Cardiac calcified amorphous tumor is a rare, non-neoplastic, pedunculated, intra-cavity mass, with very high preponderance of distal embolisation. Differentiation from calcified atrial myxoma or calcified thrombi is very difficult. Histo-pathologic examination is the mainstay of diagnosis. Treatment is emergency excision. A 46-year-old female presented with heart failure. On echocardiography, 1.9x1.7 cm pedunculated mobile mass in left ventricle attached to intraventricular septum was seen. On cardiac MRI lesion was isointense. The mass was excised. Histopathology revealed fibrin deposition with eosinophilic amorphous material in the centre with calcification in the periphery without any myxomatous tissue. A final diagnosis of CAT was established.

The hydatid disease of heart, caused by Echinococcus granulosus has an incidence of 0.5%-2% , in the sheep grazing areas of the developing and under-developed countries. The cyst of interventricular septum has a 5%-9% incidence with complications of conduction block and arrythmias. Transesophageal echocardiography(TEE) is useful for intraoperative cyst localization and excision. Our image review highlights the TEE findings of our young patient with multiple hydatid cysts of interventricular septum , with the septal tricuspid leaflet adherent to the cyst membrane.

Permanent pacemaker implantation is life saving but sometimes the procedure may itself become life threatening. Right ventricular perforation is a rare complication during pacemaker insertion that could be life-threatening and need immediate intervention. Chest X-ray, echocardiogram and computer tomogram of chest are used to diagnose lead migration and its complications. We present a rarest of the rare case in which a seventy six year old patient undergoing permanent pacemaker implantation suffered both iatrogenic cardiac injury leading to hemopericardium and pacemaker malfunction as well as injury to left pleura leading to massive pneumothorax and hemodynamic instability which was managed successfully.

Iatrogenic aortocoronary dissection is a rare but potentially fatal complication of coronary catheterizations. Although the incidence is comparatively low, dissection often leads to procedure failure with increased risk of myocardial infarction and death. Iatrogenic aortocoronary dissection is principally caused by disruption of intima at the ostia of the right or left coronary artery during interventional procedures and appears as luminal filling defects, the persistence of contrast or intimal tear outside the coronary lumen. Dissection could propagate in the anterograde direction causing subtotal or total occlusion of the coronary lumen or extend in the retrograde direction into the sinus of Valsalva, ascending aorta, aortic arch or descending aorta resulting in hemodynamic instability. We present a case of Right Coronary Artery dissection leading to Type-A aortic dissection suffered during diagnostic coronary catheterization. This required emergency supracoronary replacement of the ascending aorta with an aortic interposition tube graft and venous grafts to coronary arteries