Sickle cell disease is a hereditary haemoglobinopathy characterized by chronic haemolysis, vaso-occlusive events and multisystem involvement. Whereas haematological and pulmonary complications are well recognized, cardiac involvement - particularly arrhythmias - has recently emerged as an important contributor to morbidity and mortality. This review examines the spectrum of rhythm disturbances in this population based on recent clinical data. Electrocardiographic abnormalities are common, including corrected QT interval prolongation, sinus tachycardia and repolarization changes. Supraventricular and ventricular arrhythmias are increasingly reported, and may contribute to sudden cardiac death, particularly during acute vaso-occlusive events. Proposed mechanisms are multifactorial, involving myocardial ischaemia imbalance and inflammation. Despite growing awareness, the prognostic significance and optimal management of arrhythmias in sickle cell disease remain poorly defined. Further studies are needed to improve risk stratification and guide targeted preventive and therapeutic strategies.

Transcatheter aortic valve implantation (TAVI) has become widely used to treat symptomatic patients with aortic stenosis (AS), but increasing demand has led to treatment delays, which are associated with increased morbi-mortality.

Headache, dizziness and vertigo are non-specific but frequently reported symptoms in patients with hypertension. When evaluating headache, clinicians must systematically exclude primary headache disorders - such as migraine, tension-type headache and trigeminal autonomic cephalalgias - before attributing symptoms to hypertension. If a primary headache is suspected, referral to a neurologist is essential for specialized management. Hypertension-related headache must fulfil specific diagnostic criteria, including a high blood pressure level (≥180/120mmHg), a demonstrated causal relationship through temporal association and symptom relief following antihypertensive treatment. Whereas severe hypertension combined with headache (e.g. malignant or accelerated hypertension, grade 3 or 4 hypertensive retinopathy) requires urgent attention, the long-term prognosis of patients with recurrent symptoms does not appear to be negatively impacted. Dizziness, often described as lightheadedness, unsteadiness or a floating sensation, must be distinguished from vertigo, which is characterized by an illusion of movement, typically rotatory. In patients with hypertension, vertigo necessitates a thorough evaluation to rule out neurological and vestibular aetiologies, in collaboration with neurologists and ear, nose and throat specialists. These patients require meticulous blood pressure monitoring because of their increased risk of cardiovascular death, particularly from stroke.

Thrombophilia encompasses inherited and acquired biological abnormalities that predispose to venous thromboembolism (VTE). Although thrombophilia testing has been available for decades, routine screening of all patients presenting with deep vein thrombosis or pulmonary embolism is neither recommended nor cost-effective. Current international guidelines support testing for clinical scenarios where results may meaningfully inform recurrence risk and thereby influence therapeutic decisions regarding anticoagulation duration, anticoagulant choice, contraceptive counselling or pregnancy management. This narrative review provides a practical, evidence-based framework for thrombophilia investigation. We address testing indications stratified by clinical context, including unprovoked VTE in young patients, hormone-associated thrombosis and unusual-site thrombosis. Practical considerations for testing timing and anticoagulant interference are detailed, including recent expert guidance on charcoal-based direct oral anticoagulant neutralization strategies. Therapeutic implications are examined across specific populations: women requiring hormonal contraception or menopause hormone therapy, cancer-associated thrombosis and chronic thromboembolic pulmonary hypertension. Thrombophilia results should be interpreted within the broader clinical context. A clinical decision algorithm synthesizing current evidence and recommendations is proposed to guide selective testing.