Third case reports issue - Continuing education

Michael Aschermann

Cor Vasa 2016, 58(5):e457 | DOI: 10.1016/j.crvasa.2016.09.003  

Summary of the 2016 ESC Guidelines on the diagnosis and treatment of acute and chronic heart failure. Prepared by the Czech Society of Cardiology

Jindřich Špinar, Jaromír Hradec, Lenka Špinarová, Jiří Vítovec

Cor Vasa 2016, 58(5):e530-e568 | DOI: 10.1016/j.crvasa.2016.09.004  

Inferior vena cava leiomyosarcoma with right atrium tumorous mass presenting as heart failure in a 70-year-old man: A case report

Pavel Kukla, Leoš Pleva, Martin Porzer, Radim Brát, Petr Handlos, Petr Buzrla, Jiří Plášek, Jan Mrozek, Miroslav Homza

Cor Vasa 2016, 58(5):e458-e465 | DOI: 10.1016/j.crvasa.2015.07.003  

Primary tumors of the heart and the inferior vena cava are relatively rare. The incidence of the former is 0.001-0.030%, while the frequency of metastatic tumors is 20-40 times higher. Out of the total number of primary cardiac tumors recorded, only about 10% are malignant, and a similar statement can be made about the inferior vena cava, i.e. most of these tumors are of secondary origin.This paper reports the case of a Caucasian male, aged 70, with a recent history of visiting equatorial Africa, who was originally admitted for dyspnea due to cardiac failure, and was subsequently diagnosed with expansion in the region of the inferior vena cava...

Papillary fibroelastoma originating from the free left ventricular wall as the cause of recurrent stroke: Description of the case and literature review

Ondřej Macura, Tomáš Paleček, Jaroslav Hlubocký, Petr Vondráček, Ivana Vítková, Jan Kuchař, Zuzana Hlubocká

Cor Vasa 2016, 58(5):e466-e469 | DOI: 10.1016/j.crvasa.2015.09.002  

Papillary fibroelastoma is the third most common primary benign cardiac tumor typically found on the endocardium of heart valves, most often left-heart ones. The authors present the case of a 52-year-old patient experiencing recurrent cardioembolic stroke involving the cerebral arteries secondary to a fibroelastoma originating from the free left ventricular wall and, given its symptomatic nature, indicated for surgical excision.

Chondrosarcoma resection followed by a branched crural revascularization of the right calf: Case report

Róbert Novotný, Jan Lessenský, Jan Hrubý, Jaroslav Hlubocký, Petr Mitáš, Jaroslav Lindner

Cor Vasa 2016, 58(5):e470-e473 | DOI: 10.1016/j.crvasa.2016.02.005  

Background: Chondrosarcoma is a malignant bone tumor accounting for 20% of all bone malignancies. We are presenting a case of a lower extremity recurrence of chondrosarcoma that encapsulated the anterior tibial artery and the fibular artery in a 35-year-old Caucasian male patient. The patient underwent a primary resection of a chondrosarcoma of the right lower extremity 3 years ago. The patient underwent regular MRI and CT check-ups of the affected lower extremity. The patient reported a hard palpable mass with intermittent pain attacks and occasional limb swelling on his right calf 3 years from the initial surgery. A CT scan revealed a new tumor arising...

Cardiac myxoma presenting with fever of unknown origin

Shi-Min Yuan

Cor Vasa 2016, 58(5):e474-e477 | DOI: 10.1016/j.crvasa.2016.02.009  

The clinical manifestations of cardiac myxoma can be miscellaneous and uncharacteristic, which may lead to delayed diagnosis and treatment, and ultimately an unexpected poor prognosis. Of these, fever of unknown origin is one of the rare manifestations of cardiac myxoma. A 56-year-old female presenting with sustained low-grade fever showed poor response to antibiotic treatment. Later, she developed chest discomfort and exertional dyspnea. She was inspected with echocardiography, which revealed a left atrial myxoma. She underwent cardiac myxoma resection. After the operation, she was complicated with complete heart block. She recovered to normal sinus...

Primary cardiac angiosarcoma in multimodality imaging - Case report and review of literature

Jan Přeček, Zbyněk Tüdös, Martin Hutyra, František Kováčik, David Vindiš, Zuzana Prouzová, Miloš Táborský

Cor Vasa 2016, 58(5):e478-e483 | DOI: 10.1016/j.crvasa.2016.04.001  

Primary cardiac tumors are very rare diseases, wherein the most frequent primary malignant cardiac tumor is angiosarcoma. Despite the advances in diagnostics and therapy, prognosis of primary cardiac angiosarcoma is still poor. Timely diagnosis is a key requirement for the patients' survival. Multimodality imaging could contribute to brief differential diagnosis of cardiac masses. Our paper presents a fatal case of cardiac angiosarcoma in a young man with special focus to multimodality imaging possibilities, including, next to echocardiography, also MRI and PET-CT. Review of literature describes a clinical characteristics of the cardiac angiosarcoma...

Papillary fibroelastoma in the right ventricle

Kryštof Krása, Josef Bešík, Luděk Voska, Martin Malý

Cor Vasa 2016, 58(5):e484-e486 | DOI: 10.1016/j.crvasa.2016.04.005  

Papillary fibroelastoma (PFE) is a rare primary cardiac tumor. Herein, we present a case of a 35-year-old asymptomatic female, who was examined using echocardiography due to arterial hypertension, which revealed a right ventricular (RV) mass. Surgical removal of the mass was performed, and histological examination confirmed the diagnosis of PFE, which is a very rare finding in this localization.Learning objectives: PFE is a rare primary cardiac tumor. It usually affects the valvular endocardium. The RV is an extremely rare location, representing only 3.4% cases. Complications of PFE in the RV include pulmonary embolism due to thrombi formation...

Catheter ablation of incessant ventricular tachycardia in a patient with mechanical cardiac support: A case report

Jozef Mikovčák, Radek Neuwirth, Jakub Střítecký, Marian Branny

Cor Vasa 2016, 58(5):e487-e490 | DOI: 10.1016/j.crvasa.2015.11.003  

In this study, we are presenting a patient with a combined heart issue - history of postinfectious cardiomyopathy and a myocardial infarction. HeartWare was implanted in this patient due to the advanced chronic heart failure. Afterwards, he had been suffering from recurrent episodes of ventricular tachycardia (VT), leading to right-sided heart failure even in the presence of functioning left ventricular assist device (LVAD). As a solution, catheter ablation was selected to achieve a decent hemodynamic stability and to bridge the patient to heart transplantation.

Brugada syndrome - Case report, risk stratification and treatment

Miroslav Derevjaník, Lucie Šedivá

Cor Vasa 2016, 58(5):e491-e496 | DOI: 10.1016/j.crvasa.2016.01.011  

Brugada syndrome (BrS) is a malignant, genetically-determined, arrhythmogenic syndrome that is characterized by abnormal electrocardiogram (ECG) findings and an increased risk of sudden cardiac death (SCD). BrS is responsible for about 4% of all sudden deaths and up to 20% of sudden deaths among patients with structurally normal hearts. Since the first report on BrS in 1992 by the Spanish cardiologists Pedro and Josep Brugada, there are still some unresolved clinical problems as risk stratification (RS) and identification of those patients at high risk of SCD who need implantable cardioverter-defibrillator (ICD). All recommendations are based on expert...

Methadone-related QT prolongation and arrhythmic storm in an addicted patient: What weapons to use in a lost war?

Angela Nicotera, Pasquale Crea, Maurizio Cusmà Piccione, Antonio Giordano, Giuseppe Picciolo, Francesco Luzza

Cor Vasa 2016, 58(5):e497-e500 | DOI: 10.1016/j.crvasa.2016.04.004  

Drug-induced QT prolongation is a common finding in patients on therapy with antidepressants, antipsychotic, diuretics, antiarrhytmic drugs, etc. Drug's interruption normally restored QT interval. A 50-year-old man, with a history of abuse of heroin in treatment with methadone, was admitted in our department for syncope. He made occasional abuse of cocaine. On the day before he had vomited and diarrhea. The electrocardiogram showed sinus bradycardia and a prolonged corrected QT interval. Serum potassium levels resulted quite low. During the ECG monitoring, multiple torsade de pointes degenerating in ventricular fibrillation with loss of consciousness...

Modified Warden procedure in adult with partial anomalous pulmonary venous connection after previous atrial septal defect repair

Gianluigi Perri, Francesca Graziani, Piergiorgio Bruno, Maria Grandinetti, Chiara Lanzillo, Marta Marziali, Antonio Amodeo, Massimo Massetti

Cor Vasa 2016, 58(5):e501-e504 | DOI: 10.1016/j.crvasa.2015.08.004  

A 20-year-old boy was admitted to our Hospital for recurrent pleural effusion, effort breathless and initial signs of right heart failure. He had primary diagnosis, in childhood, of secundum ASD and had undergone, at the age of 16 years, ASD repair with patch. A MRI showed anomalous connection of two pulmonary veins in highest superior vena cava. We performed a modified Warden procedure with a prosthetic conduit. We report the advantages of this technique in reintervention in adult congenital patient.Learning objective: To give information about the possible surgical technique in adult congenital patient with anomalous pulmonary veins connection...

Multiple silent atherosclerotic aneurysms with penetrating ulcer of the aortic arch treated with a hybrid procedure

Francesco Sbrana, Michele Coceani, Angelo Monteleone, Francesca Pignatelli, Christina Petersen, Dante Chiappino, Emilio M. Pasanisi, Sergio Berti

Cor Vasa 2016, 58(5):e505-e508 | DOI: 10.1016/j.crvasa.2015.10.005  

Aortic aneurysms result from degeneration and abnormal production of elastin and collagen. Besides medical therapy, management includes periodical imaging to identify the best moment for surgery. Nowadays, the alternative to traditional surgical techniques is represented by a hybrid approach in which debranching is followed by positioning of an endograft. We describe a case of a patient with multiple atherosclerotic aneurysms and a penetrating ulcer of the aortic arch treated with a hybrid approach.

Invasive aspergillosis following the heart transplantation - A case report

Július Godava, Jan Krejčí, Petr Hude, Eva Ozábalová, Tomáš Honek, Petr Němec, Michal Tichý, Marta Pažourková, Lenka Špinarová

Cor Vasa 2016, 58(5):e509-e512 | DOI: 10.1016/j.crvasa.2015.12.002  

According to the ISHLT registry infectious complications are the leading cause of death in the first year after heart transplantation. Presented case report describes the fate of 63-year-old patient with heart failure due to coronary artery heart disease, which in March 2012, underwent a heart transplantation. In May he comes with symptoms of respiratory infection. Diagnosed invasive aspergillus pneumonia, for which deployed specific treatment with voriconazole. For unsatisfactory effect enhanced by the addition of amphotericin B. Despite all the care patient a month after diagnosis died of sepsis. A subsequent autopsy found the cause of death: abscessing...

Quadricuspid aortic valve: A case report

Shi-Min Yuan, Song-Li Yan

Cor Vasa 2016, 58(5):e513-e514 | DOI: 10.1016/j.crvasa.2016.03.001  

Quadricuspid aortic valve is rare. A 47-year-old female complained of mild exertional dyspnea and was referred to this hospital. Transthoracic echocardiography showed a quadricuspid aortic valve with mild aortic regurgitation. She was doing well without any progression of her mild symptom at 9-month follow-up. In this report, a very rare type D quadricuspid aortic valve is described. Transthoracic echocardiography may provide with exact anatomies of the quadricuspid aortic valve. Patients with mild symptoms may warrant a close follow-up.

Anomalous origin of right coronary artery from pulmonary artery with aneurysmal coronary arteries

Michele Gallo, Frida Rizzati, Massimo Padalino, Giovanni Stellin

Cor Vasa 2016, 58(5):e515-e517 | DOI: 10.1016/j.crvasa.2015.07.004  

We describe a case of 16-year-old asymptomatic boy that was referred for evaluation of a heart murmur. Echocardiography and angiography showed an anomalous right coronary artery from the pulmonary artery with dilatation of left coronary artery and several large collateral vessels. The goal of surgical therapy is establishment of a physiologic bi-coronary circulation.

High shear stress on the background of clinical restenosis at the site of step-down phenomenon after drug eluting stent implantation

Csaba Jenei, Gábor Závodszky, György Paál, Balázs Tar, Zsolt Kőszegi

Cor Vasa 2016, 58(5):e518-e521 | DOI: 10.1016/j.crvasa.2015.08.005  

A retrospective modeling was performed in a case with restenosis after 6 months of a DES implantation to investigate the effect of the step-down at the distal edge of the stent on the wall shear stress (WSS) using 3D coronary angiography reconstruction and the intracoronary pressure traces during a cardiac cycle. The kinetics of the WSS was calculated through the cardiac cycle along the reconstructed vessel by fluid dynamic analysis. Contrary to the previous reports the greatest amplitude and average of the arterial WSS was detected where the restenosis developed later at the site of the step-down.

Intercostal artery pseudoaneurysm: A rare complication of coronary angiography

Mehdi Boussaada, Majed Hassine, Mezri Maatouk, Mejdi Ben Messaoud, Marouane Mahjoub, Fethi Betbout, Mondher Golli, Habib Gamra

Cor Vasa 2016, 58(5):e522-e524 | DOI: 10.1016/j.crvasa.2016.02.011  

Intercostal artery pseudoaneurysm during coronary angiography is a rare but potentially lethal complication that needs special attention in order to make the diagnosis on time. We report the case of a patient who developed intercostal artery pseudoaneurysm during percutaneous coronary angiography, and who survived thanks to a rapid diagnosis, urgent care and strict monitoring.Learning objective: Make the practitioner aware of such a complication in order to make a rapid diagnosis and an adequate management.

Minimally invasive treatment of a life threatening ruptured thoracic aortic aneurysm

Ivo Petrov, Zoran Stankov, Stefan Stafanov, Tzvetan Minchev, Petar Polomski, Hristo Stojanov, Galina Kozarova, Gloria Adam

Cor Vasa 2016, 58(5):e525-e529 | DOI: 10.1016/j.crvasa.2015.11.002  

We report a case of a life threatening thoracic aortic aneurysm rupture, treated successfully with minimally invasive approach. A 34-year-old man was admitted to our hospital in critical clinical condition, presenting with acute chest pain for 18 h, hematemesis and rapidly decreasing hemoglobin, despite massive transfusion done, severe hypotension, anuria and ileus. The patient had history of surgical aortic coarctation repair at age of 13. Contrast-enhanced CT images revealed a thoracic aortic aneurysm rupture with severe left-sided hemothorax. Based on the patient general condition, age and anatomy of the lesion thoracic endovascular aneurysm repair...

Lipertance - jeden krok v léčbě kardiovaskulárního rizika, aneb nikdy to nebylo jednodušší

MUDr. Zuzana Zafarová

Cor Vasa 2016, 58(5):648-652 | DOI: 10.33678/cor.2016.035  

Zápis ze schůze výboru ČKS konané 19. ledna 2016 v kanceláři ČKS v Praze

T. Bracková, M. Táborský, L. Klímová

Cor Vasa 2016, 58(5):643-645  

Miloš Táborský et al.: Novinky v kardiologii 2016

Prof. MUDr. Jan Petrášek, DrSc.

Cor Vasa 2016, 58(5):642  

Opustil nás pan profesor MUDr. Karel Horký, DrSc.

Michael Aschermann

Cor Vasa 2016, 58(5):639-640  

Zemřel prof. MUDr. Pavel Firt, DrSc. (16. 7. 1927-16. 8. 2016)

Jan Pirk

Cor Vasa 2016, 58(5):641  

Editorial Board

Editorial board

Cor Vasa 2016, 58(5):i | DOI: 10.1016/S0010-8650(16)30105-9