Holt-Oram syndrome is an autosomal dominant condition associated with skeletal malformations of the upper limbs, and congenital heart disease. Approximately 40% of cases represent new mutations. Defective development of the embryonic radial ray (e.g. aplasia, hypoplasia, fusion, other anomalous development) results in a wide spectrum of phenotypes, including triphalangeal or absent thumbs, foreshortened arms and phocomelia. The syndrome is associated with defective development of cardiac structures that results in atrial septal defect (ASD), most commonly the secundum type, heart block of varying degrees, or both. We report a rare cardiac defect patent ductus arteriosus (PDA) and ventricular septal defect (VSD) in a case of Holt-Oram syndrome.

Dextrocardia with situs inversus is a rare clinical entity with an estimated incidence ranges from 1 in 8000 to 1 in10,000. Percutaneous intervention in patient with dextrocardia and situs inversus is clinically challenging due to abnormal orientation of coronary geometry and the intervention requires appropriate use of guiding catheters, engagement technique, appropriate radiological angles as well as views. In this case-report, we describe percutaneous intervention with stenting in 48-year-old male patient with dextrocardia and situs inversus. We successfully deployed drug-eluting stents in right coronary artery and left circumflex artery.

Background: A strong association between abnormal lipid variables and development of atherosclerosis is widely established. However, few data exist on the association between lipid levels and the extent or severity of coronary lesions in patients with coronary artery disease. Objective: We aimed to determine the link between lipid levels and the extent or severity of coronary lesions in patients with suspected coronary artery disease using Friesinger index (FR). Methodology: In this prospective and singe-center study, consecutive patients who underwent coronary angiography for diagnostic purposes were analyzed. Each participant was evaluated for lipid levels i.e. total cholesterol, triglycerides, high-density lipoprotein (HDL) cholesterol, low-density lipoprotein (LDL) cholesterol, very-low-density lipoprotein (VLDL) cholesterol, non-HDL cholesterol, triglycerides/ HDL cholesterol, and triglycerides/non-HDL cholesterol. The extent of coronary disease was evaluated using FR index. Results: A total of 566 patients (mean age: 56.17 ± 9.99 years) were included in the study. The mean FR index was 5.40 ± 3.78. A significantly positive correlation was observed between FR index and total cholesterol (P = 0.002), triglycerides (P < 0.001), VLDL cholesterol (P < 0.001), non-HDL cholesterol (P = 0.006), triglycerides/HDL cholesterol ratio (P = 0.008), and triglycerides/non-HDL cholesterol ratio (P = 0.002). On the contrary, an inverse correlation was observed between FR index and HDL cholesterol (P < 0.001). Age or gender played no role in governing the FR index severity, while body-mass index, hypertension, diabetes, and smoking showed significant association with FR index (P < 0.001 for all). Conclusion: The present study demonstrates a significant link between the extent of coronary artery disease and levels of certain lipid variables.

BACKGROUND ST elevation myocardial infarction is an acute emergency, more than 50% of deaths due to STEMI occur within first 1 hour, mainly due to various arrhythmias. Various arrhythmia can complicate the course of STEMI. This study was done to access the incidence and pattern of arrhythmias complicating STEMI and the prognostic implications of these arrhythmias. MATERIALS AND METHODS 100 patients were included in the study that fulfilled the required criteria. They underwent detailed history taking and systemic examination. Patients were monitored through cardiac monitor and serial ECG recording were taken specially if any rhythm disturbances were observed and data was entered in a pretested proforma. RESULTS Among 100 patients, 60 were male and 40 were female. Commonest arrhythmias noticed in this study were sinus tachycardia (31%), followed by bundle branch block (30%), ventricular arrhythmia (25%) AV blocks (20%) sinus bradycardia (18%), supraventricular arrhythmia (4%) and AIVR in 1%. Mortality was more in patients with ventricular tachycardia and complete heart block. Majority of arrhythmias (76%) occur during first hour of hospitalization. CONCLUSION The commonest arrhythmia encountered were sinus tachycardia followed by bundle branch block (BBB), AV block and sinus bradycardia, AV block and sinus bradycardia were common with IWMI and ventricular arrhythmia and bundle branch block were common with AWMI.

Meta AnalysisA meta-analysis of randomized controlled trials investigating tirofiban combined with conventional drugs by intracoronary administration for no-reflow prevention Qian Zeng et al.; Guangxi-China Original Investigations Sex difference in clinical outcomes of Chinese patients with atrial fibrillation and coronary stenting according to age Jian-Yong Zheng et al.; Beijing-China Chronic thromboembolic pulmonary hypertension in patients with persistent chest symptoms after acute pulmonary embolism Elif Şahutoğlu et al.; İstanbul-Turkey How did the updated hemodynamic definitions affect the frequency of pulmonary hypertension in patients with systemic sclerosis? Alper Sarı et al.; Ankara-Turkey Pulmonary hypertension in patients with sarcoidosis: A single-center experience Deniz Kaptan Özen et al.; Kocaeli-Turkey Evaluation of radial artery endothelial functions in transradial coronary angiography according to different radial access sites Elton Soydan et al.; İzmir-Turkey Case Reports An intriguing case of acute coronary syndrome caused by rotten tuna Chiara Gargiulo et al.; Pavia-Italy Failed transcatheter mitral valve-in-ring implantation followed by transapical valve-in-valve within the ring and ad hoc paravalvular leak closure Beytullah Çakal et al.; İstanbul-Turkey A rare cause of mitral regurgitation after aortic valve replacement: Iatrogenic mitral valve perforation Begüm Uygur; İstanbul-Turkey