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We present a 17-year-old woman with a 5-year history of systemic lupus erythematosus (SLE). The patient referred to us with the rheumatic involvement of the mitral valve and was treated with mitral valve repair by ring annuloplasty and anterior leaflet augmentation with autologous pericardium. Follow-up, however, disclosed precocious calcification of the valve, necessitating mitral valve replacement.

We report the case of a 48-year-old woman with a history of transient ischaemic attacks (TIA). The patient was diagnosed with a large patent foramen ovale (PFO), for which she underwent percutaneous PFO closure. Two years postprocedurally, the patient suffered frequent TIA and assessment showed the displacement of the device. The device was surgically removed, and the septum was repaired with a pericardial patch. Afterward, however, the patient experienced repeat TIA. It was discovered that the patient had a pulmonary arteriovenous fistula (PAVF), and a diagnosis of a trauma was made. The PAVF was later coil embolised. This case illustrates the importance of evaluating PFO closure patients for the associated causes of right-to-left shunting.

A 21-year-old man who had suffered an episode of complete heart block 2 months earlier and thus undergone pacemaker implantation presented with syncope. Echocardiography showed cardiac tamponade and raised the suspicion of lead penetration. The effusion was drained. Multi-sliced CT scan confirmed that the right aspect of the pacemaker wire was extracardiac, causing the cardiac tamponade.