Dual right coronary artery (RCA) is a rare coronary anomaly. This anomaly is often undetected and may be totally asymptomatic to presenting as acute coronary syndrome. Here, we present a 41 year old male diabetic and smoker presented with acute onset severe chest pain of 30 minutes duration which was managed as acute coronary syndrome .His urgent coronary angiogram revealed single ostial origin of right coronary artery ( RCA) with total occlusion from proximal segment followed by double right coronary arteries with their respective distal branches.

Isolated pseudoaneurysm of a sinus of Valsalva is an uncommon sequelae of infective endocarditis. It is very uncommon in native aortic valve stenosis as compared to aortic regurgitation. We present a case of a 46 year old gentleman with a severely stenotic aortic valve with infective endocarditis, and a pseudoaneurysm of the non coronary sinus of Valsalva. The pseudoaneurysm was repaired with a prosthetic patch and the aortic valve was replaced by a mechanical prosthesis. Transthoracic echocardiography and computed tomography aortogram are an ideal diagnostic tools in suspected cases. Surgery can be curative with excellent results.

In?uenza is a common, but serious illness, which has a burden of disease all over the world. It is estimated that there are about 3 to 5 million severe case of the disease that may require hospital admission, and around 290,000 to 650,000 deaths in each seasonal outbreak. The whole population is at risk of becoming ill due to in?uenza. However, children and patients with chronic illnesses, such as those with cardiovascular diseases or multiple disorders, have a higher risk of developing complications. The prevention of infection due to in?uenza through vaccination is well known in the childhood population, but also has an important role in the maintenance of health and prevention of mortality and morbidity in patients with cardiovas- cular disease. This is due to known cardioprotective mechanisms, mainly in the prevention of acute myocardial infarction or heart failure. Nowadays, immunization must be included in the comprehensive secondary prevention in these patients.

A 53-year-old man with a known allergy to metamizole presented for acute gonalgia, receiving metamizole by mistake. He suffers a severe allergy reaction accompanied by chest pain and signs of acute lower myocardial infarction, which subsides with treatment of anaphylactic shock and fibrinolysis, without observing intracoronary thrombus or signs of complication of atherosclerotic plaque.

Balloon aortic valvuloplasty (BAV) provides an excellent alternative to surgical intervention and has become the preferred intervention for initial palliation for aortic stenosis in neonates, infants, children, adolescents, and young adults. The elderly patients with calcific aortic stenosis do not benefit from BAV. With the exception of neonates, most patients can be discharged home within 24-hours of the procedure. Although there is definitive evidence for pressure gradient relief immediately after as well as at follow-up and postponement of surgical intervention following BAV, the progression of aortic insufficiency at late follow up remain a major concern. In the neonatal population, severe aortic insufficiency may develop requiring surgical intervention. Despite these limitations, balloon aortic valvuloplasty is currently considered as therapeutic procedure of choice in the management of congenital aortic stenosis in the pediatric and young adult population. Careful follow-up to detect recurrence of stenosis and development of significant aortic insufficiency is recommended.