Severe pulmonary hypertension (PH) has been considered a significant contraindication to cardiac transplantation. Ongoing clinical experience, however, has shown that temporary support using left ventricular assist devices (LVADs) in these patients can result in significant reductions in PH. A comprehensive review of the available literature regarding the use of LVADs in heart failure patients with PH was conducted. The existing literature to date supports the use of LVADs in heart failure patients with PH and demonstrates that significant reductions in PH in these patients can be achieved. This subsequently allows for safe and effective cardiac transplantation in patients who were previously excluded from this modality. For heart failure patients with severe PH, the use of LVADs can provide significant benefits by significantly reducing PH and allowing subsequent staged transplantation.

Aluminium phosphide is commonly used as an insecticide and can be toxic to humans at the cellular level by interfering with mitochondrial energy metabolism. We report on three cases of severe aluminium phosphide cardio-toxicity, resulting in severe decrease in both ventricular heart functions. The first case succumbed to intractable ventricular arrhythmias complicated by multi-organ failure before she died; while the other two cases required invasive hemodynamic support and eventually improved over the course of 10-14 days. We describe our experience and the challenges faced while managing one of them.

• The series presented is one of the largest in a single centre. • Arterial embolisation is a life-saving procedure in patients with pelvic haemorrhage. • In pelvic traumas associated with haemorrhage, prognosis is dependent upon prompt treatment. • Transfusion status is significantly related to clinical efficacy.

The objective of this study was to assess the prevalence of anemia and to investigate its association with comorbidities and its impact on clinical outcomes in patients with heart failure. The association of predefined anemia, as well as the correlation of serum hemoglobin level as a continuous variable, with outcomes of emergency department visits, hospitalization, and mortality was investigated. There were fewer anemic patients in New York Heart Association classes I and II than in classes III and IV. Anemia was associated with higher rates of emergency department visits, hospital admissions, and all-cause mortality. Multivariable analysis showed that anemia is independently associated with mortality. When hemoglobin level was considered as a continuous variable, the authors noted that the mortality risk correlated with hemoglobin level disappears when hemoglobin level exceeds 140 g/L. The authors conclude that anemia has strong impacts on functional class and other clinical outcomes in patients with heart failure.

Background: Coronary artery disease is the most common form of cardiovascular disease while Atrial fibrillation is the most common sustained arrhythmia. We set out to investigate the prevalence and clinical profile of patients with atrial fibrillation who present for selective coronary angiography and whether this has an effect on the angiogram findings and the treatment options offered to them. Methods and Results: This was a retrospectively collected database of 494 patients presenting for SCAG from 01.11.2010 to 30.11.2010 and 01.04.2010 to 30.04.2010. We collected and analyzed clinical characteristics of patients, their SCAG finding and modes of treatment offered up to discharge. 24.6% of patients had AF. They tended to be older, more commonly women, current or ex-smokers; presented with symptoms of atypical chest pain and were more likely to have a history of congestive heart failure or valvular heart disease. They had a longer hospital stay. Using CHADS-Vasc score, 83.6% were moderate to high risk for CVA. At SCAG, they were more likely to have non-significant coronary artery disease, and hence were more likely to be treated conservatively. Conclusion: AF patients presenting for SCAG constitute a unique subset of patients who despite having a higher likelihood of non-significant coronary stenosis are still prone to suffering from poorly-understood and under-appreciated myo-cardial ischemia.