An 80-year-old man underwent permanent dual-chamber pacemaker implantation for his sick sinus syndrome. During the implantation procedure, the patient complained of mild shortness of breath after left subclavian vein puncture. Under fluoroscope, mild left pneumothorax was found. There was an airspace subsequently interposing between the main pulmonary... Join discussion...

Objective In acute myocardial infarction, cardiovascular magnetic resonance (CMR) allows for quantifying the extent of salvaged myocardium after reperfusion as a potential strong end point for clinical trials. The aim of this study was to investigate whether the early prognostic significance of myocardial salvage assessed by CMR is sustained at long... Join discussion...

Objective To examine whether warfarin use and outcomes differ across CHADS2 and CHA2DS2-VASc risk strata for non-valvular atrial fibrillation (NVAF). Design Population-based cohort study using linked administrative databases in Alberta, Canada. Setting Inpatient and outpatient. Patients 42 834 consecutive patients ≥20 years of age with newly diagnosed NVAF... Join discussion...

The role of cardiac magnetic resonance (CMR) for detection of myocardial injury in asymptomatic subjects has been tested so far only in selected healthy or unhealthy populations, such as competitive athletes and patients with liver cirrhosis. 1 2 Aquaro et al should be congratulated for their original study, which is the first to assess the prevalence... Join discussion...

Aortic valve sclerosis-stenosis is the most common valvular pathology in industrialised countries, evolving from aortic valve sclerosis into aortic stenosis (AS). Aortic valve sclerosis is present in 25% and AS in 2% of people aged >65 years. Heyde syndrome is an acquired and intricate pathology encountered in AS and in the obstructive form of hypertrophic cardiomyopathy (HOCM)... Join discussion...

The pervasive public health message is that moderate amounts of endurance exercise help maintain optimal health and reduce cardiovascular risk. While not enough people meet national physical activity guidelines, there are some at the opposite end of the activity spectrum who far exceed the recommended ‘dose’ of exercise. The cardiovascular... Join discussion...

Symptomatic bradycardia contributes significantly to mortality and decreased functional status in many low and middle income countries (LMIC). In contrast to the developed world, where bradycardia often results from sinus node dysfunction, patients requiring pacemakers in LMIC more commonly present with complete heart block. 1–3 Yet many patients... Join discussion...

Introduction With an ageing population and improved diagnostic modalities, the number of patients with valvular heart disease is dramatically increasing. Considering projected changes in the age distribution, a further accentuation of this trend can be expected and this may indeed be considered "the next cardiac epidemic". 1 Obviously, we... Join discussion...

Objective To study the prevalence and medium term outcome of subclinical rheumatic heart disease (RHD) in India. Design Cross sectional echocardiographic screening study. Setting School children aged 5–15 years living in rural areas of north India. Patients A cross sectional echocardiographic screening study was carried out among... Join discussion...

Background High molecular weight von Willebrand factor (vWF) multimers (HMWM) are often deficient in patients with severe aortic stenosis (AS) owing to shear stress-enhanced proteolysis of vWF. It has also been reported that AS is associated with increased activation of blood coagulation. Objective To investigate whether patients with AS with a... Join discussion...