IntroductionAn obstructive lesion of the left main coronary artery (LMCA) has typically been described on the electrocardiogram (ECG) as a generalised ST segment depression (SST) (maximum in V4-V6) associated with inverted T waves in the same leads and elevation. of the SST in aVR1. Likewise, elevated SST in aVR is associated with multivessel coronary artery disease 1. The presence of these findings, together with an adequate clinical correlation, should alert medical personnel to promptly rule out these conditions and prevent possible adverse outcomes.However, these electrocardiographic changes are not 100% specific for an obstructive lesion of the LMCA, since elevated SST in AVR could be observed in multivessel coronary disease (three or more vessels), occlusion of the proximal segment of the anterior descending artery, and diffuse subendocardial ischemia 2.Regarding the pathophysiology of hypokalemia, at the level of the cardiomyocytes, an increase in the resting membrane potential is generated, and the duration of the action potential and the refractory period increase. Changes that are potentially arrhythmogenic, such as ST segment depression, T wave flattening, and prominent U waves, which have been described as a “hallmark” of hypokalemia 3.However, an elevation of the SST in AVR simulating an LMCA lesion is a rare finding within the electrocardiographic alterations described in hypokalemia, which include: premature atrial and ventricular complexes, sinus bradycardia, prolonged QTc, junctional tachycardia, AV block, ventricular tachyarrhythmias, as well as SST depression, with a decrease in the amplitude and inversion of the T wave and an increase in the amplitude of the U wave, usually from V4 to V6 4. Below, we describe a clinical case of severe hypokalemia simulating on an ECG an obstructive lesion pattern of the LMCA.

Introduction:Less than 10% of people with vasculitis experience cardiac impairment; however, all primary vasculitides can target the heart1. Regarding antineutrophil cytoplasmic antibody (ANCA)-associated vasculitis, both granulomatosis with polyangiitis (GP), microscopic polyangiitis (MP), and eosinophilic granulomatosis with polyangiitis (EGPA) can affect any cardiac tissue 1.Among ANCA-associated vasculitis, EGPA is the one that most frequently affects the heart 2. Nevertheless, in EGPA, cardiac manifestations are more common in ANCA-negative patients. Eosinophilic myocarditis is the most common, but restrictive or dilated cardiomyopathy, pericarditis, coronary artery vasculitis, valvular defects, rhythm disturbances, left ventricular dysfunction, and intracardiac thrombosis, among other things, can also occur3. Heart involvement in GP and MP is seen in a small percentage of patients, with pericarditis and supraventricular arrhythmias being the most common cardiac manifestations, occurring in 1% to 6% of patients 1. Nevertheless, cardiac thrombosis is a less frequent manifestation, occurring in less than 1% of patients 1.

Streptococcus intermedius is a commensal bacterium reported in few cases as the causative agent of brain and lung abscesses, pneumonia, and endocarditis. Lung abscesses due to Streptococcus intermedius are rare, especially in pregnancy. We describe the first case of lung abscess due to streptococcus intermedius in a pregnant woman.

In receptors of solid organ transplant, calcineurin inhibitors has become a pillar of immunosuppressive treatment. Several case reports have shown hypertrophic and dilated cardiomyopathy as a side effect of tacrolimus. We present the case of a woman receptor of a kidney transplant who developed hypertrophic cardiomyopathy due to Tacrolimus.

Left ventricular non-compaction (LVNC) cardiomyopathy is an uncommon unclassified or genetic myocardial disorder. Frequent premature ventricular complexes (PVCs) as unique finding in LVNC cardiomyopathy are rare. We report a case of a 36-year-old woman in whom isolated LVNC was diagnosed due to an incidental finding of PVCs in pre-operative consultation.