Primary spindle cell sarcoma of the left atrium is an extremely rare tumour. Surgical excision is the mainstay of treatment since it responds poorly to chemotherapy or radiotherapy. In spite of all the treatment, the prognosis remains poor due to inadvertent delay in diagnosis, few therapeutic options and propensity to metastasize. We present a 47-year-old male who underwent a surgical excision of a left atrial mass in February 2010. It was proved to be a high-grade spindle cell sarcoma on histopathology. He presented again in October 2010 with recurrence of the tumour for which he was re-operated. However, the tumour recurred again within one month, to which the patient succumbed.

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Coexistent aneurysms of the coronary and inominate arteries are extremely rare. We present the case of a 28-year-old male with an aneurysm of the left anterior descending coronary artery and an aneurysm of the inominate artery presenting with hoarseness and severely depressed left ventricular function (ejection fraction of 25%). He underwent successful surgical resection of both aneurysms. The inominate artery aneurysm was excised and the brachiocephalic trunk was reconstructed off-pump. The coronary artery aneurysm was excised and distal aorto-coronary bypass grafting was done on cardiopulmonary bypass.

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A 32-year-old kidney transplant recipient presented with Klebsiella pneumonia. He developed sudden tension pneumothorax with pneumopericardium on chest radiography ( Figure 1). Pericardiocentesis revealed a continuous flow of air from the pigtail catheter, raising suspicion of a broncho-pleuro-pericardial fistula. Computed tomography confirmed the findings, although a fistula could not be demonstrated ( Figure 2). Despite prompt treatment with broadspectrum antimicrobials and drainage, the patient's condition deteriorated and he died after 3 days. Pneumopericardium is an emergency, presenting as cardiac tamponade with mortality > 50%. The etiology is traumatic, post-thoracic surgery, infectious (gasproducing organisms) or broncho-pericardial fistulas. It is diagnosed by the halo sign on chest radiography and confirmed by computed tomography. Tension pneumopericardium calls for fluid resuscitation and urgent pericardiocentesis. Spontaneous resorption usually occurs in 2 weeks. In our case, the exact etiology was unknown, but infectious etiology is a possibility.