Congenital coronary anomalies are uncommon with an incidence ranging from 0.17 % in autopsy cases to 1.2 % in angiographically evaluated cases. The recent development of ECG–gated multi–detector row computed tomography (MDCT) coronary angiography allows accurate and noninvasive depiction of coronary artery anomalies. This retrospective study included 2572 patients who underwent coronary 64-slice MDCT coronary angiography from January 2008 to March 2012. Coronary angiographic scans were obtained with injection of 80 ml nonionic contrast medium. Retrospective gating technique was used to synchronize data reconstruction with the ECG signal. Maximum intensity projection, multi-planar reformatted, and volume rendering images were derived from axial scans. Of the 2572 patients, sixty (2.33 %) were diagnosed with coronary artery anomalies (CAAs), with a mean age of 53.6 ± 11.8 years (range 29–80 years). High take-off of the RCA was seen in 16 patients (0.62 %), of the left main coronary artery (LMCA) in 2 patients (0.08 %) and both of them in 2 patients (0.08 %). Separate origin of the left anterior descending artery (LAD) and left circumflex artery (LCx) from left sinus of Valsalva (LSV) was found in 15 patients (an incidence of 0.58 %). In 9 patients (0.35 %) the right coronary artery (RCA) arose from the opposite sinus of Valsalva with a separate ostium. In 6 patients (0.23 %) an abnormal origin of LCX from the right sinus of Valsalva (RSV) was found with a further posterior course within the atrioventricular groove. A single coronary artery was seen in 3 patients (0.12 %). It originated from the right sinus of Valsalva in one patient and from LSV in two patients. In two other patients (0.08 %) the left coronary trunk originated from the RSV with separate ostium from the RCA. LCA originating from the pulmonary artery was found in one patient (0.04 %). A coronary artery fistula, which is a termination anomaly, was detected in 4 patients (0.15 %). Although these anomalies, which are remarkably different from the normal structure, exist as early as birth, they are incidentally encountered during selective angiography or at autopsy. The incidence in reported angiographic series ranges from 0.6 % to 1.3 %. Variations in the frequency of primary congenital coronary anomalies may possibly have a genetic background. The largest angiographic series of 126595 patients, by Yamanaka and Hobbs, reported a 1.3 % incidence of anomalous coronary artery. The results of this study support the use MDCT coronary angiography as a safe and effective noninvasive imaging modality for defining CAAs in an appropriate clinical setting, providing detailed three-dimensional anatomic information that may be difficult to obtain with invasive angiography.

Spontaneous coronary artery dissection is a rare cause of ischemic heart disease and sudden death. Prompt diagnosis is of paramount importance, especially in cases when it manifests with ST elevation myocardial infarction (STEMI). We report a case of a 42 year-old woman, who presented with an anterior STEMI in a hospital without on-site percutaneous coronary intervention (PCI) facilities. She was transferred to our hospital and coronary angiography revealed a spontaneous dissection of the left main stem coronary artery (LM). The dissection was successfully managed with PCI. PCI appears to be a potential option, for the treatment of selected cases with spontaneous LM dissection, presenting with an acute coronary syndrome.

High-frequency muscle tremor can mimic atrial flutter. Unnecessary therapies and aggressive interventions may have devastating consequences in these cases. We present a case of a patient with global pseudo-atrial flutter waves in the setting of essential tremor strictly confined to the arms. Two-dimensional transthoracic echocardiography (2D TTE) was used to discriminate normal sinus rhythm from pseudo-atrial flutter waves.

Obesity poses a significant challenge to societies and healthcare systems worldwide. Metabolic bariatric surgery (MBS) has emerged as a proven primary intervention for severe obesity. This cross-sectional study investigated the interplay between sociodemographic and psychological factors and their influence on attitudes toward eating and body mass index (BMI) among candidates undergoing MBS. Recruitment took place over a period of more than five years. Sociodemographic and BMI data were collected, and psychological evaluations were conducted using standardized self-report questionnaires and clinical interviews. Data were analysed using Pearson and Spearman correlations, multiple linear regression, and bootstrapped mediation analysis. After exclusion of those who did not meet surgical suitability criteria, declined participation, or had incomplete data, the study included 515 participants. Significant associations were found between lower educational attainment, unmarried status, and higher BMI. High neuroticism was linked to increased BMI, depression, and anxiety. Resilience was moderately negatively correlated with anxiety and depressive symptoms and showed a small but statistically significant indirect (partial mediating) effect on the relationship between neuroticism and anxiety or depressive symptoms, although its small magnitude and the cross-sectional design preclude causal interpretation. The findings demonstrate that several variables play substantial roles in eating attitudes and influence BMI in this population. Notably, resilience emerges as a significant psychological factor. However, further research is warranted to fully elucidate its role and impact. These insights provide valuable guidance for refining preoperative assessments.

Background: This study examined demographic, anthropometric, and psychological factors associated with health-related quality of life (HRQoL) among Greek candidates for bariatric surgery. Methods: A total of 524 candidates for bariatric surgery (mean age = 41.49 years, SD = 11.18) were recruited from the Interbalkan Medical Centre of Thessaloniki between May 2019 and November 2024. Participants completed standardized measures assessing depressive symptoms, anxiety, disordered eating attitudes, psychological resilience, personality traits, and HRQoL. Eight theory-informed multiple linear regression models were fitted to examine cross-sectional associations with the SF-36 domains, adjusting simultaneously for 12 demographic, anthropometric, and psychological covariates. Heteroscedasticity-consistent (HC3) standard errors and false discovery rate (FDR) correction were applied. Results: Depressive symptoms were negatively associated with all eight SF-36 domains after multivariable adjustment and FDR correction. Higher BMI was associated with poorer scores across all four physical HRQoL domains, as well as Social Functioning and Vitality, while older age was negatively associated with all four physical domains. Anxiety symptoms were independently associated only with Mental Health. Psychological resilience was positively associated with General Health Perceptions and Vitality, whereas higher Neuroticism and Extraversion were associated with poorer and better mental and psychosocial HRQoL, respectively. Adjusted R² values ranged from 0.245 to 0.548 across the eight SF-36 domains. Discussion: Depressive symptoms emerged as the most consistent correlate of HRQoL among Greek candidates for bariatric surgery, whereas BMI, age, resilience, anxiety, and personality traits demonstrated more domain-specific associations. These findings highlight the relevance of comprehensive preoperative assessment addressing both physical and psychological functioning. Conclusions: Longitudinal studies are needed to clarify temporal relationships and determine whether these characteristics are associated with postoperative HRQoL outcomes.