Congenital absence of the pericardium presenting as acute myocardial necrosis.

Congenital absence of the pericardium is a rare defect of which recognition is critical because it can be associated with catastrophic outcomes. While some carriers of this condition may present with a lethal complication, most are asymptomatic, and the defect is found incidentally. The case of a 49-year-old woman is described who presented with acute myocardial necrosis and absence of obstructive coronary artery disease, and in whom a complete left pericardial defect was found.

When size matters: lessons learned from left main stent embolization and retrieval.

While the advantages of drug-eluting stents (DES) have been demonstrated in moderate and small-sized vessels, the benefits of DES use in selected larger vessels are increasingly recognized. In the following case presentation, the use of a DES outside the approved vessel diameter to treat left main coronary artery disease led to retrograde migration of the stent over the guiding catheter. Solutions to capturing and retrieving a stent in this position are discussed and our approach to resolving the situation is presented.

The endocarditis that was not: an unusual case of heparin-induced thrombocytopenia with unusual complications.

The complications of heparin-induced thrombocytopenia have been well described previously. However, evidence of the possibility that heparin-induced thrombocytopenia can trigger a thyroid storm has never been published before. A catastrophic evolution of a man referred with a high endocarditis suspicion previously treated with heparin, who successively developed arterial thrombosis and thyroid storm, is described.

Impact of time interval from the last meal on glucose response to exercise in subjects with type 2 diabetes.

We evaluate the influence of the time interval from the last meal on the blood glucose response to exercise in men with type 2 diabetes. Nineteen men with type 2 diabetes participated in an exercise training program carried out at 60% of maximal oxygen uptake (VO2peak) for 1 h, 3 times a week. Capillary whole blood glucose was measured immediately before and after each exercise session, and the time interval from the last meal (breakfast, lunch, or dinner) was recorded.