Physiological measurements are now commonly used to assess coronary lesions in the cardiac catheterisation laboratory, and this practice is evidence-based and supported by clinical guidelines. Fractional flow reserve is currently the gold standard method to determine whether coronary lesions are functionally significant, and is used to guide revascularization. There are however several other physiological measurements that have been proposed as alternatives to the fractional flow reserve. This review aims to comprehensively discuss physiological indices that can be used in the cardiac catheterisation laboratory to determine the functional significance of coronary lesions. We will focus on their advantages and disadvantages, and the current evidence supporting their use.

Background: Healthcare providers are facing unprecedented challenges in the era of the coronavirus disease 2019 (COVID-19) pandemic. The current situation compels the use of alternatives for communication between the patients and healthcare providers. The use of telemedicine has expanded globally during the COVID-19 pandemic. The range of online consultations varies from advising patients to providing diagnosis and follow-up. Methods: We assessed the attitudes of health professionals toward the use of social media for online consultations during the COVID-19 pandemic using an online survey that was distributed to medical professionals in Iraq. Results: The total number of participants was 124 Iraqi medical professionals in different specialties (72.4% men and 27.6% women). The majority of participants (71.6%) reported that they had previous experience with online consultation and patient communication using social media before the onset of the COVID-19 pandemic. A large proportion of the participants (72.2%) indicated that online consultation was useful for patient health and safety. Conclusions: Despite the limitations facing online consultation and lack of proper infrastructure for telemedicine in Iraq, many health professionals indicated a positive attitude and recommend extending the use of online consultation after the era of the COVID-19 pandemic.

Background: Atrial fibrillation is a relatively common complication of acute myocardial infarction with significant impact on the short and long-term prognosis. Methods: A systematic literature review was done through Pubmed and CENTRAL to extract data related to new-onset atrial fibrillation following primary PCI. Results: Searching resulted in twenty-one matched studies. Extraction of data showed an incidence rate of new-onset atrial fibrillation (2.8%-58%). A negative impact was found on the outcomes of patients treated with primary PCI with increased short and long-term mortality and morbidity. Conclusion: New-onset atrial fibrillation is an adverse prognostic marker in patients with acute myocardial infarction treated invasively. Preventive measures and anticoagulant therapy should be considered more intensively in this subset of patients.

Complications during acute coronary intervention are rare and life-threatening. We present a case of a patient with acute coronary syndrome admitted for percutaneous coronary intervention to the left anterior descending artery. The straightforward procedure was challenged by multiple complications of coronary artery perforation, cardiac tamponade, stent loss, and ventricular fibrillation. The management was complicated by covered stent embolization into the left circumflex artery without a wire inside. We were able to retrieve the lost covered stent by re-accessing the lumen with a coronary guidewire followed by advancing a balloon distal to the stent and extraction of the whole system outside. The case illustrates the possibility of facing multiple complications in one procedure including the loss of covered stent and how to prevent and manage this serious complication.