Cardiac metastasis is usually seen with lung carcinomas or malignant melanoma, but rarely with  leukemia, and is usually a post-mortem diagnosis. Secondary cardiac tumors arising from the left atrium, where benign myxomas predominate, are uncommon. 

In foreign literature, 90% of renal artery stenosis (RAS) is atherosclerotic, while 10% is secondary  to fibromuscular dysplasia (FMD). However, an important differential for hypertension in the  young Asian population is Takayasu’s arteritis. We present four patients who initially presented  with hypertension in the young due to RAS. Clinical criteria coupled with non-invasive studies  in all four cases led to the diagnosis of Takayasu’s arteritis. All four patients had good outcomes. 

Approximately 3,500 non-cardiac surgeries are being performed each year in the University of Santo  Tomas Hospital (Manila, Philippines). No study has yet been made to evaluate the cardiovascular  outcomes of these surgical patients. This prospective cohort study was performed to determine the  30-day cardiovascular outcomes in patients undergoing non-cardiac surgery in the private and clinical  divisions of this institution and to evaluate the utility of currently used risk scoring systems. 

The coronary collateral circulation (CCC) is an alternative source of blood supply in coronary artery  disease (CAD). A recent meta-analysis found that among patients with stable CAD, the presence of CCC has a relevant protective effect in terms of mortality. Among patients with acute coronary syndrome (ACS), surrogate end-points such as infarct size, systolic function, ventricular dilatation and post-infarct aneurysm formation have positive results in relation to the presence of CCC. The prognostic value of the presence of CCC at the time of ACS is still undefined with regard to hard outcomes, specifically, reduction of mortality. 

Clopidogrel is a P2Y12 receptor antagonist given to patients with coronary heart disease, usually in combination with aspirin. It is metabolized to its active component through the cytochrome P450 2C19 (CYP2C19) isoenzyme. Proton pump inhibitors (PPI) are commonly used in patients who are receiving clopidogrel, especially those at high-risk for gastrointestinal bleeding. However, certain PPIs are likewise metabolized through the CYP2C19 isoenzyme. Co-administration of the two classes of drugs may lead to lower levels of clopidogrel, leading to lower antiplatelet efficacy and lower effects on cardiovascular disease prevention of the drug.

Aortic aneurysm is a life-threatening condition related to its catastrophic complications of rupture and dissection that warrants consideration of early surgical repair. The decision to intervene for aortic disease remains a challenging decision because of the concomitant high-risk factors and comorbid illnesses as well as increased morbidity and mortality related to it.

Studies have shown that intraoperative transesophageal echocardiography (IOTEE) provides important information that may alter patient management and outcome in various cardiac surgeries. This is the first study to report our local experience on the clinical utility of IOTEE and the first paper to include patients who underwent percutaneous cardiac procedures.