Bradyarrhhtmias can cause low cardiac output (CO) state despite normal left ventricular ejection fraction and normal stroke volume. CO defined as product of the heart rate (HR) and SV. Cardiorenal syndrome (CRS) type I can be a consequences of Low CO state secondary to slow HR

Portal venous gas can be detected by a bedside point of care ultrasound examination. We present the case of a 73-year-old female with advanced ischemic cardiomyopathy. She developed vague abdominal pain. Her findings were consistent with portal venous gas with point-of-care ultrasound. She had nonobstructive mesenteric ischemia.

COVID-19 infection can present with thrombotic manifestations like PE with no ultrasonographic evidence of lung parenchymal affection. BLUE protocol provides excellent step by step approach for diagnosis of acute dyspnoea. Adding FECHO to BLUE protocol complete the picture and help making solid diagnosis especially in sub-massive and massive PE

Patient in sinus rhythm with dilated cardiomyopathy and low ejection fraction < 35% have a 4% risk of embolic event (1). This is a soft indication for therapeutic anti-coagulation(controversial) (2). Presence of excess Intra-cardiac Smoke-like Echoes increase risk of embolic event and switch the soft indication to strong one

Gliosis with haemorrhagic transformation is a late reported complication of stroke (1-2), Sometimes there is a big discrepancy between clinical and radiological diagnosis, Clinical decision must be multi-aspects decision and does not depend on a single unusual investigation.

Stevens-Johnson Syndrome (SJS) happen as a result of infection, side effects to medications or of unknown etiology. Carbamazepine is a common cause (SJS). Good history taking is crucial if clinically indicated treatment with carbamazepine. carbamazepine should be avoided with previous history of severe drug reaction like mast cell activation syndrome.

A 39-year-old woman was admitted with right leg deep venous thrombosis (DVT). She was started on apixaban tablets but developed pulmonary embolism. The medical history showed sleeve gastrectomy. The failure of the antithrombotic drug shed light on the efficacy and pharmacodynamic changes of DOACs after bariatric surgery