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There are few case reports of cases of carotid and aortic dissection related to the ergotamine abuse, but the cases that affect the coronary arteries is a very rare coronary. We present a patient of a 48-year-old female with an ST-segment elevation myocardial infarction attributable to chronic ergotamine use. The coronary angiography showed dissection of right coronary artery proximal.

Fistula arising from ruptured sinus of Valsalva aneurysm is an uncommon cause of congestive heart failure, and it is even rarer in the absence of an aneurysm. We present the case of a female patient with acute idiopathic rupture of the right sinus of Valsalva to the right ventricle and atrium in the absence of typical aneurysm. This anomaly resulted in a left-to-right shunt leading to rapidly progressive heart failure.

This is the case of a 73-year-old male patient referred from another facility and diagnosed with non-ST elevation acute coronary syndrome admitted for cinecoronariography (CCG) and eventual angioplasty. The patient had a history of blood hypertension, smoking, and dyslipidaemia, as well as severe aortic stenosis and ascending aortic aneurysm. The patient underwent mechanical aortic valve replacement of the ascending aorta with coronary re-implantation into the aortic tube (conventional Cabrol surgery). DDDR pacemaker implantation due to asymptomatic bradyarrhythmia. Upon admission, the patient experienced angina pectoris symptoms (HR 70 bpm, BP 160/80 mm Hg). The electrocardiogram showed lower negative ST and T depression. As regards the enzyme curve, peak creatinine phosphokinase (CPK) was 680 U/L and CPK-MB 76 U/L (upon admission). The CCG showed the Cabrol surgery graft, critical blockage of the right coronary artery (RCA) proximal anastomosis, and left coronary artery with no significant angiographic lesions (Fig. 1A). Considering the patient's clinical condition and the CCG results, RCA stent angioplasty was performed (Fig. 1B). The patient progressed with no symptoms during hospitalisation and had no complications. The Cabrol technique includes replacement of the ascending aorta and aortic valve using a composite graft. Anastomotic complications related to the Cabrol technique have also been reported. These lesions have usually been managed surgically although some reported cases have been managed by percutaneous coronary intervention.