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Background: Takotsubo cardiomyopathy is frequently considered as a benign disorder. We present an atypical form with cardiogenic shock that was managed by interventional cardiology measures. Case presentation: A 58 years old female patient with a past history of hypertension, obesity and multiple sclerosis was admitted at the Hospital Center of Montlucon for septic shock of urinary origin. During hospitalization in intensive care unit, the patient presented a markedly increasing of troponin levels with a diffused ST-segment elevation. Transthoracic Echocardiography showed an altered left ventricular ejection fraction at 35% with hypokinesia of apex and lateral ventricular segments in conjunction with compensatory hyperkinesis of the base; these findings were strongly suggestive of a diagnosis of Takotsubo cardiomyopathy. Despite concomitant anemia, renal failure and sepsis, all adequately treated with complete remission, the patient developed frequent episodes of ventricular tachycardia that prompted an emergency coronarography. During this procedure, the patient presented a cardiogenic shock and bradyasystole that were successfully managed by intra-aortic balloon pumping and temporary transvenous pacing. Finally, there were no coronary lesions and ventriculography confirmed a Takotsubo cardiomyopathy. Given the unstable hemodynamic status of this patient, she was addressed to the University Teaching Hospital of Clermont-Ferrand for more specialized care. Conclusion: This case alerts the physician to be more vigilant when managing all patients with Takotsubo cardiomyopathy, because some cases could be fatal. In severe cases, intra-aortic balloon pumping and temporary epicardial pacing can be life-saving.

COVID-19 is a worldwide crisis with a great impact in health structures. Delay in the management of routine medical conditions has been reported during this pandemic. We describe the case of a spontaneous dissection coronary arteries which has been initially misclassified as a case of COVID-19 infection

Strict monitoring of the heart rhythm in patients with COVID‐19 even nonsevere case and patient with low cardiovascular risk factors is very important to prevent fatal outcomes.

Free floating right heart thrombus is a rare phenomenon in the context of acute pulmonary embolism and it is associated with a poor outcome. The increased use of echocardiography has led to an increased detection of right heart thrombi. However, optimal management of free floating right heart thrombus remains controversial with no clear consensus. We present the case of a 74-year-old woman who presented to the emergency department with acute onset dyspnea on minimal exertion which had developed over a period of 1 day. A computed tomography of the chest demonstrated massive bilateral proximal pulmonary embolism. A bedside transthoracic echocardiography performed showed a moderately dilated, poorly functioning right ventricle with visible highly mobile serpiginous thrombus moving to and fro across the tricuspid valve. Thrombolytic therapy was immediately initiated with tenecteplase which resulted in excellent results. Although there is no clear consensus for the management of right heart thrombus associated with pulmonary embolism, thrombolysis is readily available and can be effective in carefully selected patients.

A new approach to the study of peripheral vascular hemodynamics in microgravity was initiated by designing an alternative methodology: air plethysmography (AP). This is the only technique that enables the quantification of vascular hemodynamics from gross measurements performed on the limbs. This paper reports a description of the device and of the measurement protocol. A comparative study showed that AP yields results that are well correlated, although not in agreement, with those obtained by means of the reference method in the laboratory (mercury strain gauge plethysmography, MSGP; for venous capacity, correlation coefficient r = 0.8, P < 0.0001, limits of agreement--0.9 ml.100 ml-1 and 1.4 ml.100 ml-1; for arterial flow index, correlation coefficient r = 0.7, P < 0.0006, limits of agreements -20.4 ml.min-1 and 37.2 ml.min-1; for half-emptying time, correlation coefficient r = 0.9, P < 0.0001, limits of agreement -0.88 s and 0.77 s), and that are characterized by good reproducibility (coefficient of variation in general lower than 12%). Preliminary findings during spaceflight, on board the Mir Space Station, yielded data that is expected to improve our knowledge of vascular deconditioning in conditions of weightlessness.