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DESCRIPTIONA 28-year-old woman presented with recurrent syncope, usually precipitated by anxiety.On examination, she had a low blood pressure of 112/72 mm Hg with normal heart sounds and showed no features suggestive of genetic abnormalities. ECG, Holter and treadmill stress tests were normal. Transthoracic ( fi gure 1 ) and transoesophageal ( fi gure 2 ) echocardiography demonstrated non-obstructive cor triatriatum. A diagnosis of vasovagal syncope with incidental cor triatriatum was made.Cor triatriatum consists of a fi bromuscular membrane dividing the left atrium into a posterosuperior chamber receiving blood from the pulmonary veins and an anteroinferior chamber containing the left-atrial appendage and mitral orifi ce. It represents 0.4% of congenital cardiac anomalies, 1 and is associated with other cardiac defects in 70-80% of cases, 2 anomalous pulmonary venous drainage being the most common. Echocardiography is crucial to determine the transmembrane gradient, pulmonary vein drainage and associated defects.

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SummaryAn 84-year-old man was admitted with a 1-year history of recurrent falls, diarrhoea and haemoptysis. He described a poor appetite for a number of years and over the last 9 months had experienced dysphagia with worsening anorexia and significant weight loss of 25 kg over the last 6 months. His deteriorating condition was compounded by ongoing type II diabetes mellitus and a past history of treated pulmonary tuberculosis, 40 pack-years of cigarette use and prostate cancer treated with radiotherapy. Ten days later he developed complete heart block and required a temporary pacemaker. The patient had a cardiac arrest due to electromechanical dissociation and died within 14 days of this admission.The diagnosis of amyloidosis was only established after an autopsy provided tissue for histochemical analysis. Amyloidosis is frequently diagnosed late in the disease course, with catastrophic consequences, particularly in the case of amyloid cardiomyopathy. BACKGROUND