Primary cardiac neoplasms are extremely rare. Angiosarcoma is the most commonly seen histological subtype and is characterized by its permeating and destructive nature. Unfortunately, primary cardiac angiosarcoma is often overlooked as an initial diagnosis because of its rarity. Since the time it was first identified in 1934, little progress has been made in improving survival outcome. Complete or partial surgical resection is still the best option for palliation, with little hope for cure. Improvements have been made in the ability to view and distinguish tumors. Echocardiography is one of the most useful diagnostic tools because of its high sensitivity; therefore, CT and MR images are often used to detect sites of metastatic disease. Immunohistochemistry staining can also be employed as an adjunctive diagnostic tool. CD31, CD34, FLI-1, and von Willebrand factor are the most commonly used markers in detecting tumors of endothelial origin. However, due to the vast heterogeneity within a tumor, immunohistochemistry staining can be quite variable. Surgical resection remains the standard modality of treatment. Primary cardiac angiosarcoma is largely resistant to chemotherapy and/or radiation. However, the exact benefit and its place in a multimodality treatment regimen are still under investigation.

In men with hypercholesterolemia, lowering serum cholesterol level by a three-month simvastatin treatment is accompanied by a marked reduction of thrombin generation both at basal conditions in venous blood and after activation of hemostasis by microvascular injury. Once blood cholesterol became reduced, adding aspirin to simvastatin did not enhance dampening of thrombin formation.

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Impairment of hepato-renal function defined by the MELD XI score is common and carries unfavourable prognosis in AHF patients.

Purpose We evaluated whether the severe acute respiratory syndrome coronavirus 2 pandemic was associated with changes in the pattern of acute cardiovascular admissions across European centres. Methods We set-up a multi-centre, multi-national, pan-European observational registry in 15 centres from 12 countries. All consecutive acute admissions to emergency departments and cardiology departments throughout a 1-month period during the COVID-19 outbreak were compared with an equivalent 1-month period in 2019. The acute admissions to cardiology departments were classified into 5 major categories: acute coronary syndrome, acute heart failure, arrhythmia, pulmonary embolism and other. Results Data from 54331 patients were collected and analysed. Nine centres provided data on acute admissions to emergency departments comprising 50384 patients: 20226 in 2020 vs 30158 in 2019 – incidence rate ratio (IRR) with 95% confidence interval (95%CI): 0.66(0.58-0.76). The risk of death at the emergency departments was higher in 2020 vs 2019: odds ratio (OR) with 95%CI: 4.1(3.0-5.8), P<0.0001. All 15 centers provided data on acute cardiology departments admissions: 3007 patients in 2020 vs 4452 in 2019, respectively, IRR(95%CI): 0.68(0.64-0.71). In 2020, there were less admissions with IRR(95%CI): acute coronary syndrome: 0.68(0.63-0.73), acute heart failure: 0.65(0.58-0.74), arrhythmia: 0.66(0.60-0.72), other: 0.68(0.62-0.76); we found a relatively higher percentage of pulmonary embolism admissions in 2020: OR(95%CI): 1.5(1.1-2.1), P=0.02. Among patients with acute coronary syndrome there were fewer admissions with unstable angina: 0.79(0.66-0.94), non-ST segment elevation myocardial infarction: 0.56(0.50-0.64) and ST-segment elevation myocardial infarction: 0.78(0.68-0.89). Conclusion In the European centres during the COVID-19 outbreak, there were fewer acute cardiovascular admissions. Also, fewer patients were admitted to the emergency departments with 4-times higher death risk at the emergency departments.