(Cor et Vasa dedicated to case reports - for the sixth time)

Michael Aschermann

Cor Vasa 2019, 61(5):451 | DOI: 10.33678/cor.2019.067  

(Patient's level of information on prevention of cardiovascular diseases)

Helena Michálková, Věra Olišarová, Lenka Šedová, Valérie Tóthová

Cor Vasa 2019, 61(5):453-458 | DOI: 10.33678/cor.2019.038  

Introduction and goal: Cardiovascular diseases constitute one of the main causes of morbidity and mortality in the Czech Republic.¹ As compared to Western European countries, the incidence of such diseases is still higher in the Czech Republic. Cardiovascular diseases include a number of forms of heart and vessel diseases.² They are most frequently: ischaemic heart disease, cerebrovascular accident, ischaemic disease of lower extremities and hypertension. Some risk factors can be influenced. The influenceable factors include healthy life style that, for prevention of cardiovascular diseases, most frequently covers stopping smoking,...

P-wave dispersion and atrial electromechanical delay in patients with inflammatory bowel disease

Habibe Kafes, Burak Açar, Lale Asarcikli, Esra Gucuk, Zeki Mesut Yalin Kilic, Omac Tufekcioglu

Cor Vasa 2019, 61(5):459-463 | DOI: 10.33678/cor.2019.035  

Background: Inflammatory bowel disease (IBD) is a group of inflammatory diseases that occur with excessive immune response against various antigens or environmental factors in sensitive individuals. Atrial electro-mechanic delay (EMD) was suggested as an early marker of atrial fibrillation in previous studies. The objectives of this study were to evaluate atrial electromechanical properties measured by tissue doppler imaging and simultaneous electrocardiography (ECG) tracing in patients with inflammatory bowel disease. Materials and methods: Thirty-five patients with inflammatory bowel disease (IBD), and 21 healthy volunteers, matched for age and sex,...

Retrospective analysis of factors influencing the results of surgical treatment of CLI: Effect of duration of ischemic defect

Peter Beňo, Marek Rusňák

Cor Vasa 2019, 61(5):464-470 | DOI: 10.33678/cor.2019.061  

Introduction: Critical limb ischemia (CLI) has been considered to be one of the most serious medical, social and economic problems not only because of the threat of limb loss, but also because of the high long-term cardiovascular mortality. Therefore, CLI is currently very popular in the field of vascular medicine, as the subject of the research as well as a clinical problem. The basic conditions for the successful treatment of CLI are: complexity of the treatment based on the multidisciplinary consensus of all interested vascular specialists, and its timeliness. Material and methodology: There were 109 surgically treated patients with CLI between...

(Summary of the recommendations for long-term secondary prevention after myocardial infarction)

Petr Ošťádal, Miloš Táborský, Aleš Linhart, Michal Vrablík, Richard Češka, Renata Cífková, Eva Králíková, Věra Adámková, Milan Kvapil, Zorjan Jojko

Cor Vasa 2019, 61(5):471-480 | DOI: 10.33678/cor.2019.064  

Successful prolonged cardiopulmonary resuscitation for circulatory arrest followed by implantation of two mechanical cardiac support devices

Katarína Baranová, Marian Levčík, Jiří Kettner

Cor Vasa 2019, 61(5):481-483 | DOI: 10.33678/cor.2019.032  

Acute heart failure caused by decompensation of chronic cardiac insufficiency is a life-threatening condition. Cardiac arrest in inpatient health facilities occurs at a frequency of approximately one in five cases for every 1,000 admitted patients. The likelihood of survival following release from hospital is only 17.6%.¹ In many resuscitated patients, neurological disorders occur a few minutes after cardiopulmonary resuscitation (CPR),² especially if a serious myocardial disease is indicated in the patient's case history. However, early treatment of shock in combination with high-quality CPR³ can significantly improve...

(Surgical remove of a dislocated Amplatzer septal occluder in the right pulmonary artery)

Tomáš Toporcer, Martin Ledecký, Stanislav Juhás, Miroslav Gejguš, Adrián Kolesár, František Sabol

Cor Vasa 2019, 61(5):484-488 | DOI: 10.1016/j.crvasa.2018.09.003  

Atrial septal defects represent 5.9% of all cases of congenital heart malformations. Percutaneous implantation of occluder devices is a widely used strategy in the treatment of this malformation. A 65-year-old woman was admitted for percutaneous closure of an atrial septal defect. During the proce- dure, dislocation of the Amplatzer occluder into the right pulmonary artery occurred. Surgery with removal of the device, closure of the defect and aortopulmonary bypass with the use of a cardiopulmonary bypass was performed with a good outcome. Dislocation of the device during atrial septal defect is a rare, but life-threatening complication. The most common...

(Interventricular septal defect as a complication of a concomitant aortic valve replacement and aortocoronary bypass surgery)

Tomáš Toporcer, Karol Trejbal, Martin Ledecký, Martin Sivčo, Adrián Kolesár, František Sabol

Cor Vasa 2019, 61(5):489-493 | DOI: 10.1016/j.crvasa.2018.09.006  

Ventricular septal defect (VSD) is a rare complication of surgical aortic valve replacement (AVR) and transcatheter aortic valve replacement (TAVI), with an incidence of 1%. An 81-year-old man underwent AVR with double aortocoronary bypass. Several hours after surgery haemodynamic instability accrued, and echocardiography showed a VSD. The patient underwent another surgery with the use of cardiopulmonary bypass. The VSD was closed through aortothomy, and annuloplasty of the tricuspid valve was performed. The postoperative period was complicated by atrioventricular block, with pacemaker implantation required. There are more possibilities for VSD treatment...

A rupture of the aneurysm of the sinus of Valsalva in a patient with history of aortic coarctation surgery - a case report

Tomáš Kolomazník, Vladimír Kaučák, Kamil Novobílský, Radim Kryza

Cor Vasa 2019, 61(5):494-496 | DOI: 10.33678/cor.2019.046  

We present a rare case of a 31-year-old woman with dyspnoea, caused by a rupture of the Valsalva sinus. As a 4-year-old, she underwent a surgery of aortic coarctation, as a 25-year-old, she suffered from subarachnoid haemorrhage from a ruptured cerebral aneurysm.

Risk of annuloplasty and patch use in infective endocarditis mitral valve repair

Tomáš Toporcer, Peter Šafár, Adrián Kolesár, František Sabol

Cor Vasa 2019, 61(5):497-501 | DOI: 10.33678/cor.2019.043  

The incidence of infective endocarditis is 3-10 per 100,000 people per year. Risk factors for this disease include heart-valve disease, the implantation of a prosthetic valve or intra-cardiac devices, drug use and patient immunodeficiency. A 38-year-old drug-using man with a history of mitral valve surgery with patch reconstruction and annuloplasty ring implantation due to infective endocarditis was admitted to the hospital because of recurrence of mitral valve endocarditis. Surgery confirmed the unaffected patch in the posterior leaflet and the ring affected by an abscess cavity. Explantation of the annuloplasty ring and implantation of a mechanical...

(A young patient with large myxoma in the right atrium)

Petra Indruchová, Róbert Petr, Miroslava Benešová, Iva Zemanová, Hana Línková

Cor Vasa 2019, 61(5):503-507 | DOI: 10.1016/j.crvasa.2018.09.005  

Myxomas are the most common cardiac tumors mostly localized in left atrium, but the diagnosis is often delayed. This article presents a case of a young patient who had been treated four years for asthma bronchiale before the final diagnosis of myxoma was established and the patient was adequately treated.

Brugada syndrome diagnosed after ventricular fibrillation with anamnesis of fever

František Nehaj, Michal Mokáň, Juraj Sokol, Marianna Kubašková, Marián Mokáň, Peter Galajda, Peter Mikolajčík

Cor Vasa 2019, 61(5):508-510 | DOI: 10.33678/cor.2019.025  

Brugada syndrome is a genetic disorder characterized by ventricular tachyarrhythmias that may lead to cardiac arrest, syncope or sudden cardiac death. This syndrome is associated with several electrocardiographic patterns such as ST elevations in the anterior precordial leads and incomplete right bundle branch block. Many people with Brugada syndrome do not have any symptoms if yes, they can occur at any time and are sometimes triggered by high temperature, alcohol or dehydration. The implantation of an automatic implantable cardiac defibrillator is the only treatment proven effective in treating and preventing sudden cardiac death in patients with...

New onset left bundle branch block: keep calm!

Pasquale Crea, Antonio Bracco, Teresa Crea

Cor Vasa 2019, 61(5):511-513 | DOI: 10.33678/cor.2019.041  

New onset LBBB represents a STEMI equivalent and, according to the current guidelines, this qualifies for primary angioplasty. However, several conditions could provoke new onset LBBB such as hyperkalemia, hypercalcemia etc. Differential diagnosis is fundamental, especially in emergency condition, in order to avoid unnecessary or harmful treatment. Clinical evaluation and careful analysis of ECG often permitted the correct diagnosis.

Circumferential membrane-like aortic dissection with intimo-intimal intussusception

Ayca Boyaci, Ozcan Ozeke, Ahmet Saritas

Cor Vasa 2019, 61(5):514 | DOI: 10.33678/cor.2019.033  

Open repair of a symptomatic popliteal artery aneurysm in a 71-year-old patient: Case report

Robert Novotný, Štěpán Malý, Květoslav Lipar, Jaroslav Chlupáč, Libor Janoušek, Jiří Froněk

Cor Vasa 2019, 61(5):515-518 | DOI: 10.1016/j.crvasa.2018.03.001  

Introduction: The most frequent site for true peripheral artery aneurysm formation is the popliteal artery (PA). The clinical presentation of popliteal artery aneurysm (PAA) ranges from the finding of an asymptomatic pulsatile popliteal mass on routine physical examination to acute limb-threatening ischaemia. Case presentation: We are presenting a case of a 71-year-old male patient with 100 m claudication interval on the left lower extremity, with a palpable pulsating circular resistance in the left popliteal fossa. Based on CT angiography results, the patient was diagnosed with a proximal popliteal artery aneurysm. A posterior approach was used for...

(Infected thoracic stentgraft and prosthetic graft with replacement by human aortic allograft)

Vladimír Sihotský, Peter Berek, Abraham John Mathews, Ivan Kopolovets, Mária Kubíková, František Sabol, Adrián Kolesár, Ľuboslav Beňa, Ján Rosocha, Mária Frankovičová

Cor Vasa 2019, 61(5):519-523 | DOI: 10.1016/j.crvasa.2018.06.002  

Background: We describe a case of successful replacement of an infected thoracic stentgraft and a prosthetic aortic graft with human aortic allograft. Case presentation: The patient was a forty-seven years old male who had an operation for aortic coarctation previously. The procedure was bypass grafting of the descending thoracic aorta from the point of coarctation to infrarenal abdominal aorta. He developed a false aneurysm in the proximal anastomosis of the bypass after thirty years. The false aneurysm was first treated by implanting of thoracic stentgraft. In eight months after implantation signs of an infection of the stentgraft developed. We performed...

Successful management of a child with Kawasaki disease complicated by acute myocardial infarction

Houssem Thabet, Nejeh Ben Halima, Ahmed Sghaier

Cor Vasa 2019, 61(5):524-528 | DOI: 10.33678/cor.2019.031  

Kawasaki disease presents as multisystemic acute vasculitis. This panvascularity essentially affects the arteries of medium caliber, with an elective tropism for the coronary arteries, whose attack makes all the gravity of the disease. Although early treatment with intravenous immunoglobulin reduces the risk of cardiovascular complications in Kawasaki disease, in refractory cases myocardial infarction can result from thrombosis of coronary artery aneurysms. This report describes successful management of myocardial infarction from coronary thrombosis in a 4-year-old infant with Kawasaki disease using intravenous Tenecteplase followed by percutaneous...

(Extracorporeal membrane oxygenation in a patient with yew and escitalopram intoxication)

Jan Štros, Rostislav Polášek, Jiří Seiner, Jiří Karásek

Cor Vasa 2019, 61(5):529-533 | DOI: 10.1016/j.crvasa.2018.08.003  

Yew intoxication is an uncommon, life-threatening emergency. Patients frequently die due to refractory cardiac shock or pulseless ventricular tachycardia and ventricular fibrillation, both of which do not respond to classical treatment with antiarrhythmics and defibrillation. The cardiac toxicity is driven mainly by taxine B, both sodium and calcium channel blocker. Hemodialysis is ineffective, because of the large molecular size of taxine B. Specific antidote is currently not available, but digoxin-specific FAB antibodies can be used instead, with partial effect. Severe cases of intoxication can profit from initiation of veno-arterial extracorporeal...

Pitfalls of anticoagulation therapy in pregnant women with mechanical valve prostheses. The case of two thrombotic events during one pregnancy

Filip Koubek, Jiří Vejvoda, David Alan, Josef Veselka

Cor Vasa 2019, 61(5):534-536 | DOI: 10.1016/j.crvasa.2018.10.002  

In anticoagulated patients with mechanical valve prostheses, heparin is still the only possible alternative to warfarin that we choose in some specific situations. One such situation is pregnancy due to the known teratogenic effect of warfarin in a dose-dependent manner. During outpatient treatment with low molecular weight heparin, its efficacy should be monitored regularly and a different target range of the monitored parameter should be kept in mind than with other diagnoses requiring anticoagulation therapy. Despite careful control, there is a considerable risk of treatment failure, particularly due to the unreliable use of the drug in ambulatory...

(ST segment elevations caused by invasion of carcinoma of the thymus to the myocardium)

Věra Müllerová, Jozef Jakabčin, Vladěna Skálová, Pavel Červinka

Cor Vasa 2019, 61(5):537-542 | DOI: 10.1016/j.crvasa.2018.07.005  

Pathological ST segment elevations in 12-lead ECG are in most cases caused by ischemic heart disease dur- ing acute transmural infarction. ST segment elevations in ECG can even have non-ischemic etiology during another cardiac disease and there are also rare causes of ST elevations of a non-cardiac origin. In this case report, the authors present the case of a 68-year-old male patient with carcinoma of the thymus, which was growing through to the cardiac structures and was the cause of pathological ST elevations in ECG.

(Hypocalcemia-induced dilated cardiomyopathy)

Dita Schaffelhoferová, Martin Vácha, Tomáš Sattran, František Toušek

Cor Vasa 2019, 61(5):543-546 | DOI: 10.33678/cor.2019.042  

Hypocalcemia is a rare, yet potentially reversible cause of dilated cardiomyopathy, with the most frequent underlying cause being hypoparathyroidism. This case report presents the case of a 74-year-old patient with dilated cardiomyopathy developing due to long-term hypocalcemia. Following calcium supplementation, the patient's condition improved as did ventricular contractile function, and signs of heart failure resolved.

Catheter-induced coronary artery dissection: the role of exhalation during contrast medium injection

Andreas Y. Andreou

Cor Vasa 2019, 61(5):547-550 | DOI: 10.1016/j.crvasa.2018.06.001  

Catheter-induced dissection of the coronary arteries is an uncommon but potentially dreadful complica- tion of diagnostic and interventional coronary procedures. Several risk factors have been implicated in the development of this complication; one of them is deep vigorous inhalation inducing a change in catheter position thereby contributing to catheter-induced coronary artery dissection. The present article describes a case of catheter-induced right coronary artery dissection where a change in catheter position induced by active patient exhalation contributed to the development of dissection. To the best of my knowledge this is the first case implicating...

Pan profesor Jan Petrášek slaví devadesáté narozeniny

Michael Aschermann, Jaromír Hradec

Cor Vasa 2019, 61(5):552  

Jaroslav Hořejší: Náš současník Purkyně – největší Čech? Životaběh s dvaceti zastaveními

Petr Bartůněk

Cor Vasa 2019, 61(5):553  

Echokardiografické vyšetřovací mise mladých kardiologů v rozvojových zemích Afriky a Asie

Lucie Pudilová, Michal Pazderník

Cor Vasa 2019, 61(5):554-556