Transthyretin amyloid cardiomyopathy (ATTR-CM) is an increasingly recognized cause of heart failure, arrhythmias, and conduction disease. After exclusion of light-chain amyloidosis, diagnosis can often be established non-invasively by bone scintigraphy with SPECT. Disease-modifying therapies are now available in Switzerland and are most effective when initiated early. Management should also address heart failure, atrial fibrillation, thromboembolic risk, conduction disorders, and concomitant aortic stenosis. Early recognition and multidisciplinary treatment are therefore essential to improve outcomes.

A 93-year-old woman presented herself with subacute exertional dyspnea in our primary care setting. Imaging revealed a large pericardial cyst without echocardiographic evidence of hemodynamic compromise. Instead, findings were consistent with heart failure with preserved ejection fraction (HFpEF) in the context of hypertensive and valvular heart disease. Optimization of heart failure therapy, including initiation of an SGLT-2 inhibitor, led to clinical improvement. This case highlights the importance of integrating imaging findings into the overall clinical context in primary care.

We report the case of an 88-year-old female patient presenting with progressive, severely pruritic skin lesions and scattered blisters on the trunk and extremities. Histological examination revealed subepidermal blister formation with a neutrophil-rich infiltrate. Differentiation from other autoimmune blistering diseases was initially challenging. The diagnosis was ultimately guided by the linear IgA deposition pattern along the dermoepidermal junction on direct immunofluorescence. This case highlights the diagnostic difficulties of this rare condition and the rapid clinical improvement following appropriate therapy.

A 77-year-old patient presents with acute back pain. Due to elevated CRP and other lab abnormalities, bacterial spondylodiscitis is initially suspected, and blood cultures are obtained early. However, a biopsy reveals uric acid crystals and cultures remain negative, leading to the diagnosis of gout spondylodiscitis. Treatment includes renal-adjusted anti-inflammatory therapy, urate-lowering therapy and flare prophylaxis.

A 71-year-old patient with known metastatic melanoma undergoing treatment with the immune checkpoint inhibitors Ipilimumab/Nivolumab presented with a rapid deterioration in general condition over the past 24 hours. Approximately three weeks after starting ICI-the-rapy, thyroiditis was diagnosed, which progressed to a substitution-requiring hypothyroidism. Currently, laboratory tests revealed severe keto-acidosis with acute blood sugar derangement (51 mmol/l) despite only a mildly elevated HbA1c (6.3 %). We hereby diagnosed fulminant ICI- associated type 1 diabetes mellitus. Symptoms improved under insulin therapy.

This guideline (GL) provides an overview of the management of dyslipidaemia based on international guidelines and new evidence from studies published up to June 2026. The GL focuses on primary care and takes into account the specific characteristics of the Swiss healthcare system. Lipid-lowering therapy should be risk-adapted, with the current 2025/2026 AGLA, ESC/EAS, and ACC/AHA dyslipidaemia GLs recommending a target-based treatment strategy. Our GL presents a structured approach to cardiovascular risk stratification and supports clinicians in selecting the most appropriate risk prediction model for individual patients. Risk modifiers - including family history, ethnicity, comorbidities, biomarkers, and lipoprotein(a) - should be considered in addition to traditional cardiovascular risk factors. In addition to lifestyle optimization, statins remain the first-line treatment. If the required LDL-C reduction is not achieved with statins alone, Ezetimibe, bempedoic acid, and PCSK9 inhibitors should be added sequentially.

Chronic wounds remain a major problem despite advances in wound care. Around 1 % of the population is affected and experiences a significant reduction in quality of life as a result. General practices are often the first port of call for impaired wound healing and chronic wounds. They are responsible for the comprehensive assessment and management of wounds and their underlying causes. This article summarises the current state of knowledge and recommendations, taking into account a cost-effective approach.

Measles is a highly contagious viral disease whose incidence has declined significantly since the introduction of vaccination in the mid-1970s. However, local outbreaks continue to occur due to insufficient vaccination rates. Adults are at higher risk of complications. The present case of a patient with acute post-infectious measles encephalitis despite a history of presumed measles vaccination underscores the critical importance of vaccination as a preventive measure. In everyday general practice, there is an opportunity to identify individuals who have not been vaccinated against measles and to guide them toward achieving full vaccination coverage.

Case report of a young immunocompetent patient presenting with aseptic meningitis due to varicella-zoster virus (VZV) infection. Reactivation of VZV manifesting as meningitis is an uncommon clinical presentation compared to herpes zoster. While a concomitant vesicular rash is frequently observed, it may be absent in some cases. With antiviral therapy initiated promptly, the clinical outcome is generally favorable.

A 48-year-old man was diagnosed with IgG4-related disease (IgG4-RD) during an evaluation for exophthalmos and unexplained pain on the left side of his face. The diagnosis was made by ruling out all other possible conditions and was based on histopathological findings. After initiating immunosuppressive therapy with corticosteroids (GC), most of the symptoms resolved. As the GC-dose was gradually reduced, a relapse occurred, leading to two courses of Rituximab. Reflecting the success of the therapy, long-term follow-up revealed a marked radiological reduction in the retrobulbar mass and a significant clinical improvement in pain.

We present a case of recurrent international normalised ratio (INR) derailment during treatment with phenprocoumon for sinus vein thrombosis. During the course of the illness, the patient developed signs of bleeding, such as epistaxis, gross haematuria and vaginal bleeding, as well as elevated liver enzyme levels. This ultimately led to hospitalisation, where a diagnosis of acute hepatitis associated with drug-induced liver injury (DILI) was made. Following the discontinuation of phenprocoumon and a switch to apixaban for anticoagulation therapy, as well as repeated administration of vitamin K, the patient's condition stabilised. The laboratory findings, liver biopsy and clinical course are most consistent with toxic hepatitis caused by phenprocoumon.