Myocardial ischaemia-reperfusion (I/R) injury is well known term for paradoxal exacerbation of cellular destruction and dysfunction, after the restoration of blood flow to previously ischaemic heart. A vast number of studies that has demonstrated the role of mineralocorticoids in cardiovascular diseases is based on the use of pharmacological mineralocorticoid receptor antagonists (MRA) such as spironolactone and eplerenone. This review paper aimed to summarize current knowledge on the effects of MR antagonists on myocardial I/R injury, as well as post-infarction remodeling. Animal models, predominantly Langendorff technique and left anterior descending coronary artery occlusion (LAD) have confirmed the potency of MRA as preconditioning and postconditioning agents in limiting infarct size and postinfarction remodeling. Several preclinical studies in rodents have established and proved possible mechanisms of cardioprotection by MRA, such as reduction of oxidative stress, reduction of inflammation and apoptosis, therefore limiting infarct zone. However, the results of some clinical trials are inconsistent with these results since they reported no benefit of MRA in acute myocardial infarction. Due to this, further studies and the results of on-going clinical trials regarding MRA administration in patients with acute myocardial infarction are being awaited with great interest.

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Syncope caused by carotid sinus syndrome due to malignancy of the head and neck is rare. The aim of this paper is an inspection into current knowledge of this syndrome, its clinical characteristics, differential diagnosis and current treatment modalities. We present a case of recurrent syncope resulting from extreme bradycardia based on a malignant process in the neck area that compresses the carotid sinus. To discover the cause of syncope, an extensive diagnosis was made including electrocardiography, 24h holter electrocardiography, computed tomography of the neck, biopsy of the lump on the right side of the neck. In order to perform the biopsy, the patient was implanted with a temporary pacemaker. Pathohistological processing of biopsy showed the existence of squamous cell carcinoma of the neck region. Due to localization of the malignant change, surgical resection was contraindicated, so the patient was treated with radiotherapy. Syncope based on carotid sinus hypersensitivity caused by a malignant process of the neck region is a significant diagnostic challenge for any clinician. Neck tumor is rarely thought of, since its frequency is rare in the general population. The disease is mostly recognized in the advanced stages when episodes of syncope are more frequent.