Introduction: Sleep disturbances are prevalent among patients with heart failure (HF) and may trigger acute exacerbations of the condition. However, the causal relationship between sleep disturbances and HF remains uncertain. This study aims to explore the association and potential causal relationship between sleep disturbances and HF.Material and methods: Observational Study: NHANES data (2005-2008) involving 10,432 participants. Sleep disturbances defined as insomnia, sleep disorders, difficulty falling asleep, trouble sleeping, and waking up during the night. Mendelian randomization (MR) Study: Genetic variants linked to sleeplessness were obtained from GWAS datasets. MR Two-sample analysis was conducted using summary statistics from sleeplessness and HF GWASs.Results: After full adjustment, the association between insomnia and HF remained significant, with an OR of 5.10 (1.81–14.33, P = 0.003). After full adjustment, the association between sleep disorder and HF remained significant, with an OR of 3.51 (1.67–7.39; P = 0.002). The IVW method provided evidence supporting a causal association between sleeplessness and HF (OR = 1.535, SE = 0.177, P = 0.016).MR-Egger analysis demonstrated a causal association between sleeplessness and HF (OR = 3.333, SE = 0.493, p =0.023). Our observational study may be influenced by unaddressed confounding factors; however, Mendelian randomization helps mitigate the bias and confounding commonly found in non-genetic observational research.Conclusions: Our study identified a correlation between sleep disturbances and HF, potentially suggesting a causal relationship. Addressing sleep disturbances may be a key strategy in reducing the risk of HF.

Drug‐induced QT prolongation, primarily antiarrhythmic drugs, is a common cause of torsade de pointes (TdP). Although there have been previous reports of drug‐induced TdP in patients, it has not been well documented when caused by citalopram during the pacemaker battery‐depletion phase. To improve delirium recognition, we report a case of citalopram‐induced TdP during the pacemaker battery‐depletion phase. An 84‐year‐old Chinese female was brought to the hospital presenting recurrent syncope. She lost consciousness and was admitted after her syncope TdP was documented. Her pacemaker was inspected and found to be operating in an extremely ineffective manner. Although she had prolonged QT interval after the pacemaker was replaced, she did not suffer another syncope attack, and ECG monitoring revealed no cardiac arrhythmia or TdP. During her admission, she was treated with citalopram for depression. Citalopram was discontinued when the QT interval shortened progressively. In this study, we described a case of citalopram‐induced TdP during the depletion phase of a pacemaker battery. This case should serve as a cautionary lesson to clinicians to avoid using citalopram during the pacemaker battery‐depletion phase.

Acute aortic dissection (ADD) is the frequently diagnosed lethal disease of the aorta. Some of the patients with acute aortic dissection is complicated by neurological symptoms. Although there are previous reports of the clinical characteristics of patients with aortic dissection presenting with neurological symptoms, acute aortic dissection with forgetting as first manifestation has not been well described. To increase the clinician awareness of AAD, we firstly reported one male Chinese patient to present with forgetfulness as an initial symptom as the first manifestation. A 53-year-old man presented at the emergency department with forgetting. First, stroke must be considered early in the differential diagnosis, as “time is brain.” Secondly, the diagnosis was acute myocardial infarction, and emergent coronary angiogram are examined. At long last, the ADD was diagnosed with enhanced CT. Thus, a much of valuable time is lost in diagnosis rather than for the treatment. Timing of surgery Optimal timing for surgery have already missed. patients while waiting for emergency surgery died following aortic dissection rupture. In patients presenting with cannot entirely account for forgetting, ADD should be considered. We believe this case report contains a worthwhile clinical lesson for clinicians.

This article describes a case involving a patient who presented with chest pain persisting for three days, elevated levels of cardiac troponin, and widespread ST segment elevation in the ECG leads. Subsequent diagnosis revealed esophageal perforation resulting from the accidental ingestion of a fish bone, leading to pericardial effusion and pneumopericardium. This case highlights the importance of healthcare professionals conducting a comprehensive investigation of the patient’s medical history when confronted with widespread ST segment elevation and elevated cardiac troponin levels to avoid misdiagnosis and mitigate potential serious consequences.