Background and Objectives: Breast cancer (BC) is the most prevalent cancer globally, with a significant mortality rate, especially among women. While advances in treatment have reduced BC mortality, cardiovascular complications resulting from anticancer therapies have become a major concern. The autonomic nervous system (ANS) may be affected in BC patients and it is assessed with heart rate variability (HRV). The aim of this study was to investigate the prevalence of impaired HRV, its predictors, and its clinical impacts in BC patients. Materials and Methods: We retrospectively screened all female BC patients and enrolled cases who underwent 24 h Holter electrocardiography monitoring with accessible clinical follow-up data. Results: This study included 136 BC patients, and the mean age was 56.8 ± 10.8 years old. Impaired HRV was present in 36.8% of patients, and hypertension was identified as a significant predictor of reduced HRV (OR = 3.61, CI: 1.01–12.92, p = 0.048). Furthermore, de novo atrial fibrillation (AF) occurred more frequently in patients with impaired HRV (20% vs. 8.1%; p = 0.044). None of the HRV parameters were associated with all-cause mortality, and cancer stage was found to be the only independent predictor of all-cause mortality (HR = 3.93, CI: 1.81–8.55; p < 0.001). Conclusions: HRV is impaired in a significant proportion of patients with BC. Hypertension plays a crucial role in the deterioration of HRV in patients with BC, and de novo AF is more common in patients with impaired HRV. However, HRV does not appear to predict all-cause mortality in patients with BC. This study highlights the importance of the optimal management of cardiovascular risk factors, such as hypertension, to prevent ANS dysfunction in cancer patients.

Objective: Peripartum Cardiomyopathy (PPCM) is a life-threatening, rare disorder that occurs during the late stages of pregnancy or the early postpartum period. The ARTEMIS (A RegisTry of pEripartuM cardIomyopathy in Turkish patientS) aims to investigate the clinical characteristics and outcomes of PPCM in Turkiye, providing insights into its management within this specific population. Methods: The ARTEMIS registry retrospectively enrolled patients diagnosed with PPCM within the last five years at 44 cardiology centers across Turkiye. Eligible participants were women over 18 years old, diagnosed with PPCM and without other known cardiac pathology. Data collected included demographic information, clinical presentation, diagnostic modalities, treatment regimens, and outcomes. Results: The study included 293 patients, predominantly between 25 and 35 years old. The majority presented with symptoms such as dyspnea and palpitations, diagnosed postpartum via echocardiography. A low use of advanced diagnostic imaging was noted, relying primarily on echocardiography for evaluation. Common treatments included beta blockers (97.8%), angiotensin-converting enzyme (ACE) inhibitors (71.3%), and in severe cases, bromocriptine (6.9%). The study highlighted a mortality rate of 5.1%, with surviving patients often requiring continued management for heart failure. Diagnostic challenges and variations in treatment responses were noted, reflecting the complexity of PPCM diagnosis and care. Conclusion: The ARTEMIS registry provides valuable insights into the management of PPCM in Turkiye, highlighting the need for targeted educational programs for healthcare providers and patients. It also underscores the importance of national registries in understanding and improving outcomes for rare diseases like PPCM.

Background/Aim: Evidence of increased mortality in perfusion abnormalities on myocardial perfusion scintigraphy (MPS) can be found. However, electrocardiography (ECG) is a cheaper and more easily accessible examination than MPS. Fragmented QRS (fQRS) is also considered to be associated with mortality in some cardiological diseases. The present study aimed to analyze the relationship between fQRS based on electrocardiography (ECG) and mortality in patients without reversible defects whose fixed hypoperfusion/perfusion defects were diagnosed and associated with myocardial infarction (MI) based on myocardial perfusion scintigraphy (MPS). Methods: Non-ischemic patients (2289 patients) with MI diagnoses based on scintigraphy were selected based on retrospective scintigraphy reports. The presence of fQRS was investigated in 85 patients whose 12-lead electrocardiographs could be accessed from the hospital archive, and their deaths due to all causes were questioned from the death information system. The relationship between left ventricular ejection fraction (LVEF), fQRS, type of exercise, number of leukocytes, other parameters, and mortality rates was analyzed. Results: The numbers of living (n = 69) and deceased (n = 16) patients were obtained. They were divided into two groups: (1) surviving patients (n = 69, number of fQRS positive 42) and (2) deceased (n = 16, number of fQRS positive 11). No distributional differences were found between mortality rates and fQRS and demographic features between groups (P = 0.558). However, a statistically significant effect was observed between mortality rates and low LVEF levels, pharmacological stress, number of leukocytes, and a low HDL level. Conclusion: The present study suggests that it may be useful to define benign features of fQRS. LVEF levels may be a very important parameter in decision-making for pharmacological stress, and its role in prediction of mortality may be higher than that obtained by fQRS.

OBJECTIVE:To identify the changes in QT dispersion (QTd), corrected QTd (QTcd), and P-wave dispersion (Pd) values with long-term alcohol abuse that could lead to severe ventricular arrhythmia, atrial fibrillation, and sudden death in alcohol use disorder (AUD) patients with excessive alcohol use.METHODS:This cross-sectional study included 48 individuals diagnosed with AUD based on DSM-5 criteria. Patients with a history of psychiatric diseases were not included. The control group comprised 48 individuals with no psychiatric diagnosis who did not abuse alcohol or other substances. Participants with body mass index > 24.9 kg/m² were excluded. Twelve-derivation electrocardiograms (ECG) were obtained from all participants.RESULTS:The mean ± SD age was 44.35 ± 10.24 years in the AUD group and 40.90 ± 13.45 years in the control group. There was no significant difference between the groups based on age (P = .108). There was a significant difference between the groups based on smoking status (P = .000). The mean ± SD period of alcohol use was 20.71 ± 12.04 years, and the alcohol intake was 5.88 ± 1.65 units/d. The AUD group demonstrated elevations in all ECG measures (QTd: 46.56 vs 26.67 ms, QTcd: 54.25 vs 30.88 ms, Pd: 44.69 vs 28.54 ms, all P = .000).CONCLUSIONS:AUD patients with excessive alcohol use had a higher risk of arrhythmia and sudden death compared to the control group. Consideration of ECG and referral to cardiologic examinations would contribute to the follow-up and health of patients with AUD.

Background: Hypertension is a major risk factor for cardiovascular diseases, stroke, congestive heart disease and renal failure. Primary hypertension is a multi-factorial complex disease and its exact etiology still remains unknown. In this study we aimed to compare serum amphiregulin and cerebellin-1 levels of primary hypertension patients with healthy subjects. Material and methods: Forty-four hypertensive patients and 44 healthy people were included. Patients with systolic blood pressure measurements ≥ 140 mm Hg and diastolic blood pressure measurements ≥ 90 mm Hg were evaluated as hypertensive. Serum amphiregulin and cerebellin 1 levels were measured using ELISA method. Results: Mean amphiregulin level was 32.1 (10.2–72.5) pg/mL in hypertension group and 36.9 (15.9–109.5) pg/mL in control group (p = 0.002). Mean cerebellin 1 levels were comparable in both groups, 82.1 (23.9–286.1) pg/mL in hypertensive group and 95.1 (60.2–293) pg/mL in control group (p = 0.261). Serum amphiregulin to predict hypertension was found to be ≤ 23 pg/mL with specificity of 97% and sensitivity of 48.5% (AUC = 0.74; 95% CI, 0.62–0.86; p = 0.001). Conclusions: Hypertension is associated with lower serum amphiregulin concentrations.

Objective: Heart failure (HF) has a high prevalence and mortality rate in elderly patients; however, there are few studies that have focused on patients older than 80 years. The aim of this study is to describe and compare the age-specific demographics and clinical features of Turkish elderly patients with HF who were admitted to cardiology clinics. Methods: The Epidemiology of Cardiovascular Disease in Elderly Turkish population (ELDER-TURK) study was conducted in 73 centers in Turkey, and it recruited a total of 5694 patients aged 65 years or older. In this study, the clinical profile of the patients who were aged 80 years or older and those between 65 and 79 years with HF were described and compared based on the ejection fraction (EF)-related classification: HFrEF and HFpEF (is considered as EF: >= 50%). Results: A total of 1098 patients (male, 47.5%; mean age, 83.5 +/- 3.1 years) aged 80 years and 4596 patients (male, 50.2 %; mean age, 71.1 +/- 4.31 years) aged 65-79 years were enrolled in this study. The prevalence of HF was 39.8% for patients who were >= 80 years and 27.1% for patients 65-79 years old. For patients aged >= 80 years with HF, the prevalence rate was 67% for hypertension (HT), 25.6% for diabetes mellitus (DM), 54.3% for coronary artery disease (CAD), and 42.3% for atrial fibrilation. Female proportion was lower in the HFrEF group (p=0.019). The prevalence of HT and DM was higher in the HFpEF group (p<0.01), whereas CAD had a higher prevalence in the HFrEF group (p=0.02). Among patients aged 65-79 years, 43.9% (548) had HFpEF, and 56.1% (700) had HFrEF. In this group of patients aged 65-79 years with HFrEF, the prevalence of DM was significantly higher than in patients aged >= 80 years with HFrEF (p<0.01). Conclusion: HF is common in elderly Turkish population, and its frequency increases significantly with age. Females, diabetics, and hypertensives are more likely to have HFpEF, whereas CAD patients are more likely to have HFrEF.

Introduction Diabetic patients are susceptible to bacterial, viral and fungal infections because of various deficiencies in the immune system. Aim To investigate a possible link between hepatitis B/C prevalence and microvascular complications as well as duration of diabetes. Material and methods In total 1263 diabetic patients (1149 type 2, 114 type 1) were enrolled in the study. The control group consisted of 1482 healthy blood donors who were over 40 years old. All diabetic patients were tested for HBsAg, anti-HBs and anti-HCV beside routine laboratory tests. Diabetic patients were divided into three groups according to their diabetes duration, and all of the patients were scanned for microvascular complications. Demographic data of all patients were recorded. Results HBsAg seropositivity was 3.7% in diabetic patients and 1.08% in the control group; this difference was statistically significant (p < 0.001). HBsAg positivity rates in type 1 and type 2 diabetics were 0.8% and 4%, respectively (p = 0.09). HCV seropositivity was 2.2% for diabetics and 0.5% for the control group; this difference was statistically significant (p < 0.001). Anti-HCV seropositivity in type 1 and type 2 diabetics was 1.75% and 2.26%, respectively. There was no relationship between diabetes duration and hepatitis B-C prevalence (p > 0.05). Also, no relationship was found between microvascular complications of diabetes and hepatitis B/C seropositivity. Conclusions Hepatitis B and C seroprevalence was found to be increased in diabetes mellitus; however, there was no relationship between hepatitis seroprevalence and the duration or microvascular complications of diabetes.

In recent years, the societies became more conscious about the nutrition. Healthy and reliable food is the main demand, however, request to functional foods which can be briefly defined as beneficial nutrients to human health increases. Kefir is an important member of the probiotics, which are the subgroup of functional foods. It is a fermented milk product and contains useful bacteria and yeasts. In this text, the health and metabolism effects of the kefir are discussed in the light of current literature.

INTRODUCTION:Slow coronary flow (SCF) is described as the slow passage of contrast to distal coronaries despite anatomically normal coronary arteries. It has been shown that increased serum prolidase activity (SPA) correlates with collagen turnover. Increased collagen turnover might be associated with the development of atherosclerotic plaques.AIM:To investigate the relationship between serum prolidase activity and slow coronary flow.MATERIAL AND METHODS:This cross-sectional study included 40 SCF patients (mean age: 55.0 ±9.5 years, 20 females) and 40 controls (mean age: 53.9 ±8.2 years, 21 females) with normal coronary anatomy and normal coronary flow. The Thrombolysis in Myocardial Infarction (TIMI) frame-count (TFC) method was used for SCF diagnosis. Serum prolidase activity was measured spectrophotometrically, and the relevant parameters were compared between the groups.RESULTS:There were no statistically significant differences between the SCF and control groups in terms of basic demographic, clinical, and laboratory data. However, the SPA was significantly higher in the SCF group compared to the control (702.7 ±13.8 and 683.9 ±13.2 respectively, p<0.001). Serum prolidase activity was significantly correlated with the mean TFC (r=0.463, p<0.001). The overall findings of this study support the predictive accuracy of the serum prolidase activity in our cohort, with a statistically significant ROC value of 681.3.CONCLUSIONS:Our study showed that SPA was increased in SCF patients. The activity of this enzyme was significantly correlated with the mean TFC.

Pericardial effusion is a common complication of open heart surgery and more frequently occurs after coronary artery by-pass grafting. There are classical symptoms such as chest pain, dyspnea and orthopnea. However, hyponatremia is an unusual finding on presentation, and reported only three times in the literature. In this paper, a case in which recurrent pericardial effusion developed after coronary artery by-pass grafting presented with reversible hyponatremia was described. Hyponatremia was resolved rapidly, only after removal of large pericardial effusion by a successful pericardiocentesis. The possible mechanisms of reversible hyponatremia, relationship with pericardial effusion, and discrepancies about diagnosis were discussed, briefly.

In recent years, the societies became more conscious about the nutrition.Healthy and reliable food is the main demand, however, request to functional foods which can be briefly defined as beneficial nutrients to human health increases.Kefir is an important member of the probiotics, which are the subgroup of functional foods.It is a fermented milk product and contains useful bacteria and yeasts.In this text, the health and metabolism effects of the kefir are discussed in the light of current literature.

showed residual flow in the fistula and we used 6 Fr right Judkins catheter to push forward AVP device inside of the 8 Fr left Judkins catheter. Eventually, a 14 and 16 mm AVP devices were deployed just below to circumflex branches. Repeat angiogram showed complete closure of the defect as well as improved filling of the coronary branches (Fig. 2B, Video 2). The patient had an uneventful hospital course. At 3-month follow-up, the patient is asymptomatic and doing well.

Objective: In present study, we aimed to investigate the effect of slow coronary flow (SCF) on left ventricular diastolic functions by using conventional and tissue Doppler imaging method. Methods: Thirty-two SCF patients with normal coronary artery (mean age, 55±13, 18 male), and 30 normal coronary flow patients with normal coronary artery (mean age, 50±10, 15 male) were enrolled to the study. TIMI frame count method was used for SCF diagnosis. The left ventricular diastolic functions of all participants were evaluated by conventional and tissue Doppler echocardiography one day after coronary angiography. All data were compared between two groups. Results: TIMI frame counts of left anterior descending artery, circumflex and right coronary artery were significantly higher in CSF group (p<0.01). There were significant decrease in early and late diastolic maximum filling rates (E/A) (p<0.01), and significant prolongation at early deceleration time (p<0.01) on conventional echocardiography in CSF group. The tissue Doppler parameters which have been measured from the four region of mitral annulus were as follows: the mean Em velocity and mean Em/Am ratio were significantly lower in CSF patients (p<0.01), and mean Am velocity were significantly higher (p<0.01). E/Em, a non-invasive predictor of left ventricular filling pressures, is similar in both groups. Conclusion: The regional and global left ventricular functions of SCF patients were significantly deteriorated compared to controls.

Aim: We investigated the effect of smoking on oxidative stress in smokers with normal coronary arteries. Material and methods: Consecutive 54 patients with normal coronaries who admitted to our hospital's coronary angiography service for coronary angiography were included to study. Patients were divided into two groups: Group 1 n=29, mean age, 47 ± 11 years composed of patients with only one risk factorsmoking- for coronary artery disease; and Group 2 n=25, mean age, 51 ± 12 years composed of patients with no risk factors for coronary artery disease. Serum samples were investigated by Erel method about total antioxidant level and total oxidant level and oxidative stress index was calculated. All participants gave informed consent. Results: While Total antioxidant levels were higher in control group 0,80±0,12 and 0,86±0,13, P= 0,044 , Total oxidant levels were higher in smokers 11,02±1,51 and 9,97±1,36, P=0,010 . Oxidative stress index which could be calculated by dividing Total oxidant level to Total antioxidant level, was higher in smokers 1,41±0,261 and 17±0,16, P=0,0002 .Conclusion: By causing total antioxidant levels reduction and total oxidant level increase long-term smoking can lead to oxidative stress which occurs in the pathogenesis of several chronic diseases

Case Report of a rare anomalous origin of the coronary artery in a patient with severe aortic stenosis Anomalous origin of the coronary artery is a rare congenital condition. Congenital coronary artery anomalies have been shown to account for %0.6 - 1.3 in angiographic series, and 0.3% in autopsy series. Anomalies of the coronary artery may present with chest pain, syncope, myocardial ischemia, malignant ventricular arrhythmia and sudden cardiac death or in the absence of any symptoms as well. We here present a rare case of congenital coronary artery anomaly in a patient with a severe aortic stenosis.CaseA 61 year-old female patient had a known history of 50 packs/year smoking, menopause and severe aortic stenosis. ECG showed a normal sinus rhythm. Physical examination demonstrated a blood pressure of 140/90 mmHg, a pulse rate of 64 beats/min, and a systolic ejection murmur (Grade 3/6) in aortic region. Echocardiography revealed normal systolic function and severe aortic stenosis (Mean gradient: 55 mmHg, aortic valve area: 0.9 cm2). Aortic valve replacement was considered to be the appropriate treatment for this patient who had complaints of syncope and chest pain. A coronary angiography was planned before the procedure due to age and presence of risk factors. Coronary angiography showed a single ostium of the coronary artery in the right sinus of valsalva (Figure-1), and an aortography was performed to search for another coronary ostium (Figure-2). Aortography confirmed that all coronary arteries were originating from a single ostium, and there was no other ostium. Patient's coronary arteries were considered normal, and she was transferred to the Cardiovascular Surgery Department.Figure 2Aortography which shows only one ostiumView Large Image Figure ViewerDownload Hi-res image Download (PPT) Case Report of a rare anomalous origin of the coronary artery in a patient with severe aortic stenosis Anomalous origin of the coronary artery is a rare congenital condition. Congenital coronary artery anomalies have been shown to account for %0.6 - 1.3 in angiographic series, and 0.3% in autopsy series. Anomalies of the coronary artery may present with chest pain, syncope, myocardial ischemia, malignant ventricular arrhythmia and sudden cardiac death or in the absence of any symptoms as well. We here present a rare case of congenital coronary artery anomaly in a patient with a severe aortic stenosis. CaseA 61 year-old female patient had a known history of 50 packs/year smoking, menopause and severe aortic stenosis. ECG showed a normal sinus rhythm. Physical examination demonstrated a blood pressure of 140/90 mmHg, a pulse rate of 64 beats/min, and a systolic ejection murmur (Grade 3/6) in aortic region. Echocardiography revealed normal systolic function and severe aortic stenosis (Mean gradient: 55 mmHg, aortic valve area: 0.9 cm2). Aortic valve replacement was considered to be the appropriate treatment for this patient who had complaints of syncope and chest pain. A coronary angiography was planned before the procedure due to age and presence of risk factors. Coronary angiography showed a single ostium of the coronary artery in the right sinus of valsalva (Figure-1), and an aortography was performed to search for another coronary ostium (Figure-2). Aortography confirmed that all coronary arteries were originating from a single ostium, and there was no other ostium. Patient's coronary arteries were considered normal, and she was transferred to the Cardiovascular Surgery Department. A 61 year-old female patient had a known history of 50 packs/year smoking, menopause and severe aortic stenosis. ECG showed a normal sinus rhythm. Physical examination demonstrated a blood pressure of 140/90 mmHg, a pulse rate of 64 beats/min, and a systolic ejection murmur (Grade 3/6) in aortic region. Echocardiography revealed normal systolic function and severe aortic stenosis (Mean gradient: 55 mmHg, aortic valve area: 0.9 cm2). Aortic valve replacement was considered to be the appropriate treatment for this patient who had complaints of syncope and chest pain. A coronary angiography was planned before the procedure due to age and presence of risk factors. Coronary angiography showed a single ostium of the coronary artery in the right sinus of valsalva (Figure-1), and an aortography was performed to search for another coronary ostium (Figure-2). Aortography confirmed that all coronary arteries were originating from a single ostium, and there was no other ostium. Patient's coronary arteries were considered normal, and she was transferred to the Cardiovascular Surgery Department.

Objective: Familial Mediterranean fever (FMF) is an autosomal recessive autoimmune disease, presenting with the attacks of fever and inflammation of serous membranes.One of the leading causes of death in autoimmune rheumatologic diseases is cardiovascular events.The purpose of this study is to evaluate the effects of FMF on the autonomic nerve and cardiovascular systems by measuring the indices of heart rate variability (HRV).Material and Methods: Thirty FMF patients and the same number of healthy volunteers were enrolled to the study.Standard deviation of all R-R intervals (SDNN), the square root of the sum of the square of the differences between successive R-R intervals (RMSSD), standard deviation of 5-minute mean values of R-R interval (SDANN), low frequency (LF), and high frequency (HF) were measured.Results: Time domain indices (SDNN, SDANN, and RMSSD) were: 124.67±40.79, 129.87±36.43(p=0.605);11.43±38.41,11.23±38.98(p=0.984); and 33.43±17.39,38.17±12.8(p=0.235) for FMF patients and controls, respectively, and similar in both groups.Frequency domain indices (HF, LF, and LF/HF) were: 290.41±290.25, 322.20±222.54(p=0.639);596.16±334.07,805.80±471.00(p=0.051); and 3.57±2.57,3.05±1.40(p=0.338) for FMF patients and controls, respectively, and similar in both groups. Conclusion:The HRV parameters were similar in both groups.However, studies including larger populations and using different methods are required to clarify if autonomic dysfunction exists in patients with FMF.

OBJECTIVESStiffness index beta (SIB), aortic strain (AS) and distensibility (AD) are the parameters used to assess elasticity of the aorta, and can be measured by non-invasive method such as echocardiography. In this study, we aimed to analyse the effects of Maraş powder and smoking on aortic stiffness by comparing young individuals.STUDY DESIGNThe study included 90 male subjects aged 18-40 years. 30 subjects were Maras powder users (mean age; 32±2), 30 were smokers (mean age: 28±2) and 30 were healthy volunteers (mean age: 29±2). After detailed physical examination, all subjects underwent transthoracic echocardiography. Systolic and diastolic diameters of the aorta were measured from the ascending aorta at modified parasternal long axis views by M-mode echocardiography. AS, AD, and SIB were calculated using standard formulae. Group parameters were then compared to each other.RESULTSThere was no significant difference between the groups in terms of demographic and clinical features, including blood pressures, lipid profile and serum creatinine (p>0.05). Although AS and AD were lower, and SIB was higher in the Maraş powder and smoking groups compared to the control group, the difference between groups was not statistically significant (for AS: 17.61±2.22, 17.75±1.93, 18.48±2.02 respectively, for AD: 9.03±1.12, 9.14±0.96, 9.9±1.12, respectively, for SIB: 2.72±1.07, 2.59±0.88, 2.37±0.71 respectively, for all p>0.05).CONCLUSIONOur study revealed that smoking and Maraş powder did not lead to a significant change in elasticity of the aorta in individuals under the age of 40.

A 60-year-old man was admitted to the emergency department with chest pain and pruritus. He was diabetic and two months previously his left anterior descending artery had been stented. He was exposed to multiple bee stings 4 h prior to presentation. On physical examination, vital signs were stable. A 12-lead electrocardiogram showed anterior ST-segment elevation. With the aim of primary percutaneous coronary intervention, he was transferred to the cathetherisation laboratory. Selective coronary angiography demonstrated that the left anterior descending artery stent was totally occluded with thrombus (Fig. 1A). Non-critical lesions were visualised in other coronary arteries. The lesion was passed with wire easily and appropriate distal flow was achieved after balloon inflation (Fig. 1B). Follow-up period in the coronary care unit was uneventful, and he was discharged without any complication. A diagnosis of Kounis syndrome (KS) secondary to bee sting was made. In contrast to current literature, this is the first stent thrombosis case described after hymenoptera envenomation. KS is defined as a group of acute coronary syndromes that manifests as unstable vasospastic or nonvasospastic angina, and even as acute myocardial infarction (MI) triggered by the release of inflammatory mediators following an allergic insult. It was first described in 1991 as coronary vasospasm and MI secondary to allergic reactions, and is also known as allergic MI. Several etiologic factors have been reported including drugs, bees, ants, jellyfish and poison ivy. The most frequent symptoms are retrosternal chest pain, dyspnoea, palpitations, weakness, nausea, urticaria, itchiness, sweating, and hypotonia. Two types of this syndrome have been defined. In type 1, the coronary arteries are normal and coronary vasospasm secondary to hypersensitivity reaction is the responsible mechanism. The clinical presentation is usually angina, but if the response is prolonged, progression to myocardial necrosis and infarction may occur. The basic hypothesis is that type 1 KS is a manifestation of endothelial dysfunction. In type 2, there is underlying coronary artery disease and hypersensitivity reaction leads to plaque erosion and coronary occlusion. The inflammatory response is essentially mast cell driven, which are the key elements of allergic reactions. Mast cells are located between cardiomyocytes and around coronary arteries in healthy people. As a result of mast cell activation, several vasoconstricting and collagen degrading compounds including histamine, platelet activating factor, and neutral proteases release. The latter activate metalloproteinases in atheromatous plaques and play an important role in their erosion and rupture. Prognosis of patients with type 1 is better than type 2 cases. Prognosis depends on the magnitude of the allergic reaction, patient’s sensitivity, comorbidities, allergen concentration, and the allergen’s portal of entrance to the body.