Background and Clinical Significance: Trousseau’s syndrome, characterized by recurrent thromboembolic events and non-bacterial thrombotic endocarditis, represents a severe paraneoplastic condition associated with poor prognosis in cancer patients. Due to the growing life expectancy of cancer patients, Trousseau’s syndrome is becoming more frequent. Consequently, risk of thrombosis and bleeding assessment, as well as early diagnosis and opportune therapy will gain importance. Case Presentation: We describe a case of a 63-year-old Caucasian male presenting with ischemic stroke. During management, he developed a mitral valve marantic endocarditis, and finally the diagnosis of pulmonary adenocarcinoma was performed. The case description is followed by a brief review of the relevant literature on the condition. Discussion and Conclusions: This case highlights the complexity of diagnosing and managing Trousseau’s syndrome. Early recognition, appropriate anticoagulation strategies, and the need for multidisciplinary management are crucial to improve the outcomes and the quality of life for cancer patients.

Background: Trousseau’s syndrome, characterized by recurrent thromboembolic events and non-bacterial thrombotic endocarditis, represents a severe paraneoplastic condition associated with poor prognosis in cancer patients. Methods: We describe a case of a 63-year-old male presenting with ischemic stroke and mitral valve marantic endocarditis, ultimately diagnosed with pulmonary adeno-carcinoma. The case description is followed by a brief review of the current literature on the condition. Discussion and Conclusion: This case highlights the complexity of diagnosing and managing Trousseau’s syndrome. Early recognition, appropriate anti-coagulation strategies, and the need for multidisciplinary management are crucial to improve the outcomes and the quality of life of cancer patients.

Background. Achieving low-density lipoprotein cholesterol (LDL-C) targets is a cornerstone of cardiovascular prevention, yet real-world data consistently show suboptimal control. We evaluated LDL-C target attainment, lipid-lowering therapy (LLT) use, adherence, and persistence in a large real-world population from Tuscany (Italy), with a specific focus on sex differences and temporal trends.Methods. Administrative health databases and laboratory records were linked to identify individuals aged ≥45 years in Tuscany between 2019 and 2023. Patients were classified into cardiovascular risk categories according to contemporary European guidelines, with corresponding LDL-C targets. LDL-C target attainment, LLT consumption (expressed as defined daily doses, DDD/1,000 inhabitants/day), adherence, and 1-year persistence were analyzed overall, by risk class, and by sex.Results. Among the Tuscan population, only 31% underwent at least one LDL-C measurement in 2023. Of 778,680 classified patients, 35.1% achieved their LDL-C target in 2023, compared with 11.6% in 2019–2021. Despite improvement, 64.9% remained above target, particularly in very high and extreme risk groups. LDL-C target attainment increased across all risk categories but remained low in very high-risk patients (22.7%). LLT consumption rose from 103 to 130.9 DDD/1,000 inhabitants/day between 2019 and 2023, driven mainly by increased use of statins, statin–ezetimibe combinations, and PCSK9 inhibitors. Adherence and persistence improved over time, with a reduction in low adherence (−9.2%) and an increase in high adherence (+5.2%). Women showed lower overall adherence than men but experienced the greatest improvement in adherence and 1-year persistence over time.Conclusions. In this large real-world population, most individuals remain far from LDL-C targets despite encouraging temporal improvements. Increased LLT use, better adherence, and the introduction of combination therapy and PCSK9 inhibitors have contributed to progress. However, substantial gaps persist, particularly in high-risk patients and in women. Structured follow-up, early intensification of therapy, and targeted strategies to reduce sex disparities are essential to further improve LDL-C control.

IntroductionEosinophilic granulomatosis with polyangiitis (EGPA) is a rare systemic vasculitis characterized by granulomatous and eosinophil-rich inflammation affecting small-to-medium-size vessels...

Background: Cardiovascular complications are increasingly recognized in patients undergoing hematopoietic stem cell transplantation (HSCT). Early detection of subclinical myocardial dysfunction may improve risk stratification, and global longitudinal strain (GLS) is emerging as a sensitive marker of early cardiac impairment. Methods: We conducted a single-center observational cohort study including 518 adult patients undergoing autologous (n = 64) or allogeneic (n = 454) HSCT between 2004 and 2025. Baseline cardiovascular risk factors, transplant characteristics, and echocardiographic parameters—including GLS in a subset—were recorded. Abnormal GLS was defined as less negative than −20%. The primary outcome was the occurrence of cardiovascular events (composite of cardiovascular death, myocardial infarction, stroke, atrial fibrillation/flutter, pericardial effusion, pulmonary embolism, and left ventricular systolic dysfunction). Multivariable logistic regression was used to identify independent predictors. Results: Median age was 53 years; 58% were male. Cardiovascular events were predominantly atrial fibrillation, pericardial effusion, and reduced left ventricular function, whereas ischemic events were rare. Over 90% of events occurred within 100 days post-transplant. Multivariable analysis identified older age (OR 1.28 per 10-year increment; 95% CI 1.10–1.48; p = 0.002), chronic kidney disease (OR 2.44; 95% CI 1.18–5.02; p = 0.01), pre-transplant atrial fibrillation (OR 2.12; 95% CI 1.04–4.31; p = 0.03), and abnormal baseline GLS (OR 1.89; 95% CI 1.02–3.52; p = 0.04) as independent predictors. Importantly, the prognostic value of GLS remained significant after excluding clinically insignificant pericardial effusions from the composite endpoint. GLS deterioration during follow-up occurred more frequently in patients receiving reduced-intensity conditioning compared with myeloablative conditioning (25% vs. 12.7%; p = 0.006). Conclusions: Subclinical myocardial dysfunction detected by GLS identifies HSCT recipients at increased cardiovascular risk. These findings support the incorporation of strain imaging into routine pre- and post-transplant cardiovascular evaluation to enable earlier detection and guide targeted interventions.

Complex cardiac implantable electronic device (CIED)-related complications often require expertise that extends beyond cardiac electrophysiology. We present 3 challenging cases of transvenous cardiac devices demanding multidisciplinary management, placing the electrophysiologist at the crossroads of diagnosis, risk assessment, and procedural strategy. These scenarios included: 1) a necrotic ulcer caused by a cold burn of a pacemaker pocket complicated by infectious endocarditis; 2) a dermatofibrosarcoma protuberans developing in proximity to a pacemaker pocket; and 3) an abandoned ventricular lead resulting in dehiscence and fistulization in the breast of a patient affected by a cardiac teratoma. Their management required the integrated expertise of plastic surgeons, infectious disease specialists, oncologists, orthopedic surgeons and cardiac surgeons-effectively constituting a "CIED team." This case series highlights how modern cardiac electrophysiology increasingly intersects with complex clinical conditions, necessitating cross-specialty collaboration, and how recent technologies-such as leadless pacing systems and wearable defibrillators-can support safe and effective solutions.