@CardioOncCO
@MMarinCuartas
@Nishaki1
@ChrissyMD2000
@ACHDocTMoe
@PanjrathG
@jsaef1
@Kentso987
@TagliariPaula
@m_taramasso
@SyedZaidMD

@JACCJournalsQ@hmkyalePublishing and Peer Review: A Roadmap for Cardiovascular Team Members
jacc.org/doi/10.1016/j.…jacc.org/doi/10.1016/j.…trial Pacemaker Performance Through Strategic Reprogramming: A Quality Improvement Initiative
jacc.org/doi/10.1016/j.…jacc.org/doi/10.1016/j.… the Rate-Limiting Step: Normalizing Value-Based Care Teams to Address CKM Treatment Gaps
jacc.org/doi/10.1016/j.…

Vascular Medicine:
Hemodynamic Insights Into an Accessory Splenic Artery Aneurysm Arising From the Superior Mesenteric Artery
jacc.org/doi/10.1016/j.…

Timely Carotid Revascularization to Prevent Stroke After Left Common Carotid Artery Occlusion During TEVAR
jacc.org/doi/10.1016/j.…

Chimney Rescue for Inadvertent Carotid Occlusion During TEVAR: When Minutes and Preparedness Define the Outcome
jacc.org/doi/10.1016/j.…

Retrograde Collateral Crossing Through Riolan's Arcade With Femoral Antegrade Reconstruction After Traction During Upper-Extremity Externalization
jacc.org/doi/10.1016/j.…

Genetics Omics and Tissue Regeneration:
Cardiac-Predominant Fukutinopathy Caused by Novel Compound Heterozygous FKTN Variants: A Diagnostic and Genetic Odyssey
jacc.org/doi/10.1016/j.…

Fulminant Biventricular Desmoplakin Cardiomyopathy With a Myocarditis-Like Presentation
jacc.org/doi/10.1016/j.…

Cardio-Oncology:
Disseminated HIV-Associated Burkitt Lymphoma With Cardiac and Presumed Central Nervous System Involvement
jacc.org/doi/10.1016/j.…

Primary Cardiac Undifferentiated Pleomorphic Sarcoma Presenting as Obstructive Shock: Multimodality Imaging Guides Management
jacc.org/doi/10.1016/j.…

Recurrent Multifocal Cardiac Myxomas With Multiterritorial Embolization: Unmasking Carney Complex
jacc.org/doi/10.1016/j.…

Carney Complex: When Surgical Excision Is Not the End of the Story
jacc.org/doi/10.1016/j.…

Cardiometabolic:
Sudden Cardiac Arrest as Initial Presentation of Familial Combined Hyperlipidemia in a Young Adult
jacc.org/doi/10.1016/j.…

Autosomal Recessive Hypercholesterolemia Due to a Novel Homozygous LDLRAP1 Frameshift Mutation
jacc.org/doi/10.1016/j.…

Ischemic Heart Disease:
Diffuse Alveolar Hemorrhage After Streptokinase Thrombolysis in ST-Segment Elevation Myocardial Infarction: A 2-Patient Case Series
jacc.org/doi/10.1016/j.…

Acute Anterior ST-Segment Elevation Myocardial Infarction Due to Left Atrial Myxoma Embolization
jacc.org/doi/10.1016/j.…

Cardio-Oncology:
Beyond Benign Histology of Cardiac Myxomas
jacc.org/doi/10.1016/j.…

Critical Care and Resuscitation:
Not All Shocks Are Created Equal: Refractory Cardiogenic Shock Unmasking Panhypopituitarism Following Acute Coronary Syndrome
jacc.org/doi/10.1016/j.…

Right Ventricular–Protective Strategies in Pulmonary Embolism With Cardiopulmonary Failure: Prone Positioning and Mechanical Ventilation
jacc.org/doi/10.1016/j.…

Imaging:
Dissecting the Origins of an Incidental Aortic Pseudoaneurysm: A Case Report and Literature Review
jacc.org/doi/10.1016/j.…

Role of Lifelong Surveillance After Acute Type A Dissection Repair: The Long Shadow of Repair
jacc.org/doi/10.1016/j.…

Cerebrovascular Disease and Stroke:
Paradoxical Stroke via Persistent Levoatriocardinal Vein and Evaluation and Management Recommendations
jacc.org/doi/10.1016/j.…

Hypertension:
Sports Nephrology: Managing Hypertension, Acute Kidney Injury, and Cardiovascular Risk in a Collegiate Football Player
jacc.org/doi/10.1016/j.…

Valvular Heart Disease:
Transcatheter Edge-to-Edge Mitral Valve Repair for Severe Degenerative Mitral Regurgitation With Coexisting Cor Triatriatum Sinistrum
jacc.org/doi/10.1016/j.…

When Transcatheter Mitral Repair Meets Cor Triatriatum Sinistrum
jacc.org/doi/10.1016/j.…

Health Promotion and Preventive Cardiology:
Early Coronary Atherosclerosis in Homozygous Familial Hypercholesterolemia: The Importance of Aggressive Lipid Lowering
jacc.org/doi/10.1016/j.…

Reducing LDL-Cholesterol Burden in Homozygous Familial Hypercholesterolemia: The Earlier, The Lower; The Longer, The Better
jacc.org/doi/10.1016/j.…

Author’s Handles:
@rajivxgulati
@claireraph
@AbdullahAlabcha
@agtruesdell
@ilanvavilinmd
@SarahFairley7
@rashaalbawardy
@draksinghi
@SachinGoelMD
@slittlemd
@cooperbkersey
@chatt_md
@garymamd
@mohananey
@CRB_EP
@IkramHaqMD
@cnkanaan
@DrBase_AMD
@JohnHenryDean
@soderstrom_mat
@KD_Patil_MD
@aida_metri
@Hondacardiol
@jamil_aboulhos
@conniejchoi
@draksinghi
@GiaconaJohn
@DPtheNP
@NutritionHF
@ankeetbhatt
@AshishSarraju
@tremartyn
@jedevillarreal
@PramodK7551667
@muzamil19951995
@sharath618
@Diegoadf94
@stefankmil
@prjancic
@OrlandoRPM
@DailyUrgencias
@JoseMeadeMD
@themdsie
@komal_safdar
@aniela_petrescu

📣👏‼️ #BigStory @OncoAlert

🔥🚨Hot Off The Press from #ESMO26

‼️NOT 1️⃣ NOT 2️⃣ NOT 3️⃣ but rather:

⭐️⭐️⭐️⭐️#FOUR 4️⃣ #Concomitant #Publications on #LungCancer published @NEJM (the world’s #Top #MedicalJournal) in conjunction with GREAT presentations @myESMO #ESMO26

✅ It’s ch & #EraOfHope for #Patients with #LungCancer

👇🏻🧵Links to #Papers & #Summaries

Our poster on RTX with or without avacopan in AAV with severe kidney involvement. Today from 10-12. FR- 0657

Acute Pulmonary Embolism 2026 Guidelines, an expert perspective including statements on:
🫀VA #ECMO & #ECPR as #MCS#MCS patients exhibiting fulminant RV failure resulting in profound refractory cardiogenic shock or impending cardiac arrest
🩸advanced reperfusion strategies in patiby VA #ECLS
🫀 alternative percutaneous right ventricular assist devices to provide targeted RV support
🖇️ bit.ly/3W3fWY0

Will be discussing anti-complement therapy in IgAN at the education symposium tomorrow! Be sure to join.

Cómo te voy a extrañar, Pancho querido. Tantos años. Siempre un profesional. Sólo nos quedó pendiente tu fiesta de cumple.

Me vas a hacer falta todas las mañanas en Excélsior.

bit.ly/3VuyvnT

Fallece a los 75 años el reportero y columnista Francisco Garfias ow.ly/sGCS50ZWFJm

🕊️ Todos los que formamos parte de #GrupoImagen lamentamos profundamente el fallecimiento de nuestro querido colaborador Francisco Garfias. Nos unimos a la pena que embarga a sus familiares y seres queridos, a quienes deseamos fortaleza y pronta resignación ante esta pérdida. Descanse en paz.

Original Article: Vasopressors or Fluids in Early Septic Shock (ARISE FLUIDS trial) nej.md/3PVdwIp

Editorial: More Than One Way to Save a Life in Septic Shock nej.md/4j1pPio

#EmergencyMedicine #CriticalCare

Despedimos a Francisco Garfias, periodista que durante casi cinco décadas informó con mirada crítica sobre la vida pública de México. Extrañaremos al reportero comprometido y al amigo entrañable. Descanse en paz. Un abrazo solidario a su familia y amigos.

Conocí a Francisco Garfias en 1997 cuando coincidimos en la Cámara de Diputados, él siempre periodista y muy buena persona. Hasta la vista Pancho !! Mis condolencias a familiares y amigos.

Murió el periodista Pancho Garfias. Mi pésame a sus familiares, amigos y compañeros.

Descanse en paz.

Las noticias en lopezdoriga.com

Academic docs doing disparities research? I can think of many better ways to help with healthcare disparities. Try practicing in Nevada or really any community with not enough healthcare. Boston doesn’t need anymore docs.

Se fue un grande y muy querido, Tío Pancho Garfias, descansé en paz. Extrañaré tus pláticas siempre con humor e intelecto.

We've spent decades staring at the arterial line. Turns out the veins have feelings too, and a congested patient can look "fine" on the monitor while their organs struggle. 🎩 tip to the authors.
eddyjoemd.com/foamed

@MayoPCCM 2026 Distinguished CHEST Educators. The DCE is an annual designation from @accpchest recognizing the top 3% CHEST faculty for sustained excellence in designing, delivering and leading PCCM education. Congratulations to our faculty! #meded

1/ How common is antiphospholipid syndrome (APS)?

The answer is more complicated than it seems.
In our new Nature Reviews Rheumatology review, we examine why defining the true epidemiologic burden of APS remains challenging.

Full paper here👉: rdcu.be/M2Loes1Gqtia

A tribute to Bob Kyle shown today at the Annual Meeting of the International Myeloma Society. #IMS26 #IMS2026
A role model and inspiration to many. Bookmark!

We will miss him. @Myeloma_Society @IMFmyeloma @Myeloma_mSMART