Cor et Vasa issue dedicated to case reports for the fifth time

Michael Aschermann

Cor Vasa 2018, 60(5):e447 | DOI: 10.1016/j.crvasa.2018.09.004  

Iatrogenic life-threatening condition in a patient with multiple rare disorders

Martyna Zaleska, Olga Możeńska, Mariola Laszuk, Piotr Suwalski, Dariusz Artur Kosior

Cor Vasa 2018, 60(5):e448-e451 | DOI: 10.1016/j.crvasa.2017.06.010  

Andersen-Tawil syndrome (long QT syndrome 7) is a rare inherited disorder, characterized by periodic paralysis, long QT, ventricular arrhythmias and skeletal abnormalities.A 52-year-old female with a history of long QT syndrome, ICD implantation (secondary prevention of cardiac arrest) and systemic vasculitis was admitted due to an electrical storm caused by endocarditis. She was admitted again short after discharge due to multi-organ failure, which was caused probably by withdrawal of steroids and VKA. Characteristic dysmorphic features resulted in Andersen-Tawil syndrome suspicion.If patients have one rare disorder they should not be excluded...

Mexiletine as one effective alternative for antiarrhythmic drugs and ablation resistant electrical storm - A case report

Martyna Zaleska, Maria Różańska, Olga Możeńska, Dariusz Artur Kosior

Cor Vasa 2018, 60(5):e452-e455 | DOI: 10.1016/j.crvasa.2017.06.011  

We present case of 78-year-old male transferred to our Department due to multiple episodes of malignant ventricular arrhythmias refractory to previous antiarrhythmic treatments (device settings optimization, amiodarone treatment, lidocaine infusion and optimal pharmacotherapy). Additionally, patient had ischemic end-stage heart failure and implanted CRT-D. We excluded secondary causes of electrical storm and due to inefficacy of medical therapy, we applied radiofrequency ablation. During 1st day after procedure life-threatening VT/VF recurred. As our last choice, we modified therapy and introduced mexiletine, what resulted in complete disappearance...

Ventricular fibrillation as a primary manifestation of Wolff-Parkinson-White syndrome

Tereza Eichlerová, Jiří Knot, Pavel Osmančík

Cor Vasa 2018, 60(5):e456-e461 | DOI: 10.1016/j.crvasa.2017.10.011  

Wolff-Parkinson-White syndrome (WPW) is defined as a condition involving an accessory pathway associated with symptoms. A typical ECG pattern of a pre-excitation shows a short PQ interval, presence of delta wave and a broad QRS complex on surface ECG. The underlying mechanism involves an accessory pathway, which enables conduction of a depolarization wave from atria to ventricles bypassing the AV node and predisposes to arrhythmias and sudden cardiac death. The most common arrhythmia in patients with WPW syndrome is atrioventricular reentrant tachycardia. However, it is not present in all patients with pre-excitation [1-4]. Up to 1/3 of patients with...

Cardiac arrest in patient with significant pulmonary regurgitation after surgical valvulotomy at 10 years of age for isolated pulmonary stenosis

Petr Klofáč, Tomáš Roubíček, Rostislav Polášek

Cor Vasa 2018, 60(5):e462-e468 | DOI: 10.1016/j.crvasa.2017.11.002  

The number of adult patients with a congenital heart defect has increased. They are 2-3 times more numerous than children suffering from congenital heart defects, therefore, it is important to be aware of the most frequent congenital heart defects in adulthood - atrial septal defect, ventricular septal defect, aortic coarctation, tetralogy of Fallot and pulmonary stenosis. These patients either underwent one or more operations in childhood, or were not operated at all (defect was not significant or inoperable), or the heart defect was not diagnosed (mostly atrial septal defect). Some of the patients for various periods of time stop attending regular...

Cardiac implantable electronic devices and chemotherapy: A risky combination

Michele Scarano, Germana Gizzi, Domenico Mastrodicasa, Cesare Mantini

Cor Vasa 2018, 60(5):e469-e471 | DOI: 10.1016/j.crvasa.2017.11.009  

The incidence of infective endocarditis in subjects with cardiac implantable electronic devices (CIEDs) is not an uncommon complication. Diabetes mellitus, chronic kidney disease, oral corticosteroids, malignancies and congestive heart failure represent common risk factors for cardiac device-related endocarditis (CDE); however, chemotherapy (CHT) may also play an important role in this serious complication. We present a case of CHT-induced CDE in a 64-year-old male with multiple cardiac risk factors.

An anomalous case of S-ICD malfunctioning: A big trouble or a soap bubble?

Pasquale Crea, Angela Nicotera, Bruna Crea, Antonio Taormina, Giuseppe Picciolo

Cor Vasa 2018, 60(5):e472-e474 | DOI: 10.1016/j.crvasa.2017.05.016  

12 h after the implant of a S-ICD the patient accused an inappropriate shock due to noise oversensing. ICD interrogation showed undersensing of ventricular signals on primary vector and significative noise on alternative vector. Surprisingly, 2 days full recovery of sensing of primary vector was observed. Trapped air was likely to be the cause of malfunctioning.

Anomalous left circumflex artery occlusion: A technical challenge in primary percutaneous coronary intervention?

Giuseppe Andò, Vittorio Virga, Olimpia Trio, Alessandro Di Giorgio, Francesco Saporito

Cor Vasa 2018, 60(5):e475-e478 | DOI: 10.1016/j.crvasa.2017.03.004  

Anomalies of the coronary arteries can be found in approximately 1% of patients undergoing coronary angiography. Most coronary anomalies do not result in signs, symptoms, or complications, and usually are discovered as incidental findings at the time of catheterization. Coronary anomalies may pose several challenges to the interventional cardiologist in the emergency setting, as anomalous vessels may be difficult to find or to selectively cannulate. The knowledge of anatomy and the appropriate selection of suitable technical devices allow achieving successful results in percutaneous intervention of anomalous coronary arteries also in emergency situations.

An unusual case of a subacute right ventricular perforation from a pacemaker lead with subsequent left hemothorax

Ryan K. Dean, Rogin Subedi, Dalvir Gill, Amitpal Nat

Cor Vasa 2018, 60(5):e479-e481 | DOI: 10.1016/j.crvasa.2017.05.007  

Dual-lumen catheter in coronary chronic occlusions

Alejandro Gutiérrez-Barrios, Soledad Ojeda, Manuel Pan, Miguel Alba, Antonio Agarrado, Jesús Oneto

Cor Vasa 2018, 60(5):e482-e486 | DOI: 10.1016/j.crvasa.2017.08.007  

Coronary chronic total occlusion (CTO) is currently considered the most complex lesion for percutaneous coronary intervention (PCI). Despite several crossing techniques are available, failure to cross a CTO with a guidewire is still the most common cause for failure of CTO PCI. We report three CTO cases successfully treated using a dual-lumen catheter after other crossing strategies failed to cross the occlusion. This tool is easy and reliable to use and could be useful in similar situations in CTO cases.

Giant-cell myocarditis - A case report and a brief review

Jan Látal, Miloslav Špaček, Jan Přeček, Zbyněk Tüdös, Martin Hutyra, Tomáš Tichý, Miloš Táborský

Cor Vasa 2018, 60(5):e487-e492 | DOI: 10.1016/j.crvasa.2017.10.010  

Giant-cell myocarditis is an extremely rare disease with high morbidity and mortality. In the majority of cases, the course of the disease is in the form of fulminant myocarditis. The cornerstone of the treatment is aggressive immunosuppresive therapy in addition to heart failure treatment, however, the need for mechanical circulatory support or heart transplant is high. In our case report, we present a patient suffering from giant-cell myocarditis, who, despite rapid diagnosis and prompt aggressive treatment, died shortly after heart transplant.

Recurrent infective endocarditis as a manifestation of Loeffler's endocarditis: The diagnostic importance of cardiac magnetic resonance imaging

Christine A. Timmer, Marcel van Deuren, André J.A.M. van der Ven, Gheorghe A.M. Pop

Cor Vasa 2018, 60(5):e493-e496 | DOI: 10.1016/j.crvasa.2017.06.014  

Hypereosinophilic syndrome (HES) affects many organ systems. Cardiac involvement is common and a major cause of morbidity and mortality in patients with HES.We present a 60-year-old patient with a history of recurrent infective endocarditis due to different Streptococcus species. Transthoracic echocardiography (TTE) revealed a circumscript echodense structure near the apex of the left ventricle, suggestive of a vegetation. Positron emission tomography revealed increased activity at the same site of the left ventricle and showed no other abnormalities. The patient was treated with intravenous antimicrobial therapy for each episode of infective endocarditis...

Cardiac implantable devices and takotsubo syndrome. A rare but potential eventuality

Matteo Casale, Salvina Quattrocchi, Roberto Bitto, Giuseppe Dattilo

Cor Vasa 2018, 60(5):e500-e502 | DOI: 10.1016/j.crvasa.2017.04.001  

Takotsubo cardiomyopathy is a syndrome which mimics acute myocardial infarction (AMI) occurring often after an emotional or physical stress. We report the case of a female patient who suffered from takotsubo cardiomyopathy associated to a coronary fistula after pacemaker implantation. Its occurrence should be always remembered by the implanters, avoiding it by an appropriate psychological screening and use of conscious sedation.

Rupture of free wall of left ventricle in a patient with takotsubo cardiomyopathy

Jan Hůlka, Jiří Soukup

Cor Vasa 2018, 60(5):e503-e507 | DOI: 10.1016/j.crvasa.2017.08.003  

Takotsubo cardiomyopathy (TTC) belongs to rare heart disease with symptoms imitating acute coronary syndrome with ST segment elevation. Usually, it occurs predominantly in women at the age of postmenopause. In most cases, the disease has an uncomplicated course, but some patients may develop severe complications (e.g. cardiogenic shock, severe heart failure, malignant arrhythmia, thromboembolism or myocardial wall rupture). Case report describes an 82-year-old man with TTC complicated by rupture of the left ventricular free wall and interventricular septum. This rare complication often leads to sudden death. Due to the unknown etiopathogenesis the...

Arrhythmogenic cardiomyopathy of left ventricle. A rare event, but possible

Michele Scarano, Germana Gizzi, Cesare Mantini

Cor Vasa 2018, 60(5):e508-e511 | DOI: 10.1016/j.crvasa.2017.09.005  

Arrhythmogenic right ventricular dysplasia (ARVD) is a form of inherited cardiomyopathy characterized by fibro-fatty substitution mainly right ventricular (RV). Affected patients may succumb to life-threatening ventricular arrhythmias and heart failure. It is even more common among athletes who experience sudden cardiac death (SCD). The disease involvement is not limited only to the RV, but the left ventricle (LV) can also be involved. We have reported a case of a 38-year-old man, with two episodes of syncope in his history. After echocardiographic investigations, the patient was referred to cardiac magnetic resonance (CMR). Morphological images showed...

An unrecognized combined congenital heart defect - Bicuspid aortic valve and ventricular septal defect as a cause of acute heart failure in adulthood

Kristýna Bayerová, Gabriela Dostálová, Zuzana Hlubocká, Tomáš Paleček, Jaroslav Hlubocký, Petr Kuchynka, Debora Karetová, Aleš Linhart

Cor Vasa 2018, 60(5):e512-e517 | DOI: 10.1016/j.crvasa.2017.10.002  

Bicuspid aortic valve is the most frequent congenital heart malformation in adulthood with incidence between 0.5 and 2%. Moreover, bicuspid aortic valve could be connected with other congenital heart defects and malformations of the aortic arch and ventricular septal defects, which is the second most frequent congenital heart malformation. Its incidence in childhood is about 25-40%, and in adulthood, the incidence is lower, about 20% of all congenital heart defects. Bicuspid aortic valve is the most frequent cause of aortic stenosis and aortic insufficiency at an early age. The heart malformations are mostly diagnosed at an early age and corrected...

Combined orthotopic heart transplantation followed by autologous stem cell transplantation in a patient with light chain amyloidosis and isolated cardiac involvement

Vito Maurizio Parato, Daniela Clemente, Francesca Muscente, Michele Scarano, Ugolino Livi, Negri Francesco, Rossana Bussani, Nicoletta Finato, Francesca Patriarca, Raffaella Stocchi, Mauro Driussi, Gianfranco Sinagra

Cor Vasa 2018, 60(5):e518-e521 | DOI: 10.1016/j.crvasa.2017.10.004  

We present a case of amyloidosis AL with isolated myocardial involvement. Because of a refractory heart failure picture, patient underwent orthotopic heart transplant (OHT). The replaced heart showed an important midwall infiltration. Ten months after he underwent autologous stem cell transplantation (ASCT) with a favorable outcome. The case demonstrates that OHT followed by ASCT in highly selected patients with light chain amyloidosis is a life-saving procedure.

"Acute coronary syndrome" and heart failure caused by a large hiatal hernia

Jiří Holý, Pavel Červinka, Nedal Omran, Ján Koscelanský

Cor Vasa 2018, 60(5):e522-e526 | DOI: 10.1016/j.crvasa.2017.10.003  

Upside down stomach (UDS) as a severe form of hiatal hernia has various clinical scenarios. Patients could be asymptomatic or present with haemodynamic collapse due to mechanical compression of the mediastinum.We herein present a case of 71-year-old woman referred to our clinic due to acute coronary syndrome with acute onset of heart failure, which was treated accordingly. Throughout the diagnostic and therapeutic process, a diagnosis of an incarcerated UDS was established as a trigger of her symptoms. An acute surgery was performed. Despite complications in the post-op period the patient recovered successfully and was referred to a rehabilitation...

The importance of a higher dose of a mineralocorticoid receptor antagonist in reducing risk of reccurent hospitalization in a patient with advanced chronic heart failure - A case report

Ghada Mairgani, Václav Mála, Filip Málek

Cor Vasa 2018, 60(5):e527-e530 | DOI: 10.1016/j.crvasa.2017.08.004  

The authors present the significance of a higher dose of a mineralocorticoid receptor antagonist in reducing the frequency of hospitalizations for decompensated heart failure in the 67-year-old patient suffering from advanced chronic heart failure.

Case report of an unusual presentation of aortic dissection

Júlio Gil, Bruno Marmelo, Luís Abreu, Hugo Antunes, Luísa Gonçalves, Davide Moreira, Luís Ferreira dos Santos, José Costa Cabral

Cor Vasa 2018, 60(5):e531-e532 | DOI: 10.1016/j.crvasa.2017.03.011  

Media sclerosis Mönckeberg affects microcirculation

Peter Lanzer, Christos C. Zouboulis

Cor Vasa 2018, 60(5):e533-e535 | DOI: 10.1016/j.crvasa.2017.05.006  

Media sclerosis Mönckeberg is known to be associated with progressive deposits of crystalline and amorphous hydroxyapatite within the media of large arteries. Here we provide evidence for calcifications within microcirculation in a 66-year-old patient with known and documented media sclerosis Mönckeberg of large peripheral arteries.

Subclavian artery stenosis: An unusual cause of periprocedural myocardial infarction following the surgical myocardial revascularization

Tomáš Lopuchovský, Matej Moščovič, Róbert Novotný, Adrián Kolesár, Štefan Lukačín, František Sabol

Cor Vasa 2018, 60(5):e536-e539 | DOI: 10.1016/j.crvasa.2017.06.009  

The introduced case report explains the atypical periprocedural myocardial infarction following the surgical myocardial revascularization. 60-year-old man has undergone the coronary bypass surgery with arterial graft of left mammary artery (LIMA) to left anterior descending artery (LAD) and venous graft to posterior interventricular branch of right coronary artery. Early in the post-surgery period a perioperative myocardial infarction (PMI) developed, with laboratory correlation of cardio-specific enzymes elevation and ECG changes in terms of ischemia in the diaphragmatic region. Echocardiography showed akinesia of the apex, apical septal and apical...

Transcatheter aortic valve replacement - Therapeutical option in a patient with complex heart disease

Petr Zdráhal, Josef Bis, Pavel Polanský, Jaroslav Dušek, Josef Šťásek

Cor Vasa 2018, 60(5):e540-e546 | DOI: 10.1016/j.crvasa.2017.06.015  

Authors are presenting a case report describing diagnostic and therapeutic approach in a patient with severe dyspnea. Dominant cause of the symptoms was combined aortic disorder and monstrous obesity. The other findings were combined mitral valve disorder and provoked midventricular obstruction of left ventricle. Complex cardiac surgery was not recommended due to aortic valve anulus size, massive calcification of both mitral and aortic valves and extreme obesity resulting in high risk of perioperative mortality. As alternative approach, transcatheter aortic valve replacement procedure (TAVR) was performed. In a very difficult terrain we finally reached...

Surgical resection of occluded abdominal stent graft followed by aorto-bi-iliac vascular reconstruction with Intergard Synergy vascular prosthesis

Róbert Novotný, Petr Mitáš, Jaroslav Hlubocký, Zuzana Hlubocká, Jaroslav Lindner

Cor Vasa 2018, 60(5):e547-e550 | DOI: 10.1016/j.crvasa.2017.11.003  

Introduction: We are presenting a case report of an 82-year-old polymorbid patient treated with Aortofix AAA Flexible Stent Graft System for symptomatic 51 mm subrenal aortic aneurysm complicated with an early closure of the right stent graft branch resulting in a severe right lower extremity ischemia.Method: Stent graft dissection and resection were performed trough midline laparotomy. Due to the severe calcifications of the supra- and sub-renal aorta, a Nucleus 25 mm balloon was inserted into the abdominal aorta instead of using an aortal cross-clamp. After the resection, aorto-bi-iliac revascularisation was performed with the use of Intergard...

Infectious aneurysm of the ascending aorta - Successful conservative treatment in a high-risk patient

Václav Pavliňák, Petr Vařejka, Jean-Claude Lubanda

Cor Vasa 2018, 60(5):e551-e555 | DOI: 10.1016/j.crvasa.2017.12.001  

Infectious aortic aneurysm is a rare disease requiring early and comprehensive management to prevent the development of serious complications. While surgical repair is still the gold standard, an endovascular approach is an alternative for some patients. Conservative management is traditionally associated with the worst prognosis. We report a case of an infectious aneurysm of the ascending aorta with an atypical clinical manifestation and a complicated diagnostic process, which resulted in successful comprehensive conservative management of a high-risk patient who rejected radical surgical treatment.

Acute tamponade due to postinfarction myocardial rupture successfully managed with urgent pericardiotomy

Shi-Min Yuan, Jin-Zao Chen, Yao-Hua Yu, Liang-Qing Lin, Xiang-Kui Fang, Jing Lin

Cor Vasa 2018, 60(5):e556-e559 | DOI: 10.1016/j.crvasa.2017.06.006  

Postinfarction myocardial rupture is rare and fatal. A 60-year-old female developed hemodynamic collapse after 2-h acute precordial pains. Acute tamponade and cardiogenic shock were confirmed. The patient underwent urgent pericardiotomy under the aid of intraaortic balloon pump and inotropic infusions. The differential diagnosis of acute chest pain is important. An early diagnosis and prompt surgical intervention of acute tamponade are crucial for rescuing the patient.

Cardiobacterium hominis and endocarditis. Rare but important clinical relevance

Annamaria Ioppolo, Claudia Morabito, Gessica D'Amico, Antonio Taormina, Emmanuele Sorace, Giuseppe Dattilo

Cor Vasa 2018, 60(5):e497-e499 | DOI: 10.1016/j.crvasa.2017.05.002  

Infective endocarditis is a severe disease with high morbidity rate. Cardiobacterium hominis (CH) is a member of the HACEK group of microorganisms. We show the case of a man of 56 years with infective endocarditis on a native mitral valve, sustained by Cardiobacterium hominis. The relevance of this case is based on the fact that infections sustained by CH, even if not so frequent (about 1-3% of all cases), are a possible cause of infective endocarditis with important clinical consequences.

A new lesion in an old stent: A new insight into very late stent thrombosis

Kamran Majeed, Richard Alcock

Cor Vasa 2018, 60(5):e560-e561 | DOI: 10.1016/j.crvasa.2017.06.001  

Společné stanovisko odborných společností k předepisování inhibitorů PCSK9

Richard Češka, Miloš Táborský, Michal Vrablík

Cor Vasa 2018, 60(5):649-653  

Echodny 2018. 21.-22. 9. 2018, Hotel NH Collection Olomouc Congress

Cor Vasa 2018, 60(5):657-660  

Jan Malík a kol. Echokardiografie u pacientů s chronickým onemocněním ledvin a úvod do kardionefrologie

Prof. MUDr. Jan Petrášek, DrSc.

Cor Vasa 2018, 60(5):654  

Editorial Board

Editorial board

Cor Vasa 2018, 60(5):i | DOI: 10.1016/S0010-8650(18)30101-2

České učebnice kardiologie

Prof. MUDr. Jan F. Vojáček DrSc., FESC, FACC

Cor Vasa 2018, 60(5):655-656