Accessory mitral valve is a rare entity which is commonly detected in children. It might present as a cause for left ventricular outflow obstruction, aortic regurgitation or a source for thromboembolic event. Diagnosis is based on echocardiographic findings, transesophageally when possible. Usually treatment is not required however treatment decisions are based on associated abnormalities and s...

Despite recent advances in iron chelation therapy, excess iron deposition in pituitary gonadotropic cells remains one of the major problems in thalassemic patients. Hypogonadism, mostly hypogonadotropic hypogonadism, is usually detected during puberty. Early diagnosis and treatment are crucial for normal pubertal development and to reduce the complications of hypogonadism. The risks and benefit...

Patients with antiphospholipid syndrome are at increased risk for recurrent arterial and venous thrombosis and therefore benefit from long term warfarin therapy. The optimal duration of warfarin therapy after a first venous thromboembolic event is however a matter of some controversy and many questions remain unanswered. After reviewing and analysing the available evidence, we discuss some comm...

Recurrent deep venous thrombosis despite well conducted anticoagulant treatment is an uncommon, but possible, event. It has been hypothesized that overt hyperthyroidism may increase thromboembolic risk. We present the case of an elderly man with a recurrent episode of deep venous thrombosis during optimal oral vitamin K antagonist treatment, associated with a new diagnosis of overt hyperthyroid...

In 2010, Douma et al introduced a formula to adjust D-dimer cut-off values for age in outpatients >50 years: Age × 0.01 mg/L. Application of this approach in different retrospective cohorts confirmed that age adjustment increases specificity while hardly affecting sensitivity. Reducing the false positive results, the ageadjusted D-dimer cut-off point raises the proportion of older patients in w...

Effective treatment of arterial thoracic outlet syndrome includes early recognition and timely correction, with sufficient decompression of the thoracic outlet. A 56-year-old female suffered recrudescent right upper extremity ischemia due to thromboembolic event, raising suspicion for arterial thoracic outlet syndrome and prompting further imaging studies for confirmation. Decompression of the ...