H-FABP is a highly sensitive biomarker for the early diagnosis of AMI. H-FABP as early marker and cTnI as late marker would be the ideal combination to cover the complete diagnostic window for AMI. Detection of myocardial injury by H-FABP may also be applied in patients with unstable angina. H-FABP can also be used as a marker for early detection of STEMI before the ECG changes become apparent.

Myxoma, a rare type of intracardiac tumor, forms a very small percentage of the cardiac cases. Reports of biatrial myxoma are rarer, with cases of single tumor reaching both atria being more common. Here, we present an unusual case of two independently growing atrial myxoma in a 29-year-old female. We emphasize that early recognition of symptoms, confirmation of diagnosis by transesophageal echocardiography, and prompt surgical excision remain vital in the management of such patients. The patient in the present case was managed successfully with no evidences of recurrence at the last follow-up.

Primary transcatheter VSR closure using ASD occluders is a feasible approach which can provide reasonable survival outcomes along with equitable mortality rates.

Recent advancement in radiology and cardiology are supporting the newly emerged technique of lung ultrasound through B-line evaluation as an easy, non-invasive and reliable technique for identifying extravascular lung water and thus diagnose acute heart failure [10,11].Lung ultrasound and significance of B-lines: Lung ultrasound has not been explored extensively for the evaluation of lungs [12]. A normal lung is filled with air and therefore when the ultrasound

A 36-year-old male was transferred to our hospital from another hospital on a ventilator. He was a known case of Berger's disease (IgA nephropathy) and was on maintenance haemodialysis for the past 3 months. He was undergoing haemodialysis by jugular venous catheter after creating Arteriovenous (AV) fistula on the left hand. One month ago, the patient was admitted at a local hospital with jugular venous catheter related infection. During his stay in the hospital, the patient had septic shock followed by resuscitated cardiac arrest. He was shifted to another secondary care hospital after resuscitation. His blood culture showed P. aeruginosa growth. He was initiated on intravenous antibiotics as per sensitivity and stabilized. Subsequently, the patient developed septic emboli and dry gangrene in both the lower limbs and was advised amputation however the patient refused. Following this the patient developed severe pain in the left upper limb. Doppler imaging showed brachial artery thrombosis at the site of AV fistula. He was advised to undergo angioplasty, but the patient and bystanders refused further treatment in the hospital. He was discharged against medical advice. However, he was admitted again after three days at the same hospital with septicaemia and altered sensorium. He underwent surgical embolectomy of the left brachial artery. Magnetic Resonance Imaging (MRI) brain showed bilateral infarcts. Immediately, the patient was shifted to our hospital in the state of sepsis and encephalopathy. He was admitted to critical care unit and a bed-side Transthoracic Echocardiogram (TTE) was performed, which suggested large vegetation attached to the interventricular septum. Blood cultures were directed for evaluation. While awaiting the blood culture report, the patient was started on antibiotics that included meropenem and cefepime for P. aeruginosa based on previous sensitivity. Simultaneously, an ophthalmology consultation was sought in a view of redness of both eyes. The patient was diagnosed with bilateral endophthalmitis after thorough ophthalmoscopic examination [Table /Fig-1b]. Next day, a Transesophageal Echocardiogram (TEE) was performed to confirm the diagnosis. It showed large vegetation on the interventricular septum and on the descending aortic wall [Table /Fig-2a,b]. The patient subsequently suffered a cardiac arrest, and could not be revived. Keywords: Arteriovenous fistula infections, Embolectomy, Endophthalmitis, Gangrene ABSTRACTNosocomial catheter-related and Arteriovenous fistula (AV)-related infections are significant concern in patients undergoing haemodialysis. These infections are associated with multiple complications as well as mortality and demands immediate and appropriate management. While coagulase-negative staphylococci, S.aureus, and Escherichia coli are the most common causes of catheter-related infections in haemodialysis patients, such infections caused by Pseudomonas aeruginosa are relatively rare. Here, we present an unusual case of 36-year-old male patient with chronic renal f...

We report a case of disseminated histoplasmosis in a 37-year-old male acquired immunodeficiency syndrome patient from south India. The patient presented with high-grade fever, cough, conjunctival nodule and papulonodular hyperpigmented skin lesions. Histology of skin lesions and conjunctival nodule showed numerous intracellular Periodic Acid Schiff-positive rounded yeast cells within macrophages. Bone marrow aspirate confirmed disseminated histoplasmosis. The patient showed dramatic response after starting treatment with Amphotercin B.

Delayed recovery of AV conduction is possible in TC, thus implying to wait for a longer period before implanting a pacemaker.

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