Takotsubo syndrome and complete heart block, which came first? A case report.

Background: In 2018, the European Society of Cardiology published two consensus documents on takotsubo syndrome (TTS), which include the current consensus on nomenclature, diagnosis, management, and complications. However, little is mentioned on the association with complete heart block (CHB), except that 'AV block [occurs in] 2.9% of cases'.

A speckle-tracking strain-based artificial neural network model to differentiate cardiomyopathy type.

In heart failure, invasive angiography is often employed to differentiate ischaemic from non-ischaemic cardiomyopathy. We aim to examine the predictive value of echocardiographic strain features alone and in combination with other features to differentiate ischaemic from non-ischaemic cardiomyopathy, using artificial neural network (ANN) and logistic regression modelling. We retrospectively identified 204 consecutive patients with an ejection fraction <50% and a diagnostic angiogram.

Hereditary haemorrhagic telangiectasia with multiple complications presenting in an older patient.

Hereditary haemorrhagic telangiectasia (HHT) is a rare autosomal dominant multi-organ vascular disorder associated with bleeding and a reduced life expectancy. We present a 91-year-old woman with complications of previously undiagnosed HHT. This case demonstrates three potential complications: pulmonary arteriovenous malformation (AVM) resulting in a right to left shunt, cerebral infarctions and pericardial effusion.

Situational judgement tests: important clarifications regarding the methodology.

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Myocardial infarction masquerading as myocarditis in a patient with factor V Leiden: unmasked with MR.

We present a case of a 21-year-old man presenting with sharp left-sided chest pain. A CT pulmonary angiogram was negative, ECG was unremarkable and a mild troponin rise was observed. Myocarditis was suspected as the most likely diagnosis, particularly in view of the patient's previous diagnosis of myocarditis 3 years prior.

Normalization of biventricular strain post steroid treatment of effusive constrictive pericarditis.

Peak left ventricular strain measured by speckle tracking echocardiography has previously been shown to normalize following pericardectomy in constrictive pericarditis, as indicated by an increase of the strain ratio between the lateral wall and septum. Here we present a case of effusive constrictive pericarditis treated with corticosteroids. Pre-treatment we observed reduced contractility of the lateral walls of both ventricles as measured by peak strain, with sparing of overall septal function, but with hypercontractility of the basal septal segment.

Super-mesenteric-vein-expia-thrombosis, the clinical sequelae can be quite atrocious.

Superior mesenteric vein (SMV) thrombosis is a rare, potentially life-threatening complication of intra-abdominal infection. Here we present a case of massive SMV thrombosis secondary to appendicitis in a 13-year-old boy. He presented with vague abdominal pain and associated symptoms, persistently elevated serum inflammatory markers and a pyrexia of unknown origin.

Waterpipe smoking and risk of coronary artery disease.

Purpose Of Review: Smoking tobacco using a water pipe is becoming more prevalent globally, particularly amongst younger populations. In addition to its growing popularity, more evidence is emerging regarding associated harm, and several misconceptions exist concerning the likely adverse health effects of waterpipe smoking (WPS). It is timely, therefore, to examine the body of evidence linking WPS to coronary artery disease (CAD).

Wünderlich ist nicht so Wunderbar: Bilateral Angiomyolipomas and Wünderlich Syndrome Requiring Emergency Embolization in a Patient without Tuberous Sclerosis.

Bilateral renal angiomyolipomata are rare and usually associated with tuberous sclerosis. Renal angiomyolipomata can rupture spontaneously giving rise to (potentially catastrophic) retroperitoneal hemorrhage (Wünderlich syndrome). We present a very rare case of bilateral renal angiomyolipomata in an individual without tuberous sclerosis, presenting with life-threatening hemorrhage.

Evaluation of a community diabetes initiative: Integrating diabetes care.

Aims: To evaluate the impact of a community diabetes initiative, aiming to improve the efficiency of type 2 diabetes (T2DM) care within the Cardiff and Vale Health Board.

Methods: In 2012, a community diabetes initiative was introduced in Cardiff and Vale. Ten National Health Service (NHS) consultant diabetologists and three nurse specialists supported 69 general practices in this region.