Aim: To compare the efficacy and safety of tyrosine kinase inhibitors (TKIs) as first-line treatment in patients with locally advanced or metastatic non-small-cell lung cancer (NSCLC) with positive...

Background: Kounis syndrome is the occurrence of acute coronary syndrome precipitated by an allergic reaction in the presence or absence of underlying coronary artery disease. The syndrome is explained by the effect of released inflammatory mediators on the coronary arteries and platelets.Case summary: We report an uncommon case of Kounis syndrome Type II in a 65-year-old man 24 h after being bitten by a hymenoptera. Clinical context, electrocardiogram, coronary angiography, and enhanced cardiac magnetic resonance imaging (MRI) imaging modality are presented.Discussion: Awareness and understanding of this syndrome is essential for starting early and appropriate therapy, thereby preventing life-threatening events. Accordingly, we highlight the importance of enhanced cardiac MRI to complete the assessment of this entity.

Background : Several clinical entities may be misdiagnosed in elderly if we consider dysphagia as a normal aging process in our daily practice. On top of usual aetiologies like motor dysfunction, investigations may uncover serious underlying conditions. Case summary : We report an unusual case where dysphagia was the warning sign for acute heart failure in a 76-year-old patient known to have dilated cardiomyopathy with reduced ejection fraction. It was due to an external oesophageal compression by the left atrium. A transthoracic echocardiography, an enhanced thoracic computed tomography-scan and esophagogastroduodenoscopy were used for the diagnosis. Diuretics were the cornerstone treatment with symptomatic improvement. Discussion : Despite the fact that cardiovascular dysphagia is an uncommon medical entity, but it remains a potential differential diagnosis, especially in elderlies with high risk for atrial enlargement.

Background: Left main coronary thrombus is a rare angiographic finding associated with serious outcomes such as sudden death and cardiogenic shock. Rupture of an underlying atherosclerotic plaque is the main risk factor. The role of cannabis consumption in the pathophysiology of acute cardiovascular disease is controversial. Case presentation: We present a case of non-ST-elevation myocardial infarction characterized by a mobile left main coronary thrombus in a young male cannabis consumer successfully treated with manual aspiration, dual anti-platelet, and unfractionated heparin therapy. Conclusion: Cannabis consumption could be a risk factor for coronary artery thrombosis. The pathophysiology mechanism of action is not well understood. Reaching an optimal management is a potential challenge for physicians.

Background: Cancer associated thrombosis is recognized. However, pulmonary embolism (PE) from testicular cancer is rarely reported. Right ventricular (RV) function and PE are closely related. The RV cannot cope with a sudden increase in afterload because of PE and this causes dysfunction, but isolated left ventricular dysfunction in this context is not reported in the literature. Case presentation: We report an unusual association of pulmonary embolism and testicular germ cell tumor complicating severe left heart failure and full recovery at three months follow up in a 33-year-old patient with no prior medical history. The diagnosis was made after comprehensive history taking and physical examination with the help of different imaging modalities. Full recovery was achieved after optimal medical therapy. Conclusion: This case raises our awareness of unusual clinical presentation as we report associated left-sided severe heart failure in cancer-related pulmonary embolism. Pulmonary embolism in healthy young adults warrant in-depth causative exploration.