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Unusual chest pain is often observed in older women with diabetes, high blood pressure, and heart disease. Some unusual manifestations of myocardial infarction have so far been reported, including earache, flank pain, fatigue, neck pain, nausea and vomiting, shortness of breath, and shoulder pain. In this article, we report a case of rare symptoms of cardiovascular disease with referral symptoms, including abdominal colic pain. The patient was a 55-year-old man with a history of diabetes under treatment with insulin who had abdominal colic pain, periodic epigastric tenderness, and frequent nausea and vomiting for 2 days. At first, he was suspected of pancreatitis, but considering that his amylase and lipase enzymes were normal and no evidence of the existence of free abdominal and pelvic fluid was observed according to ultrasound results, the hypothesis of pancreatitis was rejected. Despite the normality of the initial ECG until the night before the visit by the cardiologist, the patient experienced more severe pain and, as a result, was referred to the cardiac internal ward until the end of the same night, after angiography, it was found that the obtuse marginal (OM1) branch of coronary arteries had severe narrowing (90-99%). Abdominal tenderness and colic pain are among the unusual manifestations of myocardial infarction. In patients with cardiac risk factors, such as diabetes and chronic kidney disease, despite the existence of a normal ECG, uncommon manifestations should be checked.

May-Turner syndrome is a relatively uncommon anatomical variation in which patients develop iliofemoral deep vein thrombosis (DVT) due to venous occlusion. In this syndrome, the left common iliac vein is compressed against the fifth lumbar vertebra by the right common iliac artery. The real incidence/prevalence of May-Turner syndrome is not precisely known, but it is estimated to be between 22 - 32% based on imaging studies. However, this syndrome is hardly ever considered in DVT diagnosis, especially in individuals with other risk factors. This venous occlusion may cause several symptoms such as leg swelling, venous thrombosis, or even more serious complications including pulmonary embolism. The use of systemic anticoagulants alone is inefficient for the treatment of May-Turner syndrome, and more aggressive approaches are necessary to prevent clots recurrence. In this article, we described a case of a young woman suffering from pain and progressive swelling of the left lower limb without any provoking factors. With a comprehensive diagnostic approach including Doppler ultrasound and seeing a thrombus in the external iliac and left femoral veins and obstruction of the left common iliac vein in the venography images, it was determined that she has iliac vein compression syndrome. When facing unilateral venous thromboses, especially in younger age groups, the differential diagnosis should also consider May-Turner syndrome.

In evidence-based medicine, constructing research questions is the most important part of research integration. Formulating a research question is the first step to conducting a credible and valuable research. Patient, intervention, comparison, outcome (PICO) is a specialized framework used by most researchers to formulate a research question and facilitate resource review. In the heart ward of Razi Hospital, Birjand University of Medical Sciences, according to the needs assessments, PICO was implemented during the Journal Club to familiarize students with research and increase their level of knowledge, attitude, as well as clinical reasoning skills. In this article, we explain the case of a 36-year-old woman with typical chest pain for 3 hours due to severe stress, without cardiac risk factors referring to the emergency room. The clinical examination was normal. The ST elevation was observed in the aVR lead. The question is “Should we perform an invasive intervention for this patient?

In recent years, non-communicable diseases (NCDs) have accounted for about 70% of the worldchr('39')s deaths. The most common NCDs are cardiovascular disease, cancer, diabetes mellitus, and chronic respiratory diseases. These diseases have four common risk factors, including inadequate physical activity, unhealthy diet, smoking, and excessive alcohol consumption. Cardiovascular diseases, despite their high prevalence, are the most preventable chronic diseases. The most common risk factor for cardiovascular disease is high blood pressure, which can be prevented if it is diagnosed and controlled carefully. Recent guidelines have changed the methods of blood pressure measurement, definition, and treatments. Recently, more emphasis has been placed on Out-of-Office Blood Pressure Measurement. Therefore, it is necessary to consider the methods of measuring blood pressure at home and 24-hour Holter blood pressure monitoring, as well as understanding its standards. The use of automatic arm sphygmomanometers to measure blood pressure is more acceptable than manual ones (mercury or Aneroid). The most accepted definitions of hypertension are BP≥140/90 mm Hg in the clinic, the average blood pressure at home≥135/85 mm Hg, and the average blood pressure in 24-hour Holter monitoring≥130/80 mm Hg. Proper treatment of hypertension by changing lifestyle and proper medication therapy can control blood pressure and prevent serious complications. Today, the use of combination drugs, especially a single pill in a single dose, has been emphasized. This study aimed to review the most recent hypertension treatment protocols based on the guidelines of the American Heart Association (AHA 2017), the European Society of Cardiology (ESC 2018), the British Heart Association (NICE 2019), and the International Society of Hypertension (ISH 2020). Furthermore, this study attempted to assess the symptoms, complications, methods of diagnosing, definitions, as well as pharmacological and non-pharmacological treatments of hypertension.

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Pheochromocytoma is a rare catecholamine-producing neuroendocrine tumor who often presented with palpitation, headache, hypertension, acute abdominal pain and chest pain but we report a case of pheochromocytoma presented with syncope [ABSTRACT FROM AUTHOR]