Chronic thromboembolic pulmonary hypertension (CTEPH) is a distinct and potentially curable form of pulmonary hypertension that develops following incomplete resolution of acute pulmonary embolism, leading to persistent fibrotic obstruction of the pulmonary arteries and progressive microvascular disease. Although CTEPH has traditionally been assessed using steady-flow hemodynamic parameters such as mean pulmonary arterial pressure and pulmonary vascular resistance, growing evidence suggests that pulmonary artery stiffness and altered vascular biomechanics are critical contributors to disease severity, right ventricular dysfunction, and patient outcomes. This narrative review summarizes current knowledge on the structural remodeling and biomechanical behavior of pulmonary arteries in CTEPH, with emphasis on changes affecting arterial compliance, impedance, and right ventricle–pulmonary artery coupling. Key mechanisms include thrombus organization, endothelial dysfunction, smooth muscle cell proliferation, extracellular matrix deposition, and mechanobiological feedback loops that reinforce vascular stiffening. The review further discusses available experimental and computational approaches used to characterize pulmonary vascular mechanics and highlights the clinical relevance of biomechanical markers in improving prognostic stratification and therapeutic decision-making. Finally, it outlines gaps in current evidence regarding reversibility of vascular stiffness and the long-term impact of surgical, interventional, and medical therapies, supporting the need for integrated biomechanical assessment in future CTEPH research and management.

Coronary computed tomography angiography (CCTA) has evolved significantly over the past decade, expanding from stable coronary artery disease (CAD) assessment to diverse cardiovascular applications. However, its role in non-ST-elevation acute coronary syndromes (NSTE- ACSs) remains incompletely defined despite excellent diagnostic accuracy. This review synthesizes current evidence on the performance of CCTA in NSTE-ACS, examining diagnostic capabilities, advanced plaque characterization, clinical outcomes, and knowledge gaps requiring future investigation. CCTA demonstrates high negative predictive value (>90%) for ruling out obstructive CAD in NSTE-ACS, particularly in low-to-intermediate risk patients. Despite this diagnostic performance, contemporary evidence reveals a persistent disconnect between anatomical accuracy and clinical benefit, with CCTA-guided strategies failing to demonstrate improvements in major adverse cardiovascular events or reductions in healthcare costs when compared to standard invasive approaches. Advanced plaque characterization techniques offer potential refinement in risk stratification. Pericoronary adipose tissue analysis via fat attenuation index correlates with vulnerable plaque features and inflammatory markers in NSTE-ACS populations. Critical evidence gaps persist regarding optimal patient selection algorithms, timing strategies across risk stratification, and cost-effectiveness analyses. Future research must prioritize outcome-driven investigations demonstrating that CCTA-guided management improves clinical endpoints, prospective validation of advanced imaging biomarkers, and integration into personalized algorithms to bridge the gap between diagnostic capability and meaningful clinical impact.

Patent foramen ovale (PFO) is a common congenital cardiac anomaly, present in approximately 25% of the general population, representing a persistent interatrial communication. This review summarizes current evidence on the clinical manifestations, diagnostic approaches, and management strategies for PFO in accordance with the most recent international guidelines. In patients with high-risk anatomical features or cryptogenic stroke, PFO closure may be indicated. The decision to close a PFO is based on careful risk stratification and comprehensive imaging, typically including contrast-enhanced transesophageal echocardiography. Several randomized controlled trials have demonstrated the efficacy of percutaneous closure devices, and PFO closure is currently considered an effective strategy for secondary prevention of cryptogenic stroke in carefully selected patients aged 18 to 60 years.

Hypertensive emergencies are critical conditions characterized by severe blood pressure (BP) elevations causing acute target organ damage. Despite advancements in hypertension management, these emergencies remain a significant clinical challenge, affecting 1–2% of hypertensive patients and often arising from poor disease control. This review integrates updated guidelines, emerging evidence, and treatment strategies to optimize outcomes. Pathophysiological mechanisms, including failure of autoregulation and renin–angiotensin–aldosterone system activation, contribute to endothelial dysfunction and microvascular injury. Effective management requires rapid, yet cautious BP reduction to prevent further organ damage while preserving perfusion. Intravenous antihypertensive agents, such as labetalol and nicardipine, are emphasized for their safety and efficacy. Comparative studies highlight nicardipine’s superior efficacy in achieving rapid BP control, whereas labetalol offers versatility with fewer cardiac side effects. In specific scenarios, such as ischemic stroke or preeclampsia, treatment is tailored to underlying conditions, reflecting guideline recommendations. Long-term outcomes depend on sustained BP control and the prevention of hypertensive-mediated organ damage. Emerging biomarkers provide insights into disease progression and potential therapeutic targets. Despite progress, research gaps remain in precision medicine and healthcare equity. Future efforts should focus on personalizing treatment and integrating advanced diagnostics to reduce morbidity and mortality in hypertensive emergencies.

Postoperative arrhythmias are commonly seen in pediatric cardiac intensive care units and are linked to higher rates of both morbidity and mortality in children with congenital heart disease. However, the incidence of early postoperative arrhythmias in the pediatric population is unclear, varying from 7.3% to 48% in the literature. We searched the PubMed, Embase, and Web of Science databases from 2000 to 2025 with the aim to perform a systematic review of the existing literature on the incidence and risk factors of early arrhythmias following heart surgery. A total of 16 cross-sectional observational studies, including 5,563 patients who underwent surgery for congenital heart disease and 901 patients who developed early postoperative arrhythmias, met the inclusion criteria. Patients developing early postoperative dysrhythmias were younger, with a lower body weight, and the duration of cardiopulmonary bypass was significantly longer. Other incriminated risk factors for the occurrence of early postoperative arrhythmias were hemodynamic instability, complexity of the surgical procedure, and higher vasoactive-inotropic scores. Pediatric patients with congenital heart disease who undergo cardiac surgery face increased morbidity and mortality due to the risk associated with the multifactorial complication of early postoperative arrhythmias. The reported incidence of these arrhythmias varies greatly among different studies and a better understanding of risk factors and pathophysiological mechanisms would improve postoperative outcomes for this notably exposed population.