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We present the first clinical report and describe the technique of using a modified Heartrail II guiding catheter to successfully puncture and remove a coronary angioplasty balloon that failed to deflate after stent implantation.

Heart failure (HF) is a major global healthcare problem with an estimated prevalence of approximately 26 million. In Asia-Pacific regions, HF is associated with a significant socioeconomic burden and high rates of hospital admission. Epidemiological data that could help to improve management approaches to address this burden in Asia-Pacific regions are limited, but suggest patients with HF in the Asia-Pacific are younger and have more severe signs and symptoms of HF than those of Western countries. However, local guidelines are based largely on the European Society of Cardiology and American College of Cardiology Foundation/American Heart Association guidelines, which draw their evidence from studies where Western patients form the major demographic and patients from the Asia-Pacific region are underrepresented. Furthermore, regional differences in treatment practices likely affect patient outcomes. In the following review, we examine epidemiological data from existing regional registries, which indicate that these patients represent a distinct subpopulation of patients with HF. In addition, we highlight that patients with HF are under-treated in the region despite the existence of local guidelines. Finally, we provide suggestions on how data can be enriched throughout the region, which may positively affect local guidelines and improve management practices.

Cardiovascular disease (CVD) is an under-recognized major health problem among women in South-East Asia. The prevalence of cardiovascular risk factors such as hypertension, diabetes mellitus, dyslipidemia, physical inactivity, and being overweight or obese has shown a significantly increasing trend among women in the region, with the exception of Singapore. The problem is compounded by low awareness that CVD is a health problem for women as well as for men, by misconceptions about the disease, and by the lack of suitable, locally available health literature. Efforts have been made by the national heart associations and other organizations to increase heart health awareness and promote healthy lifestyles. Singapore initiated these prevention programs in the early 1990s and has been successful in reducing the prevalence of cardiovascular risk factors. The governments of the region, in accordance with the Noncommunicable Disease Alliance, have begun implementing appropriate preventive strategies and improving health-delivery systems. However, psychological, social, and cultural barriers to cardiovascular health awareness in women need to be addressed before these programs can be fully and successfully implemented.

1Senior Consultant Cardiologist, National Heart Institute Kuala Lumpur 2Consultant Cardiologist, Subang Jaya Medical Centre, Selangor 3Consultant Cardiologist, Sarawak General Hospital Heart Centre 4Consultant Physician, Hospital Raja Permaisuri Bainun, Ipoh 5Consultant Cardiologist, Subang Jaya Medical Centre, Selangor 6Family Medicine Specialist, Primary Health Clinic Tanglin, Kuala Lumpur 7Consultant Cardiologist, Hospital Pulau Pinang, Penang 8Consultant Cardiologist, Universiti Kebangsaan Malaysia Medical Centre, Kuala Lumpur 9Specialist in Internal Medicine, Hospital Kuala Lumpur, Kuala Lumpur 10Consultant Cardiologist, National Heart Institute Kuala Lumpur 11Consultant Cardiologist, University Malaya Medical Centre Kuala Lumpur