Dual versus single antiplatelet therapy in patients undergoing transcatheter aortic valve replacement: a systematic review and meta-analysis.

Background: Although dual antiplatelet therapy (DAPT) with clopidogrel and aspirin is a widely accepted strategy in patients undergoing transcatheter aortic valve replacement (TAVR), this approach is not evidence based. We therefore sought to systematically review the current evidence for this practice in terms of 30-day outcome looking at stroke, MI, bleeding, and death.

Methods: Relevant studies were identified through electronic literature search.

Evaluation of Trends of Inpatient Hospitalisation for Significant Haemorrhage in Patients Anticoagulated for Atrial Fibrillation before and after the Release of Novel Anticoagulants.

Compared to Vitamin K antagonists (VKA), novel oral anticoagulants (NOACs) appear to be safer in terms of major bleeding risks with added advantage of having fixed dosing schedules when used in patients with non-valvular atrial fibrillation (AF). We sought to study the differences as sources and severity of anticoagulant-associated haemorrhage in patients with AF in the year preceding introduction of NOACs (first cohort) as compared to post approval of the NOACs (second cohort) by retrospectively reviewing the hospital admissions, as well as the pharmacodynamic and pharmacokinetic interactions between time periods. There were 359 patients for the first cohort and 405 patients for the second cohort, including 57 patients prescribed NOACs.

Left ventricular non-compaction presenting with heart failure and intramural thrombus.

Left ventricular non-compaction (LVNC) is a rare disorder caused by the arrest of myocardial compaction during embryogenesis, leading to a non-compacted endocardial layer with marked trabeculations. The diagnosis is primarily based on echocardiographic demonstration of a spongy myocardium. Here, we present a young male with LVNC presenting with left heart failure and multiple left ventricular thrombi.

Haemophagocytic lymphohistiocytosis mimicking septic shock after the initiation of chemotherapy for squamous cell carcinoma of the neck.

Haemophagocytic lymphohistiocytosis (HLH) is a rare but potentially fatal disorder resulting from a highly stimulated immune response with uncontrolled accumulation of lymphocytes and macrophages in multiple organs. Both the inherited and acquired forms of this disease exist; the latter can sometimes occur secondary to different malignancies. In this report, we present a middle-aged Hispanic man who presented with features of septic shock during the course of chemotherapy for squamous cell carcinoma of the neck.

Accelerated arterial and venous clots in a young pregnant woman: a saga of thrombotic storm.

Thrombotic storm is a rare condition, characterised by serial thrombotic events, which escalates rapidly within a few days to a few weeks involving multiple and unusual sites. Since it usually responds to anticoagulation and is often lethal if not treated promptly, early diagnosis is crucial. We describe a case of a young pregnant woman with multiple acute arterial and venous thrombotic events including stroke and myocardial infarction, who successfully recovered with continued anticoagulation therapy.

Papillary fibroelastoma of the aortic valve: An unusual cause of angina.

Papillary fibroelastoma of the aortic valve is an uncommon benign tumor of the heart that can present with embolic events. We report a case of 54-year-old lady with exertional chest pain and prior history of ST segment elevation myocardial infarction who was subsequently found to have a fibroelastoma of the aortic valve. The absence of angiographically significant coronary artery disease and resolution of anginal symptoms post-surgery in our patient points to the possibility of fibroelastoma causing these anginal symptoms.

Laugh-induced seizure: a case report.

Introduction: A laugh-induced seizure is an unrecognized condition and to the best of our knowledge no case has been reported in the medical literature until now. We present an interesting and extremely rare case in which laughing generated the seizure activity that was recorded and confirmed by video electroencephalography.

Case Presentation: A 43-year-old obese Caucasian man with history of bipolar disorder and chronic headache presented with multiple episodes of seizures, all induced by laughter while watching comedy shows.

Postoperative thrombotic thrombocytopenic purpura after aortofemoral bypass.

Thrombotic thrombocytopenic purpura (TTP) is uncommon in the postoperative setting, even more so after vascular surgery. We present a case of thrombocytopenia after aortofemoral bypass, which highlights the importance of a high index of suspicion for postoperative TTP to avoid life-threatening consequences.