Spontaneous coronary artery dissection (SCAD) is a rare cause of acute coronary syndrome and sudden cardiac death. Amongst various etiologies thought to be responsible for this condition, atherosclerosis seems to be the most common. There are various case reports on (SCAD) of single coronary artery but the presence of SCAD of all three arteries is not known. We describe a case of a 45-year-old gentleman without any conventional coronary risk factors, who was referred to us at Tata Main hospital, Jamshedpur, for cardiac evaluation prior to his urethral surgery. Although asymptomatic cardiac-wise, his ECG incidentally revealed healed inferior wall myocardial infarction. Echocardiogram confirmed hypokinetic inferior wall with left ventricular ejection fraction of 50%. His coronary angiography showed spontaneous dissection of LAD, LCX and RCA which was managed conservatively.

This case report describes a 47-year-old female healthcare worker who developed reverse takotsubo cardiomyopathy (TTC) following the administration of the COVISHIELD COVID-19 vaccine. Within minutes of receiving the vaccine, she experienced acute shortness of breath, nausea, and restlessness, along with a significant drop in blood pressure. She was diagnosed with an anaphylactic reaction and promptly treated with adrenaline and fluids. In the intensive cardiac care unit, she exhibited hypotension, had vision loss, and developed pulmonary edema. Further evaluation revealed abnormal ECG findings, elevated troponin levels, and reduced left ventricular ejection fraction (LVEF). Coronary angiography ruled out obstructive coronary artery disease. The patient gradually improved over several days and was discharged with a recovered left ventricular function. This case highlights the occurrence of TTC triggered by anaphylaxis to the COVID-19 vaccine and emphasizes the need for preparedness to manage such emergencies in vaccination centers.

A rare but possibly catastrophic consequence of drug-eluting stents (DES) is very late stent thrombosis. We report a case of 74-year-old male who sustained a ST elevation myocardial infarction (STEMI) 12 years after initial Paclitaxel eluting stent implantation (PES). This is the longest time between stent placement and the development of an acute coronary event due to very late stent thrombosis that we are aware of (VLST). The implications for prognosis and therapy are significant because they highlight the uncertainty around the recommended duration of antiplatelet medication in patients with DES. Clinicians face challenges in treating those patients particularly when competing medical conditions demand the discontinuation of antiplatelet therapy. VLST is concerning since the underlying pathophysiology is unknown, and the best preventive treatments and duration of antiplatelet medication after stent implantation are unknown.