European Journal of Cardiovascular Medicine

Coronary ischemia typically presents with retrosternal pain that radiates to left arm (1). It may presentatypicallyinvariousformslikeindigestion(2),otalgia(3),facialpain(4)andsyncope(5). Headache as the sole presentation of myocardial infarction (MI) is rare; however it has been reported previously. In a study of 150 patients with angina, about 6% were found to have concomitant headache In this article, we present a patient with myocardial infarction, whose main presentation was with headache and review other cases published in the literature.

Erythropoietin produced mainly in the kidney is the main regulator of erythropoiesis. Experimental studies identified additional, non-hematopoietic, protective effects during myocardial ischemia and reperfusion due to inhibition of apoptosis, stimulation of vasculogenesis and progenitor cell mobilisation. Based on these findings, five prospective, randomised, clinical trials have been performed. A short term regimen of erythropoietin was applied during PCI in patients with STEMI up to a cumulative dose of 100.000 IU. No changes in myocardial function or infarct size were observed after erythropoietin. Yet in two studies an increase in adverse events after erythropoietin was observed, whereas one study found an increase in major adverse clinical events in the control group. This review discusses experimental evidence of erythropoietin in acute myocardial infarction and its failure in clinical trials.

Patent ductus arteriosus (PDA) associated with coarctation of aorta is not an uncommon association. Surgery is considered as the gold standard treatment for this condition. Percutaneous interventional therapies can be offered to this condition, addressing both entities separately as device or coil closure of PDA along with keratoplasty with or without stenting, sequential sittings. Covered stents which are used for coarctation of aorta with aneurysm can theoretically be used in this condition thus avoiding multiple procedures. We report a case of PDA with coarctation of aor- ta, where a novel strategy of using a covered stent in the aorta to tackle both lesions in the same procedural sitting. The procedure was successful with excellent post-procedure and short-term result. This is the third of such cases reported in the literature.

Cardiovascular disease (CVD) remains the largest healthcare burden in the Western world; and the increasing prevalence of type II diabetes mellitus, at least partially driven by a trend in lifestyle changes associated with global economic development, is likely to fuel this CVD burden worldwide.