Raised platelet size has been shown to be associated with adverse cardiac events. Mean platelet volume has increased in acute coronary syndromes and also in cardiac syndrome X in our study. Life style modification may optimize platelet size and improve symptoms in these patients.

Altered autonomic nervous system regulation affects heart rate profile, increased resting heart rate, decreased heart rate increment, and decreased heart rate decrement, during exercise and this effect is strongly and independently associated with the severity of coronary artery disease.

tion of the aortic aneurysms was favorable for percutaneous intervention, firstly, we implanted endovascular stent-grafts for the aortic aneurysms (Fig. 4a). After the recovery period, the patient underwent successful aneurysm resection and coronary artery bypass operation including end-to-end anastomosis of the two edges of the LAD (red arrow) and aorta-saphenous vein graft implantation (red arrowheads) at the distal portion of the RCA and proximal ligation (yellow arrow) (Fig. 4b). This is the first reported case of a hybrid therapy for multiple aortic aneurysms combined with giant CAA's.Our case supports the opinion that aneurysmal disease is a systemic illness affecting multiple arterial segments including coronary arteries.

Coronary artery fistulas are rare coronary anomalies which generally require coronary angiography for definitive diagnosis. Improvements in ultrasound technology has enabled direct, transthoracic visualization of long portions of coronary arteries. We report a patient with a symptomatic coronary to left ventricular fistula, which was diagnosed with transthoracic echocardiography.

Myocardial bridging is systolic compression of an epicardial coronary arterial segment by overlying myocardium. It is a rare coronary anomaly, which is generally considered to be benign. It has been suggested that myocardial ischaemia may be seen. In this article, a case of myocardial infarction caused by myocardial bridging is presented.