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Traditionally reflecting critical stenosis of the proximal left anterior descending (LAD) artery, Wellens' syndrome (WS) is an electrocardiogram (ECG) pattern of biphasic or deeply inverted T waves in leads V2 and V3. This critical stenosis can progress to an extensive anterior myocardial infarction (MI) if early and appropriate management is not received promptly. The diagnosis of severe stenosis of the LAD coronary artery can be made by using electrocardiographic changes in Wellens' syndrome. Due to the significant area that the LAD vascularizes, patients who exhibit symptoms and test results suggestive of this syndrome should be referred right away for an angiographic exploration in order to confirm the diagnosis and guide treatment. We report a case of a 71-year-old male admitted to our department for acute chest pain. His ECG showed Wellens' syndrome type 2 during both chest pain and pain free with slightly elevated troponin. His TIMI score was 3 and the GRACE score was 136. Critical stenosis of the LAD coronary artery was found in the coronary angiography, which required a drug-eluting stent. The patient was discharged asymptomatic from medical therapy. The diagnosis was established on the basis of the patient's interview, ECG analysis, and coronary angiography., Competing Interests: The author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article., (© The Author(s) 2024.)

Chronic constrictive pericarditis is a pericardial affection that causes a severe impairment of myocardial compliance. Among its many etiologies, tuberculosis is the most common cause, mainly in developing countries. Multimodal imaging methods are essential tools for guiding diagnosis. We present the case of a 64-year-old man with no past medical history who presented with dyspnea stage II of NYHA and right heart failure. At admission, he was stable, with normal blood pressure and a normal heart rate. His ECG showed a low voltage of QRS complexes. Transthoracic echocardiography revealed significant pericardial thickening enveloping the ventricles, with significant respiratory flow variation. A thoracic CT scan and cardiac MRI confirmed the presence of pericardial thickening and calcifications. The patient underwent beat-heart pericardial decortication. The anatomopathological examination of the surgical piece revealed Mycobacterium tuberculosis. The postoperative check-up after 6 months showed good clinical and echocardiographic evolution., (© 2024 The Authors. Published by Elsevier Inc. on behalf of University of Washington.)

Acute coronary syndromes are a clinical entity frequently encountered in practice and are responsible for significant morbidity and mortality, despite therapeutic advances. The initiation of early reperfusion therapy reduces mortality and morbidity and improves patients' prognosis, but this depends on how quickly patients receive their treatment. Although it is often easy to diagnose in the presence of typical symptoms, certain patients, such as diabetics, sometimes have atypical symptoms, resulting in a delay in management. In nearly 50% of cases, inferior wall ischaemia is accompanied by right ventricular myocardial infarction; the clinical outcomes range from no hemodynamic compromise to severe hypotension and cardiogenic shock. In this article, we present the case of a 54-year-old male patient with active smoking and poorly controlled type 2 diabetes as cardiovascular risk factors who initially consulted at the first hour for epigastric pain, for which he received symptomatic treatment. As the symptoms persisted, he was admitted to our department at the eighth hour, where he was diagnosed with a biventricular infarction., Competing Interests: The author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article., (© The Author(s) 2024.)

Renal infarction is a rare pathology, threatening the functional prognosis of the kidney. Given the lack of clinical features specific to this pathology, the practitioner may wrongly diagnose pyelonephritis or other causes of abdominal pain. Renal infarction frequently occurs in patients with thromboembolic risk factors, most often secondary to atrial fibrillation. We report the case of a 49-year-old patient, with no previous history, who presented to the emergency room with palpitations and pain in the right flank with an atrial fibrillation rhythm on the ECG, in whom abdominal CT angiography showed signs of a focal renal infarction of the right kidney. Later, the progression was towards non-traumatic macroscopic hematuria with preservation of normal renal function, which resolved spontaneously after a few days. AF was accepted in the face of significant dilatation of the left atrium, in consultation with the patient, and he was put on a beta-blocker to control the rate. Renal infarction must be considered despite its rarity to initiate adequate treatment and increase the chances of renal rescue., (© 2024 The Authors. Published by Elsevier Inc. on behalf of University of Washington.)

Pulmonary hypertension is a condition characterised by elevated pulmonary arterial pressures secondary to various aetiologies; the most common ones are left heart diseases. Similarly, an association between thyroid diseases and pulmonary hypertension has been reported in some cases, but the pathophysiological relationship has not been fully elucidated. Etiological investigation is an important step in the management of pulmonary hypertension and determines the appropriate treatment. In this report, we present a case of severe pulmonary hypertension in a 57-year-old woman, in which mixed aortic valve disease and hypothyroidism were involved., Competing Interests: The author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article., (© The Author(s) 2024.)