At the time they were introduced in 1988, the nonionic contrast agents were significantly more expensive than the previously available agents due to substantial development expenses and higher manufacturing costs. However, the improved safety and tolerability of the newer agents was generally considered to warrant the additional expenditure. Over time, the acquisition costs of the nonionic monomer agents declined from approximately $1.00 per mL in 1990 to $0.25–0.30 per mL today. This reduction in costs is attributable to the fact that the development costs of these agents were recouped

It is well known that technology for electrophysiology (EP) has advanced substantially over the past two decades to include the ability to map and treat arrhythmias that originate in any of the heart chambers, including the left atrium and the pulmonary veins via transseptal puncture.^1–5 However, it is also known that successful EP studies are largely dependent on several factors: anatomy of the heart; ability to make good catheter contact with the endocardium during arrhythmia treatment; and the cardiologist’s ability and experience in accurately manipulating EP cath

Case Presentation. A 58-year-old Asian woman presented with substernal chest pressure made worse by swallowing. This discomfort had been present for 2 years and had recently become more severe and frequent.

Panel A. Computed tomographic scan of the chest demonstrated a very large, unruptured aneurysm of the aortic root.
Panel B. Echocardiographic image in the parasternal shortaxis view demonstrating the huge sinus of Valsalva aneurysm (A), the right coronary leaflet (R), left coronary cusp (L) and non-coronary cusp (N).
Panel C.