We present a rare and complex case of a 76-year-old male patient with a history of low-grade neuroendocrine tumor (NET) of the small intestine, status post resection, who presented with recurrence of the tumor in the liver and subsequent carcinoid heart syndrome (CHS). The recurrent liver tumor caused severe tricuspid regurgitation and CHS, highlighting the rare association between NETs and CHS, particularly in the elderly population. This case underscores the importance of multidisciplinary care and close monitoring for patients with recurrent NETs and potential cardiac complications.

This case report details the challenging presentation of a 68-year-old patient of cardio-circulatory collapse with pericardial effusion and recurrent pleural effusions. Hypotension did not respond to conventional intensive care measures. Despite comprehensive investigations, the underlying cause remained unidentified until intravenous thiamine replacement therapy was administered, restoring normotension and preventing pericardial or pleural effusion recurrence. The case underscores the importance of early recognition of thiamine deficiency in patients with pericardial and pleural effusions or critical illness, emphasizing the need to expand vigilance for thiamine deficiency and consider replacement therapy without a definitive diagnosis.

Chest pain with focal ST elevation in the presence of elevated cardiac markers is usually believed to be secondary to an acute myocardial infarction. Moreover, widespread ST elevation is believed to be a hallmark sign of acute pericarditis. However, we present the case of a young male who presented with chest pain, elevated troponins, and focal ST elevations; however, left heart catheterization showed patent coronary arteries. The patient was treated for acute myo-pericarditis with ibuprofen and colchicine. This case illustrates the fact that focal ST elevation in a patient with chest pain and elevated markers of cardiac injury is not always secondary to an acute myocardial infarction.

Introduction: Atrial fibrillation (AF) is highly prevalent in heart failure (HF) and is linked to increased mortality and hospitalization in both preserved (HFpEF) and reduced ejection fraction (HFrEF). Catheter ablation (CA) has emerged as an effective rhythm-control strategy beyond medical therapy (MT), but phenotype-specific differences remain unclear. We compared the efficacy and safety of CA versus MT in AF with HFpEF or HFrEF. Methods: PubMed, Embase, Scopus, and Cochrane databases were searched through December 2025. Random-effects meta-analyses were conducted in R (version 4.5.3), reporting risk ratios (RRs) and mean differences (MDs) with 95% confidence intervals (CIs). Results: Fifteen studies involving 27,130 patients (CA: 13,579; MT: 13,551) were included. Catheter ablation significantly reduced overall all-cause mortality (RR 0.44), with a significant benefit in HFpEF (RR 0.44), whereas the reduction in HFrEF did not reach statistical significance (RR 0.53, 95% CI 0.21–1.38). Cardiovascular mortality and cardiovascular hospitalization were also reduced overall, without significant differences between HF phenotypes. Stroke and atrial arrhythmia recurrence were not significantly reduced in the primary analyses, and favorable findings observed in sensitivity analyses were considered exploratory . Catheter ablation significantly improved LVEF in HFrEF but not in HFpEF, while effects on exercise capacity and biomarkers varied across outcomes and phenotypes. Adverse events were comparable between treatment strategies. Conclusion: Catheter ablation was associated with favorable clinical outcomes compared with medical therapy in AF with HF; however, the magnitude and statistical certainty of benefit varied across heart failure phenotypes and outcomes.

We present a case of a 30-year-old male who was admitted with Streptococcus pneumoniae meningitis. He initially responded well to antibiotic therapy. However, the patient later developed symptomatic sinus bradycardia, which was likely due to intracranial hypertension. Even though the patient showed overt symptoms, vigilant monitoring, interdisciplinary collaboration, and cardiac evaluation helped avoid unnecessary interventions. This case highlights the importance of recognizing and managing rare cardiac complications associated with central nervous system infections.