Premature Ventricular Complexes (PVCs) are among the most frequent ventricular arrhythmias observed in daily cardiology practice. Although often benign, sustained high ectopic activity can result in left ventricular dysfunction known as PVC-induced Cardiomyopathy (PVC-CMP), a condition that is frequently reversible when the arrhythmia is effectively suppressed. The underlying mechanisms are multifaceted, involving electromechanical dyssynchrony, contractile inefficiency, abnormal calcium cycling, neurohormonal activation, and progressive structural remodeling. The likelihood of developing PVC-CMP varies among individuals and is influenced by electrophysiological and structural factors. Diagnosis relies on prolonged rhythm monitoring, comprehensive multimodality imaging, and demonstration of ventricular recovery after reducing the ectopic burden, which, in turn, confirms causality. Over the past decade, major advances in electrocardiographic mapping, cardiac imaging, and ablation therapy have transformed this field, demonstrating excellent efficacy and safety profiles. In parallel, artificial intelligence and computational mapping are emerging as powerful tools for prediction and procedural guidance. Recognition of PVC-CMP as a distinct, treatable cardiomyopathy highlights the importance of early detection and individualized therapy, offering the prospect of complete functional recovery and the prevention of heart failure progression.

Introduction/Background: A cardiovascular implantable electronic device infection (CIEDI) is a rare but serious complication, often difficult to diagnose. We present a unique case of CIEDI involving a long-standing right atrial pseudoaneurysm with pericardial abscess related to an old pacemaker system. Case Presentation: A 51-year-old woman with a dual-chamber pacemaker presented with prolonged fever and lead dysfunction. Multimodal imaging revealed lead perforation into the pericardial sac, resulting in an abscess. A hybrid approach combining open surgery, percutaneous extraction, and targeted antibiotic therapy led to full recovery. Conclusion: Accurate diagnosis through advanced imaging and multidisciplinary care is essential for the management of complex CIEDI and to improve outcomes.

Introduction: Eosinophilic myocarditis is a rare and aggressive form of infiltrative cardiomyopathy associated with significant morbidity and mortality, especially when diagnosis is delayed. Symptoms are often vague and overlap with other cardiac conditions, making recognition challenging. Positron emission tomography combined with computed tomography has become more relevant as a supplementary diagnostic tool, although its effectiveness in follow-up remains underexplored. This report discusses a likely paraneoplastic case in classical Hodgkin’s lymphoma, emphasizing that metabolic cardiac activity on serial imaging closely mirrored clinical progression. Case Presentation: A 75-year-old woman with classical Hodgkin’s lymphoma initially responded well to chemotherapy and maintained stability for over eighteen months. She later developed progressive heart failure with restrictive physiology, biventricular involvement, severe pulmonary hypertension, and an apical intraventricular thrombus. Laboratory tests indicated intermittent eosinophilia and varying inflammatory markers. Multimodal imaging revealed diffuse myocardial edema and extensive endocardial fibrosis, indicating eosinophilic involvement. Across five oncological scans, myocardial metabolic activity increased alongside the patient's deterioration. Despite thorough investigations, including biopsies and ruling out infectious, autoimmune, infiltrative, and coronary causes, histological confirmation remained elusive. Given her advanced cardiac condition, comorbidities, and complications from treatment, immunosuppression and invasive interventions were not viable options, and the patient continued to decline. Conclusion: This case illustrates the diagnostic challenges of eosinophilic myocarditis in unusual paraneoplastic contexts and underscores the value of multimodal imaging and interdisciplinary collaboration. The metabolic changes observed across sequential scans support this approach for early detection and follow-up, though additional validation is required.

La red de Chiari es un remanente embrionario localizado en la aurícula derecha que tradicionalmente se consideraba carente de significación clínica. Sin embargo, como ocurre en el caso que presentamos, puede ser un factor facilitador en diferentes patologías. Se trata de una paciente de 70 años con antecedente de tromboembolismo pulmonar y trombosis venosa profunda que ingresa por un ictus embólico. En el ecocardiograma se encuentra una masa en aurícula derecha que correspondía a un trombo sobre la red de Chiari asociado a foramen oval permeable que desapareció tras varios días de anticoagulación. Este caso es un buen ejemplo de cómo esta estructura puede participar en fenómenos embólicos y de la utilidad del ecocardiograma en su valoración.