Introduction Apical hypertrophic cardiomyopathy (HCM) with microfistulas is a rare condition, and the incidence of multiple microfistulas draining into the left ventricle (LV) ranges from 0.07% to 0.09%., Diagnosis can be established via contrast ventriculography, coronary angiography, and echocardiography.– Two-dimensional echocardiography with color and pulsed-wave Doppler allows visualization of microfistula flow and measurement of diastolic flow velocity (DFV) using the same approach as for the left anterior descending artery (LAD). […]

Abstract Background Dobutamine stress echocardiography (DSE) using the conventional protocol (CP-DSE) may lead to important adverse effects. Objective This study was aimed at assessing the safety of DSE using a modified protocol (MP-DSE). Methods Data were collected from our institutional database to compare MP-DSE with the CP-DSE. In the CP-DSE, atropine could be administered during the fourth stage or its extension. In the MP-DSE, atropine was initiated at the beginning of the third stage, and there was no stage extension. […]

Introduction Spontaneous coronary artery dissection (SCAD) remains a diagnostic and therapeutic challenge in the evaluation of chest pain. Misinterpretation of symptom characteristics and failure to consider the patient’s epidemiological profile may lead to inappropriate diagnostic workups and treatment strategies. The case described herein represents only the second report with similar characteristics published in major medical databases. This case underscores the importance of considering uncommon causes of chest pain and acute coronary syndrome (ACS), while also providing a brief review of […]

Introduction After acute myocardial infarction (AMI), some cases progress with deep T wave inversions on electrocardiogram (ECG). This electrocardiographic abnormality can continue for a prolonged period, even if a coronary intervention within a short time of AMI progression results in successful myocardial reperfusion. However, these deep T wave inversions can raise management questions when the patient is already being followed up in an outpatient clinic, particularly in the absence of relevant symptoms to support the resurgence of an ischemic process. […]

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