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Hepatocellular carcinoma (HCC) is one of the leading causes of cancer and cancer related deaths worldwide. Metastasis of HCC into the cardiac cavity is mostly caused by direct tumor thrombus invasion through the major hepatic veins and of vena cava inferior with continuous extension into the right cardiac cavity. Right heart metastasis without invasion of inferior vena cava (IVC), which may be caused by haematogenous spread of cancer cells, is rarely reported. We report a case of HCC with IVC and right atrium (RA) thrombus in a patient who presented to us with decompensated cardiac failure. Strikingly, the patient was young and with negative serum HBsAg, and anti-HCV results. Our case highlights a rare presentation of meta­static intracardiac tumor thrombus involving the RA in advanced HCC without any symptoms of cardiac failure, and henceforth, the role of screening echocardiography for all patients with advanced HCC especially with vena caval involvement to rule out intracardiac thrombus.

Micro-organisms have always been a part of the ecosystem. In fact, they play a major role in balancing metabolism as they colonize the system. In the past two decades, studies about the human micro biome has been elevating and still continuing as it is perceived as a possible threat to health status or also could be promising and hope filling in novel therapeutics in the mere future. Despite many on-going debates about the relationship of gut bacteria to the physiopathology of cardiovascular diseases, it has been simultaneously established through ample amount of reports and studies conducted both in vivo and in vitro. In this review, we will be stressing on several studies emphasizing on the gut micro biome, their role in influencing the physiopathology of cardiovascular diseases while also reflecting CVD as a global health burden, factors affecting the differences in gut microbiota, gut dysbiosis and its effects on the hosts’ metabolism, the intervention of probiotics in balancing gut dysbiosis, bacteriotherapy and the possible hypothesis of SCFAs and TMAOs to be explored on manipulating the gut microbiota in preventing blood pressure, obesity and hypertension which are major risk factors for cardiovascular diseases.