https://he05.tci-thaijo.org/index.php/CCIT <p><strong>Thai Journal of Cardiothoracic Disease</strong></p> <p><strong><em>ISSN: </em></strong><em>1686-6614<strong> E-ISSN:</strong> </em></p> <p><strong><em>Publication Frequency : </em></strong><em>3 issues per year (January-April), (May-August), (September-December).</em></p> <p><strong><em>Aims and Scope: </em></strong><em>Chest Diseases, Cardiovascular Diseases, Critical Care Medicine and Cardiovascular Thoracic Surgery</em></p> สถาบันโรคทรวงอก en-US Thai Journal of Cardiothoracic Disease 1686-6614 <ol> <li>เนื้อหาและข้อมูลในบทความที่ลงพิมพ์กับวารสารโรคหัวใจและทรวงอกถือเป็นข้อคิดเห็น และความรับผิดชอบของผู้เขียนบทความโดยตรงซึ่งกองบรรณาธิการวารสารไม่จำเป็นต้องเห็นด้วย หรือร่วมรับผิดชอบใด ๆ</li> <li><span style="font-size: 0.875rem;">บทความ ข้อมูล เนื้อหา รูปภาพ ฯลฯ ที่ได้รับการตีพิมพ์ในวารสารสถาบันโรคทรวงอกถือเป็นลิขสิทธิ์ของวารสารวิชาการ หากบุคคลหรือหน่วยงานใดต้องการนำทั้งหมดหรือส่วนหนึ่ง ส่วนใดไปเผยแพร่ กรุณาอ้างอิงบทความนั้น ๆ</span></li> </ol> https://he05.tci-thaijo.org/index.php/CCIT/article/view/6123 <p> A 61-year-old woman presented with dyspnea on exertion. Her vital signs and physical examination findings were normal. Basic laboratory results were within normal limits. She underwent an echocardiogram to evaluate cardiac function. A transthoracic echocardiogram revealed a cystic mass attached to the posterior annulus of the mitral valve. Cardiac magnetic resonance imaging (CMR) was performed to detect residual myocardial ischemia and confirmed the diagnosis of caseous calcification of the mitral annulus, measuring 2 × 2.6 cm.</p> <p> In this case, coronary angiography revealed multivessel disease with a mass-like blood supply shadow on the cineangiography view. She was scheduled for surgical revascularization as soon as possible.</p> <p> Caseous calcification of the mitral annulus (CCMA) is a rare variant of mitral annular calcification (MAC), a chronic degenerative process that typically occurs in elderly patients, particularly women. Hypertension, chronic kidney disease (CKD), and altered calcium-phosphate metabolism are also associated with this condition¹. CCMA is observed in approximately 0.067% of all echocardiographic examinations and is present in 0.63% of all patients with MAC². The mass-like calcification should be included in the differential diagnosis of cardiac masses when determining treatment options.</p> <p> Caseous calcification is commonly asymptomatic; therefore, unnecessary treatment should be avoided, and monitoring the patient's progress is recommended in most cases³. Rarely, caseous calcification may cause mitral valve regurgitation, fistula formation, or systemic embolization⁴, in which case surgical removal of the mass should be considered.</p> Sura Boonrat Copyright (c) 2025 Central Chest Institute of Thailand https://creativecommons.org/licenses/by-nc-nd/4.0 2025-09-12 2025-09-12 1 1 1 2 https://he05.tci-thaijo.org/index.php/CCIT/article/view/6487 <p> This study aimed to present nursing care for a patient with acute myocardial infarction complicated by cardiogenic shock and left ventricular thrombus, which are severe and complex complications with a mortality rate of 40-50% despite appropriate treatment. This case study employed systematic nursing process analysis based on nursing theories and evidence-based practice. Data were collected through observation, interviews, and medical record analysis during March25 - April24, 2025, at the Cardiac Care Unit, Nakhon Pathom Hospital.</p> <p> A 65-year-old Thai male patient was admitted for treatment with syncope, loss of consciousness, and chest tightness. Electrocardiogram examination revealed ST-segment elevation in V1-V5. Cardiac catheterization examination found complete occlusion at the mid-LAD position. He received treatment with PPCI combined with thrombus aspiration and DES insertion. The patient had severe complications including cardiogenic shock requiring inotropic medications and mechanical circulatory support device insertion. Echocardiographic examination revealed an EF of 23% and left ventricular thrombus. Nursing care was implemented according to 9 nursing diagnoses as follows: risk for cardiac arrest from decreased cardiac output per minute, impaired oxygenation, decreased gas exchange efficiency, pulmonary edema due to decreased cardiac efficiency, electrolyte imbalance due to decreased renal filtration efficiency, risk for ischemia at the procedural access site, risk for complications from mechanical cardiac support device insertion, risk for thromboembolism to brain and other parts of the body from left ventricular thrombus, discomfort due to restricted movement at the procedural site, risk for bleeding tendency from anticoagulation therapy and liver dysfunction. The patient and relatives had anxiety about the current condition due to lack of understanding and insufficient knowledge for self-care. The focus was on critical condition monitoring, hypoxemia management, prevention of complications from specialized equipment use, health behavior change promotion focusing on smoking cessation motivation and anxiety related to self-care management and psychosocial concerns. The results showed that the patient had good response to treatment, no severe complications occurred, received holistic care was provided and safe hospital discharge was achieved.</p> <p> The results of this study can be applied as practice guidelines for nursing care of patients with complex cardiovascular conditions, helping to develop quality of care and reduce complication rates for rapid and accurate treatment. Additionally, it serves as academic information for nursing personnel competency development and efficient interdisciplinary patient care planning.</p> pribpree hongsrithong Copyright (c) 2025 Central Chest Institute of Thailand https://creativecommons.org/licenses/by-nc-nd/4.0 2025-09-12 2025-09-12 1 1 3 19