Crochet Leads the Way.

The crochetage sign-a notch near the R-wave peak in the inferior leads-in conjunction with right axis deviation, complete or incomplete right bundle branch block, and right ventricular hypertrophy (R/S ratio >1 in lead V1) on 12-lead electrocardiogram are highly suggestive of atrial septal defect. (Level of Difficulty: Intermediate.).

Capecitabine-Associated Coronary Vasospasm and Cardiac Arrest.

Capecitabine is a prodrug of fluorouracil that specifically targets cancer cells, commonly used as monotherapy for metastatic breast and colorectal cancer. Its side effects include nausea, diarrhea, vomiting, abdominal pain, anorexia, palmar-plantar erythrodysesthesia, anemia, and hyperbilirubinemia. Rarely, this chemotherapy agent has been associated with cardiotoxicity, including cardiac arrest, likely secondary to coronary vasospasm. This case report serves to highlight the unfortunate case of a 32-year-old female who suffered a ventricular fibrillation cardiac arrest three days after initiating capecitabine therapy.