We describe systemic-to-pulmonary collateral arteries that developed after bilateral pulmonary artery banding in a patient with hypoplastic left cardiac syndrome. The growth of collateral arteries should be evaluated carefully because bilateral pulmonary artery banding under prostaglandin E1 administration is considered an initial palliative option.

A patent arterial duct in pre-term neonates is frequent. Systemic complications consecutive to left-to-right shunting are well known but fatal myocardial ischaemia has not been described till now. The presented premature baby died from catecholamine refractory cardiogenic shock. Autoptic examination revealed acute ischaemic changes predominantly in the inner third of myocardium, speaking of coronary hypoperfusion due to a steal phenomenon secondary to the patent arterial duct.

We report the case of a young woman with a troponin mutation of C to T nucleotide substitution in exon 17 of troponin 2 (TNNT2; c.868C.T; p.Arg288Cys) leading to hypertrophic obstructive cardiomyopathy. Following surgical resection of the outflow obstruction, she had near-complete resolution of her asymmetric left ventricular hypertrophy, such that cardiomyopathy could no longer be diagnosed on echocardiographic grounds. We believe that this unusual case shows important aspects relating to the interplay between genetic and environmental mechanisms and the overlap in the phenotypic spectrum between primary subaortic stenosis and obstructive hypertrophic cardiomyopathy.

Left main coronary artery aneurysms are very infrequent (0.1%) and the majority is related to atherosclerotic obstructive lesions. We describe a young male having no conventional coronary risk factors presenting with acute inferior wall myocardial infarction. Coronary angiography revealed a prominent aneurysm of the left main coronary artery with selective extension towards the proximal left circumflex artery without associated coronary lesions.

Occasionally complex congenital cardiac disease presents for the first time in adulthood, encouraging us to reflect anew on our understanding of familiar conditions. A 59-year–old woman, who had had two normal pregnancies, attended with breathlessness and was found to have a double inlet left ventricle with concordant ventriculoarterial connections and a straddling tricuspid valve adherent to the malaligned ventricular septum.