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Background: ST-segment elevation myocardial infarction (STEMI) remains a leading cause of mortality worldwide, primarily caused by acute thrombosis over atherosclerotic plaques. Simultaneous acute thrombosis in two coronary arteries is an exceptionally rare event. This report highlights a unique case of STEMI associated with cardiogenic shock due to dual coronary artery thrombosis and provides insights from a literature review on this rare condition. Methods: We report the case of a 58-year-old male with a history of hypertension, type II diabetes, and heavy smoking, who presented with a two-day history of chest pain and cardiogenic shock. Diagnostic evaluation included an electrocardiogram showing ST-segment elevation in AVR and ischemia, along with echocardiography revealing severe left ventricular dysfunction (ejection fraction 20%). Emergency coronary angiography was performed to identify the underlying pathology. Additionally, a literature review was conducted to analyze the characteristics and outcomes of similar cases of dual coronary artery thrombosis. Results: Coronary angiography identified significant occlusions in the proximal circumflex branch and the left anterior descending artery (LAD), a combination rarely reported in the literature. Our review confirmed that dual thrombosis involving the LAD and right coronary artery (RCA) is the most frequently described presentation of this condition, while simultaneous CFX and LAD thrombosis is exceedingly rare. Most reported cases, including ours, were associated with cardiogenic shock, highlighting the severity of this clinical entity. Despite successful thrombus aspiration and stenting, our patient experienced severe complications, including infections, pleural effusions, and paralytic ileus, ultimately requiring evaluation for left ventricular assist device implantation. Conclusions: This case underscores the complexity and critical challenges of managing STEMI with cardiogenic shock due to simultaneous coronary thrombosis. The findings from our literature review suggest the need for heightened clinical awareness and tailored revascularization strategies. Further studies are warranted to optimize management approaches and improve outcomes in such rare and high-risk scenarios. [ABSTRACT FROM AUTHOR]

Over the past two decades, transcatheter aortic valve replacement (TAVR) has expanded its application across all surgical risk levels, including low-risk patients, where, due to longer life expectancy, reducing common pitfalls of TAVR is essential. To address these needs, many technological advancements have been developed. Myval and the new generation Myval Octacor (Meril Life Sciences Pvt. Ltd) are novel balloon-expandable (BE) transcatheter heart valve (THV) systems designed for the treatment of severe aortic stenosis. This review aims to illustrate the design features of these novel THVs and the main evidence from available studies. Furthermore, we provide evidence of these THVs' performance in challenging scenarios such as extra-large aortic annuli, bicuspid aortic valves, and valve-in-valve/valve-in-ring procedures. Myval and Myval Octacor have demonstrated comparable early safety and clinical efficacy to the leading contemporary THVs, exhibiting remarkably low rates of moderate to severe paravalvular leak (PVL) and permanent pacemaker implantation (PPI). The wide range of sizes offered by the Myval family may minimize the risk of under-/oversizing, potentially explaining the lower rates of the aforementioned phenomena. Moreover, the presence of both internal skirt and external reinforced cuff may also explain the low rate of moderate to severe PVL. [ABSTRACT FROM AUTHOR]

Background: The natural history of atherosclerosis has not clearly been elucidated yet. Some works reported that flogosis plays a role in plaque instability. Why does this inflammatory process start? We investigated the correlation between Chlamydia pneumoniae acute infection and plaque rupture., Methods: We compared blood concentrations of IgM anti-Chlamydia pneumoniae in patients affected by acute myocardial infarction (AMI) and in patients affected by stable angina., Results: Our results showed a minimal statistical difference, with a more positive value in patients with AMI. Subsequently, the group affected by AMI was divided into two subgroups with and without plaque rupture: the subgroup with plaque rupture showed a higher blood concentration of Chlamydia antibodies. This subgroup was also divided into two other subgroups according to blood white cell concentration: the subgroup with normal concentration of white blood cells showed the highest value of Chlamydia antibodies., Conclusions: Chlamydia pneumoniae could play an important role in atherosclerotic plaque instability