Isolated Tricuspid Regurgitation Alternans in Acute Myocardial Infarction: A Rare Entity.

Pulsus alternans is characterized by alternating strong and weak beats, and occurs with failing hearts. Left ventricular pulsus alternans is known to occur with ischemic heart disease, valvular heart disease, and outflow tract obstructions. Isolated right ventricular (RV) pulsus alternans is a rare entity. We report the case of a 51-year-old male patient who presented with inferior wall myocardial infarction and cardiogenic shock. He was diagnosed to have an isolated tricuspid regurgitation alternans signifying severe RV dysfunction. The patient was resuscitated and treated with primary percutaneous intervention to the right coronary artery. We also review the literature associated with RV pulsus alternans and its mechanisms.

Global Longitudinal Strain in Wellens' Syndrome.

We present the case of a young man with "noncardiac" chest pain, subsequently diagnosed as Wellens' syndrome. We report the early changes in left ventricular global longitudinal strain imaging findings in these patients despite preserved ejection fraction, and review the features associated with this stereotypical cardiac condition. The patient underwent a successful percutaneous coronary intervention.

Endovascular Embolization of Intrapulmonary Sequestration.

Traditionally, management of lung sequestrations has been surgical. This is one of the few reports where a percutaneous management has resulted in resolution of symptoms and offers a novel approach for management.

Sheath-Induced Sterile Abscesses.

Sterile inflammatory reactions at vascular access sites have rarely been reported in the literature. Simple conservative treatment, as in this case, can lead to resolution of even extensive sterile abscesses.

Collagenofibrotic Glomerulopathy: Report a Rare Case.

Collagenofibrotic glomerulopathy is a rare clinical entity with fewer than 40 cases reported worldwide. We describe a case of adult onset nephrotic syndrome with partial villous atrophy of the intestine who was diagnosed with this rare entity. Collagenofibrotic glomerulopathy is characterized by subendothelial and mesangial collagen type III deposition and increased procollagen III peptide levels. Extra renal involvement has been described in the form of hypertension, anemia and microangiopathic hemolytic anemia but villous atrophy has not been associated with this condition so far, possibly reflecting the paucity of literature. We describe this case and review the condition in this report.

Concertina Effect.

Accordion effect or concertina effect - also known as "crumpled coronary" - is an uncommon occurrence during coronary angioplasty. It usually has no major clinical sequelae and should be differentiated from spasm, dissection, and thrombosis, which require special management.

Coronary Artery Air Embolism.

Coronary artery air embolism can be fatal if not proficiently managed. Vasospasm is said to be protective in that it breaks the larger air bubbles, as occurred in the present case.

Flibanserin: A controversial drug for female hypoactive sexual desire disorder.

Sexual functioning is an integral part of human life. Female sexual dysfunction (FSD) adversely affects quality of life and general well-being. The Food and Drug Administration recently approved flibanserin, for treatment of female hypoactive sexual desire disorder (HSDD), regarded as the most common FSD, amid great controversy. A novel multifunctional serotonin agonist and antagonist, flibanserin, has been shown to be efficacious in treating HSDD but with a rather tenacious side effect profile. We review this interesting drug in its entirety. Data for the article were collected by reviewing articles on PubMed, the drug (Addyi) website, and related websites on the internet.