In this first short-term placebo-controlled trial of tadalafil in patients of ES, the drug was well tolerated and significantly improved exercise capacity, functional class, SO(2) , and pulmonary hemodynamics.

We report a rare case of a 25-year-old asymptomatic female who was referred for evaluation of a cardiac murmur. She had recent history of treatment for pulmonary tuberculosis. On investigation, she was diagnosed with left ventricular pseudoaneurysm (PSA) likely secondary to rupture of myocardial tubercular abscess. She was operated successfully for the left ventricular PSA and was discharged from the hospital in a good condition.

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

BACKGROUND Implantation of prosthetic cardiac valves to treat haemodynamically significant valvular diseases has become common; however, it is associated with complications. Thus, this study was intended to evaluate the indications for implantation of prosthetic valve and complications after its implantation and prognosis after treatment of one of its complication, i.e. stuck valve. MATERIALS AND METHODS This was a single-centered study wherein 50 patients who came to the emergency department with stuck valve were assessed. The 2D echocardiography was performed in all patients. Thrombolysis was done and the gradients were reassessed. Further response to treatment and development of complications before and after treatment were observed. RESULTS Of total patients, 60% were females. Mean age group was 30-40 yrs. Most of them were asymptomatic for 6 years and there was lack of compliance in 90% of patients. Most common indication for valve replacement was mitral stenosis (60%) followed by mitral regurgitation (20%), aortic regurgitation and aortic stenosis (10%) and combined mitral and tricuspid regurgitation (10%). Commonest valve was St. Jude (90%). Pannus was observed in 10% patients and thrombus was observed in 50% patients. Most patients had gradients 45/20 mmHg across mitral valve. In about 90% patients, gradients decreased after thrombolysis (12/5 mmHg). The complications after thrombolysis were hemiparesis (4%), death before thrombolysis (6%) and death after thrombolysis (4%). CONCLUSION Considering these results, it can be concluded that prosthetic valves are seldom associated with some complications. Further, thrombolysis can be effective in patients with prosthetic valve thrombosis.

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Background: The aim of this study was evaluation of nocturnal dipping of blood pressure in ST-elevation myocardial infarction (STEMI) patients and determining the effect of dipping on outcomes at 12 months follow-up.Methods: This was an observational, single-centre, retrospective study that included STEMI patients, performed in a tertiary care hospital in India from November 2016 to October 2017. The primary endpoint of the study was the assessment of outcomes at 12 months.  The patients were divided into two groups on the basis of blood pressure dipping, i.e., patients with positive dipping were considered in group 1 and patients with negative dipping were considered in group 2.Results: Total 43 patients were included in the study. Group 1 consisted of 27 patients and Group 2 consisted of 16 patients. Mean 24 hr systolic blood pressure (SBP) and asleep SBP in Group 1 patients was 128.15±18.05 mmHg and 122.67±18.94 mmHg, respectively. Mean 24 hr diastolic (DBP) and asleep DBP in Group 1 patients was 78.07±10.73 mmHg and 73.41±12.35 mmHg, respectively. In the patients with non-dipping, mean 24 hr SBP and asleep SBP was 130.56±27.32 mmHg and 135.13±29.58 mmHg, respectively. Mean 24 hr DBP and asleep DBP was 76.00±15.40 mmHg and 79.69±17.05 mmHg, respectively. The mean percentage of asleep dipping of SBP was 5.7±6.7% in Group 1 and -4.6±6.82% in Group 2. Similarly, the mean percentage of asleep dipping of DBP was 7.6±9.0% in Group 1 and -6.3±9.1% in Group 2.Conclusions: In view of the results, it can be concluded that ambulatory blood pressure monitoring in patients with STEMI can provide a significant prognostication of the future events.