Contact address: Claudia Matei, Department of Cardiology, “Dr. Constantin Opris” Emergency County Hospital, George Cosbuc Street, no 31, Baia Mare, Romania. E-mail: cabdia@yahoo.com 1 “Dr. Constantin Opris” Emergency County Hospital, Baia Mare, Romania 2 “Vasile Goldis” West University, Arad, Romania 3 “Niculae Stancioiu” Heart Institute, Cluj-Napoca, Romania Abstract: Introduction – Atrial fi brillation (AF) accounts for over 50% of strokes, also known as cerebrovascular accidents (CVAs). We report a case of a right atrial (RA) myxoma presenting as paroxysmal AF, syncope and acute chest pain, in a patient with previous CVA. Description of the problem. A 62-year-old Caucasian woman was admitted for an episode of syncope and acute chest pain. Two years earlier she had suffered a CVA. Paroxysmal AF was noted at that time. At current presentation pulmonary thromboembolism (PE) was ruled out by pulmonary CT. TTE combined with TOE showed a large moving mass in the RA, prolapsing through the tricuspid valve into the right ventricle. The coronary arteries were normal. The patient underwent surgical treatment. The histopathological study confi rmed diagnosis of myxoma. Questions, problems. Up to 25% of myxomas are found in RA. Chest pain is infrequent. Syncope is experienced by approximately 20% of patients. Our patient had confi rmed TTE obstruction of the tricuspid valve and PE was ruled out by CT pulmonary scan. Conclusions – TTE must be considered at admission to clarify etiology in all AF and stroke patients. Although TOE is more sensitive, TTE is usually adequate for the diagnosis of cardiac myxomas.

Aim: In a period of 4 years we created a regional registry on acute coronary syndromes on a target population of 1 million inhabitants, and we followed the evolution of all patients with acute coronary syndromes (ACS). During this period we performed an intense educational activity in order to increase the adherence to European guidelines regarding the treatment of ACS. Material and method: The registry included 10 hospitals in 2004 and 13 hospitals in the following years, serving a population of 1 million inhabitants. Data regarding clinical presentation, risk factors, therapy and evolution were collected, centralized and processed in the clinic of cardiology of Targu Murescedil. Results: The registry included a number of 3455 patients with ACS, from which 1457 acute myocardial infarction (AMI) and 1998 unstable angina (UA). Mortality rates in AMI in the territorial hospitals was: 19,8% in 2004 which decreased to 11.04% in 2007, in parallel with an increase in the number of cases sent to interventional center (from 20% in 2004 to 28.51% in 2007). Conclusions: After the experience in running a registry on ACS, we conclude that we succeeded to decrease the mortality rates in AMI by increasing the adherence to European guidelines and by increasing the rates of patients sent to interventional center.