This standard treatment protocol resulted in overall satisfactory outcomes. Randomized controlled trial is suggested to confirm its efficacy.

In his second week of severe acute respiratory syndrome (SARS) illness, a patient developed an unusually complicated course of acute coronary syndrome. One day after initial stabilization of a non-ST-elevated anterior myocardial infarction (MI), he sustained an ST-elevated anterior MI. Eight hours after emergency coronary intervention to the culprit lesion, he developed another ST-elevated MI in the inferior territory. Acute inflammation and cytokine storm in the immunopathological phase of SARS may play a role in coronary plaque instability. Physicians should be alert to this potentially fatal complication and adopt appropriate vigilant and aggressive management strategies.

Bochdalek hernia (BH) is a congenital diaphragmatic hernia which rarely presents in adulthood. We report on a 25‐year‐old man admitted with 3‐year recurrent and self‐limiting abdominal pain and vomiting. Chest radiograph showed left pleural opacity which shifted position in the decubitus film suggesting pleural effusion. Before attempting drainage, point‐of‐care (POC) thoracic ultrasound (TUS) demonstrated features of intrathoracic gastrointestinal content above the left hemi‐diaphragm. Computed tomography of the thorax confirmed a large left BH. Acute recurrent symptoms 3 months post‐discharge was associated with BH enlargement and early bowel ischemia, which was successfully managed by emergency surgery. This case illustrates the importance of pre‐procedural imaging with POC‐TUS before pleural procedures in all cases of suspected or apparent pleural effusion, and of prompt surgical treatment of symptomatic BH despite clinical stabilization.