Echocardiography showed a voluminous free-floating left atrial thrombus in an 80-year-old woman affected by rheumatic mitral stenosis with long-standing atrial fibrillation who was admitted because of transient left arm paralysis and drop attack without loss of conscience. She refused open heart surgery and was treated with warfarin. One month later echocardiography detected complete disappearance of the thrombus; no episodes of peripheral embolization had occurred since the beginning of medication with warfarin. According to this report, warfarin is a valuable alternative to surgical treatment for freefloating left atrial thrombi.

This study aims to describe the most important cardiac structures in the Heterodon nasicus through echocardiography and anatomical dissection. Echocardiographic and echo-Doppler measurements were performed on twenty healthy adult Heterodon nasicus (10.10). The values of the ventricular length, aortic diameter, pulmonary trunk diameter, the mean thickness of the interventricular septum, and thicknesses of the wall of the cavum pulmonale (Cav. P) and cavum arteriosum (Cav. A), were measured. The aortic flow and pulmonary trunk flow were recorded. Two dead specimens (1.1) were dissected. The male's pulmonary trunk diameter was bigger compared to the female's in both the long and short axis. The reproductive ecology of Heterodon nasicus has yet to be fully elucidated upon, however, male territorialism and dispersal from the hibernacula, and multiple male courtships toward a single female were described, hence, the more active reproductive activity of the male and the consequent sexual selection toward a higher aerobic performance can be hypothesised. A moderate interventricular right to left shunt was noticed in the Cav. V of all the specimens, which is considered normal and should not confuse the clinician. Congenital defects, cardiomyopathies, valvulopathies, and pericardial diseases are known to occur in ophidians and other reptiles. Reliable data and profound knowledge of the anatomy and physiology of the ophidian heart are fundamental for the in vivo diagnosis of cardiac diseases in snakes.

A two-year-old male veiled chameleon (Chamaeleo calyptratus) was referred for a gular oedema and bilateral blepharoedema. The echocardiography revealed a ventricular hypertrophy, pericardial effusion, and valvular regurgitation of the right atrioventricular valve. Treatment with hydrochlorothiazide, enalapril, and carvedilol was commenced. Within 3 weeks of treatment, the valvular regurgitation was noticeably decreased. In the 4^th week of treatment, the echocardiography revealed a reduction in the myocardium hypertrophy. After an additional month of home treatment, the patient was presented with anorexia and decreased activity. Despite the supportive care, the patient died. The histopathology revealed mild to moderate fibrosis of the epicardium. Moderate to severe fibrosis, degeneration of the myofibrils, fatty atrophy, interstitial oedema and mild calcification was seen in the atria. The tunica intima, media and adventitia of the major cardiac vessels were moderately fibrotic, swollen and interfused by myxoedema. The kidney histopathology revealed moderate sclerosis and atrophy of the glomeruli, vacuolation of the tubular epithelium, fibrosis, and infiltration of the leucocytes in the interstitium. The therapeutic protocol with hydrochlorothiazide, ACE inhibitor enalapril and β-blocker carvedilol reduced the myocardium hypertrophy and the valvular regurgitation; however, the prolonged use of diuretics jeopardized the renal function in our patient. Frequent blood analyses are necessary using diuretics in reptile patients.

When a decision i s made to trea t HBI in a breast fed infant , there are a number of options available but t hey ha ve never been compared. We enrolled fu lltem,healthy breast feed newborn infants when their serum bilirubin(BI)level s reached l7mg/dl and assig ned them ram:lcmly to one of four interve ntions.l)Discontinue breast f eeding (DBF) ,2)pho-t o therapy and DBF , 3)phot opther apy ,conti n ue BF, 4)obser ve. There were