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The following electronic only articles are published in conjunction with this issue of Heart.

Acute myocardial infarction caused by a septic coronary embolism diagnosed and treated with a thrombectomy catheter

M Taniike, M Nishino, Y Egami, I Kondo, R Shutta, K Tanaka, T Adachi, J Tanouchi, Y Yamada, K Kawano

Acute myocardial infarctions are common in bacteraemia but are seldom diagnosed during life. A 64 year old man with severe chest pain who had fever for several days due to possible bacteraemia was shown by ECG and echocardiography to have possible lateral infarction. Immediate coronary angiography showed possible thrombus in the left circumflex artery, which was treated by thrombectomy catheter. Bacterial thrombus was removed and was verified by histological examination. A stent was implanted without complications. Acute myocardial infarction caused by septic embolism is usually fatal; however, thrombectomy may be useful in these cases.

(Heart 2005;91:e34) www.heartjnl.com/cgi/content/full/91/5/e34

Total relief of severe left ventricular outflow obstruction after spontaneous rupture of chordae tendineae in a patient with hypertrophic cardiomyopathy

A Q Araujo, W V Azeredo, E Arteaga, C Mady

In hypertrophic cardiomyopathy (HCM), rupture of mitral chordae tendineae is infrequent and causes acute haemodynamic deterioration. A 38 year old male patient had chordae rupture leading to prolapse of both mitral leaflets and severe regurgitation, without change in symptomatic status. One year before, he had had mild mitral regurgitation and a resting left ventricle outflow tract of 105 mm Hg that disappeared in the present evaluation. In this unique case, worsening of mitral regurgitation was counterbalanced by total relief of the severe obstruction. This case report highlights the role of the mitral valve apparatus in the genesis of obstruction in HCM, further stimulating surgical techniques in which mitral repair can be the main procedure.

(Heart 2005;91:e35) www.heartjnl.com/cgi/content/full/91/5/e35

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