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Background MicroRNAs are small, endogenous, non-coding RNAs that regulate the expression of many genes. It has recently been shown that circulating microRNAs may be biomarkers of hypertrophy and fibrosis in patients with hypertrophic cardiomyopathy (HCM). Objective To determine whether circulating levels of microRNAs involved in HCM are associated with electrocardiographic and echocardiographic parameters. Methods This study enrolled 20 patients with familial HCM and 20 blood donors. Peripheral serum levels of miR-29a-3p, miR-199a-5p and miR-451a were assessed by quantitative real-time polymerase chain reaction and compared with levels in the control group. Whether circulating levels of miRNAs in HCM patients correlated with electrocardiographic and echocardiographic parameters was also assessed. Results Median circulating levels of miR-29a and miR-451a were significantly higher in HCM than the control group. Median miR-199a levels did not differ between groups. However, circulating levels of miR-199a negatively correlated with corrected QT duration (Bazett formula). Median miR-29a levels positively correlated with QRS duration. In addition, circulating levels of miR-29a correlated with maximal wall thickness, left ventricular mass index and left atrial volume index. Conclusions The data suggested that serum levels of miR-29a and miR-451a were significantly increased in HCM patients. As the circulating level of miR-29a correlated with QRS duration, left ventricular hypertrophy and left atrial dilatation, the serum miR-199a level negatively correlated with corrected QT duration. These miRNAs may be seen as potential biomarkers for further research in HCM pathophysiology.

Cardiac manifestations of hydatid cysts are rare and occur in 0.5% to 2% of all cases of human hydatidosis. Behçet's disease is a vasculitis which is often associated with venous thrombosis. An intra-cardiac mass in a patient with Behçet's disease should raise the suspicion of thrombosis. However, we report a 32-year-old gentleman with Behçet's disease and history of multiple episodes of venous thrombosis who was first diagnosed with having an intra-cardiac thrombus on echocardiogram. Five months later, his echocardiogram revealed a hydatid cyst in the right ventricular apex which was also confirmed by cardiac magnetic resonance.

Pericardial effusions are common in patients with anterior myocardial infarction and resolve slowly after it. The diagnosis is generally established via echocardiography. However, a persistent, large pericardial effusion after the myocardial infarction may mask a more hazardous complication: pseudoaneurysm. Herein, we report a young gentleman presenting with dyspnea who had myocardial infarction and was misdiagnosed with large pericardial effusion.

Background The information on electrocardiographic features of patients with coronavirus disease 2019 (COVID-19) is limited. Our aim was to determine if baseline electrocardiographic features of hospitalized COVID-19 patients are associated with markers of myocardial injury and clinical outcomes. Methods In this retrospective, single center cohort study, we included 223 hospitalized patients with laboratory-confirmed COVID-19. Clinical, electrocardiographic and laboratory data were collected and analyzed. Primary composite endpoint of mortality, need for invasive mechanical ventilation, or admission to the intensive care unit was assessed. Results Forty patients (17.9%) reached the primary composite endpoint. Patients with the primary composite endpoint were more likely to have wide QRS complex (>120 ms) and lateral ST-T segment abnormality. The multivariable Cox regression showed increasing odds of the primary composite endpoint associated with acute respiratory distress syndrome (odds ratio 7.76, 95% CI 2.67–22.59; p 120 ms (odds ratio 3.62, 95% CI 1.39–9.380; p = 0.008) Patients with a wide QRS complex (>120 ms) had significantly higher median level of troponin T and pro-BNP than those without it. Patients with abnormality of lateral ST-T segment had significantly higher median level of troponin T and pro-BNP than patients without. Conclusions The presence of QRS duration longer than 120 ms and lateral ST-T segment abnormality were associated with worse clinical outcomes and higher levels of myocardial injury biomarkers.

Fibrinolysis is an option for the management of mechanical prosthetic valve thrombosis when surgery has prohibitive risks. Current guidelines suggest recombinant tissue plasminogen activator (not to exceed 100 mg) with unfractionated heparin. A low-dose (25 mg) alteplase regimen as treatment in patients with a high risk of bleeding warrants further research. This report describes the case of a 65-year-old woman with a history of mechanical prosthetic mitral valve replacement who was diagnosed with signet ring cell adenocarcinoma of the stomach and obstructive mechanical prosthetic thrombosis on echocardiogram. Details of challenging aspects of this case and the use of modified fibrinolytic therapy are provided.

Atrioventricular nodal reentrant tachycardia (AVNRT) is the most common type of reentrant paroxysmal supraventricular tachycardia that occurs in the presence of dual AV nodal physiology. Wolff-Parkinson-White (WPW) syndrome is another type of supraventricular tachycardia characterized by short PR intervals, delta waves and wide QRS complexes on the surface electrocardiogram (ECG), reflecting atrioventricular pre-excitation. Uncommonly, AV nodal reentry and accessory pathways can coexist. In this case report, we present a patient who had frequent episodes of palpitation and syncope and recently presented to the emergency department (ED) with the complaint of dizziness. We performed successful radiofrequency (RF) catheter ablation of mitral annulus posterolateral accessory pathway and AVNRT which was the cause of the second tachycardia induced during the same session. Keywords: Atrioventricular nodal reentrant tachycardia, Wolff-Parkinson-White syndrome, Radiofrequency ablation

Q fever is a zoonotic disease caused by Coxiella burnetii, an obligate intracellular bacterium, which cannot be grown using routine blood culture methods. Although C. burnetii is reported to be the causative agent in approximately 50% of blood culture-negative infective endocarditis cases in developed countries, the incidence in Turkey is yet to be defined. The clinical course of Q fever endocarditis is generally subacute and chronic; the disease may be present for years with only subtle symptoms and no vegetation visible on echocardiography while the bacteria gradually destroy the heart valves. This is the case of the successful treatment of a young man with Q fever endocarditis that had an acute clinical course. In 1 month, he developed New York Heart Association class IV heart failure and a large, 3-cm vegetation was observed on an echocardiogram.

Antiphospholipid syndrome (APS) is a clinical disorder that creates an increased risk of arterial or venous thrombotic events or pregnancy-associated complications and includes the presence of autoantibodies against negatively charged phospholipids. This syndrome is often associated with systemic autoimmune diseases, such as systemic lupus erythematosus (SLE). Libman-Sacks endocarditis is a form of non-bacterial thrombotic endocarditis and is infrequently seen in APS. There are few data documenting the echocardiographic response of APS valve disease to medical treatment. This is an unusual case of a young female patient with SLE and APS who had chorea and non-bacterial thrombotic aortic valve endocarditis. Echocardiography revealed that the vegetation had receded after a combination of warfarin and immunosuppressive therapy.

A sinus of Valsalva aneurysm is a rare cardiac anomaly, and it is usually clinically silent. However, it may lead to symptoms when it compresses adjacent cardiac structures. Herein, we would like to report a 45-year-old lady with exertional dyspnea who was first diagnosed with having a cystic cardiac mass on transthoracic echocardiogram. Then, transesophageal echocardiogram and cardiac computed tomography revealed an unruptured aneurysm of noncoronary sinus of Valsalva.