Diagnosis of persistent left superior vena cava: the role of echocardiographyCase reports

Joana Maria Laranjeira Correia, Vanda Neto, João Fiuza, Gonçalo RM Ferreira, Miguel Correia

Cor Vasa 2023, 65(5):777-778 | DOI: 10.33678/cor.2023.035  

Persistent left superior vena cava (PLSVC) is a rare but the most common thoracic venous anomaly. It results when the left superior cardinal vein caudal to the innominate vein fails to regress and can be associated with other cardiovascular abnormalities. While PLSVC is often asymptomatic, it can cause serious complications during vascular interventional procedures or surgical treatment of cardiac anomalies. Incidental identifica- tion of a dilated coronary sinus on echocardiography should raise the suspicion of PLSVC. The diagnosis should be confirmed by agitated saline contrast echocardiography.

Parapneumonic ST segment elevationCase reports

Joana Maria Laranjeira Correia, Gonçalo RM Ferreira, Vanda Neto, João Fiuza, António Costa, Maria Luísa Gonçalves

Cor Vasa 2023, 65(5):773-776 | DOI: 10.33678/cor.2023.014  

The presence of ST-segment elevation on the 12-lead electrocardiogram in a patient with suggestive symp- toms of myocardial infarction should trigger an early diagnosis of ST-segment elevation myocardial infarction and urgent intervention to restore coronary perfusion, usually by percutaneous coronary intervention. However, several diseases and conditions can mimic an acute myocardial infarction or the ST-segment elevation pattern on the electrocardiogram. We report a clinical case of a patient hospitalized with the first diagnosis of pneumonia, who developed a de novo anteroseptal ST-segment elevation on electrocardiogram and clinical pain suggestive...

(New-onset conduction disorders after TAVI and the ability of their reparation in practice)Case reports

Dagmar Ulrichová

Cor Vasa 2023, 65(5):770-772 | DOI: 10.33678/cor.2023.070  

Transcatheter aortic valve replacement (TAVI) has become a suitable alternative to surgical aortic valve replacement (SAVR) for patients not accepted by surgeons, but also a preferred method for lower-risk pa- tients, especially in older age groups. However, compared to SAVR, it is burdened with a higher risk of iatrogenic heart rhythm disturbances. These disturbances occur mostly periprocedurally or in the early postoperative period and some of them are fully reversible. Our case report describes the case of a patient after TAVI in whom a new-onset cardiac rhythm disturbance including ongoing syncope was documented. The aim of this case report is...

(Transcatheter aortic valve implantation in a patient with extreme risk of development of infective endocarditis)Case reports

Eliška Kupcová, Martin Hajšl, Martin Malý

Cor Vasa 2023, 65(5):766-769 | DOI: 10.33678/cor.2023.069  

Aortic stenosis is the most common acquired valvular heart disease by adults and due to aging of population prevalence will increase. Since 2002 transcatheter aortic valve implantation (TAVI) has become a well-rec- ognized alternative for surgical aortic valve replacement (SAVR). Initially for inoperable patients or the high surgical risk patients, later even for the patients with medium and low risk. It all relates with technological progress of the method and increasing experience of cardiac centers. As invasive procedure, it has its own complications, including prosthetic infective endocarditis (TAVI-IE) with the incidence 0.3-3.4% and mortality...

(Overt coronary artery fistula in a patient with systemic scleroderma)Case reports

Petr Binar

Cor Vasa 2023, 65(5):763-765 | DOI: 10.33678/cor.2023.048  

Chronic coronary syndrome can be a result of atherosclerotic stenosis or vasospasms, but it can also be rarely caused by anatomical vascular anomalies, such as the coronary artery fistulas (CAF). The case report of a patient with CAF leading to myocardial ischemia through the steal phenomenon will be presented here. A relation of CAF to systemic scleroderma will be discussed, as this disease was also verified and treated in this particular man.

(Patient with a rare tuberculous form of constrictive pericarditis)Case reports

Jozef Dodulík, Radovan Jursa, Jiří Plášek, Lenka Dodulíková, Pavel Kukla, Vladimír Židlík, Jan Václavík

Cor Vasa 2023, 65(5):757-762 | DOI: 10.33678/cor.2023.056  

Pericarditis is a relatively rare heart disease. In our conditions, the most common etiological agent is viruses. Rarer agents include Mycobacterium tuberculosis, more typical in developing countries. Complications are not frequent, but the most common complications of pericarditis include the formation of an effusion, the development of cardiac tamponade, constrictive pericarditis or the development of myopericarditis. We present the case of a 52-year-old patient indicated for total pericardectomy for tuberculous constrictive pericarditis.

Cardiovascular diseases and frontal QRS-T angleOriginal research articles

Lutfu Askin, Okan Tanriverdi, Fatih Poyraz

Cor Vasa 2023, 65(5):749-756 | DOI: 10.33678/cor.2023.030  

The frontal QRS-T angle is an electrocardiographic measurement that reflects the spatial relationship between the depolarization and repolarization vectors in the heart. It is determined by the angles between the QRS and T wave vectors in the frontal plane. A wider QRS-T angle is associated with increased ventricular ectopic activity, impaired left ventricular function, and increased risk of cardiovascular diseases (CVDs). Several studies have suggested that a wider frontal QRS-T angle is associated with an increased risk of developing CVDs, including myocardial infarction, heart failure, and sudden cardiac death. Overall, the evidence suggests that...

Heart surgery before the cardiopulmonary bypass eraOriginal research articles

Nazmul Hosain, Md Anisuzzaman

Cor Vasa 2023, 65(5):741-748 | DOI: 10.33678/cor.2023.013  

Until the late 19th century, the heart was thought as an organ that shouldn't be touched. Famous surgeon Stephen Paget in 1895 wrote: "Surgery of the heart has probably reached the limit set by the nature, no new methods, and no new discovery can overcome the natural difficulties that attend a wound of the heart." But surgeons like Axel Cappelen in Norway in 1895, and Ludwig Rehn in Germany in 1896 dared to enter into this taboo territory and repaired stab injuries of the heart. With these, the era of cardiac surgery began. Later, the two world wars opened the opportunities of exploring heart wounds for the war veterans like George Gray Turner, Henry...

Prevalence and predictors of pacemaker dependency: Data from a cardiac centre registry in IraqOriginal research articles

Haitham Ali Abdullah, Ali Al-Mossawi, Kasim Abbas Ismail Al-Iqabby

Cor Vasa 2023, 65(5):735-739 | DOI: 10.33678/cor.2023.022  

Background: Pacemaker dependency can be defined generally as inadequate or absent patient intrinsic rhythm, it has a dangerous consequence during conditions that may affect pacemaker function. Objectives: To identify the prevalence of pacemaker dependency among patients with permanent pacemaker and to analyze the particular factors that may affect its occurrence. Grouping the patients to pacemaker dependent or not has a great effect on patient management. Patients and method: A cross-sectional study enrolled 400 patients with permanent pacemaker for different bradyarrhythmia abnormalities. Patients visited Ibn Al-Bitar Specialized Center for cardiac...

Comparison of cyanoacrylate agents VariClose^® and VenaSeal^™ in the treatment of insufficient saphenous veinsOriginal research articles

Peter Baláž, Slavomír Rokošný, Adam Whitley

Cor Vasa 2023, 65(5):729-734 | DOI: 10.33678/cor.2023.054  

Objective: The goal of this study was to compare the cyanoacrylate venous sealing systems VenaSeal^™ and VariClose^® in the treatment of superficial venous insufficiency. Methods: A single-centre retrospective analysis on patients treated between April 2018 and April 2022 with cyanoacrylate adhesives for lower limb superficial truncal vein insufficiency was performed. Results: The VariClose^® system was used in 27 patients (30 veins) and the VenaSeal^™ system in 97 patients (125 veins). The median follow-up periods for patients treated with VariClose^® and VenaSeal^™...

Jan Mach: Lékařské procesy v Čechách a na Moravě na přelomu tisíciletíBook reviews

Prof. MUDr. Jan Petrášek, DrSc.

Cor Vasa 2023, 65(4):720  

V tomto roce si připomeneme 90 let od vydání první učebnice elektrokardiografie u násFrom the history of cardiology

Petr Bartůněk

Cor Vasa 2023, 65(4):718-719  

A Stroke and a Strange Intrapulmonary ShuntCase reports

Joana Laranjeira Correia, Gonçalo R. M. Ferreira, Vanda Neto, João Fiuza, António Costa, Miguel Correia

Cor Vasa 2023, 65(4):715-717 | DOI: 10.33678/cor.2022.135  

Pulmonary arteriovenous malformations (PAVMs) spectrum extends from microscopic lesions to single or multiple large abnormal pulmonary artery to pulmonary venous connections. The main complications of PAVMs result from intrapulmonary shunt and include stroke, brain abscess, and hypoxemia. Paradoxical embolism is considered one of the main causes in young stroke patients and rarely, paradoxical embolism can also develop at pulmonary level. We describe a case of a previously healthy 44-year-old woman with the evidence of intrapulmonary shunt on transesophageal echocardiogram during the study of a cryptogenic stroke. However, no arteriovenous malformations...

(Atheroma of mitral annulus - cause of progressive dyspnoea)Case reports

Beata Bortlíčková, Iva Procházková, Radim Brát

Cor Vasa 2023, 65(4):710-714 | DOI: 10.33678/cor.2023.041  

A 75-year-old female with progressive dyspnoea, having gradually increased during one year, was refer- red by her cardiologist to our University Hospital Ostrava to transoesophageal echocardiography. On the transthoracic echocardiography there was found a large tumor in the posterior mitral valve annulus with unknown etiology, tumor made mitral stenosis and regurgitation. In the differential diagnosis we think about myxoma, rare lipoma, and atheroma. We did not think about infective endocarditis (abscess) because there were no clinical symptoms. The patient was sent to magnetic resonance imaging, which didn't confirm stenosis of mitral valve. We didn't...

(Loeffler endocarditis (pancarditis) as a rare cause of heart failure)Case reports

Patrik Šulc, Jiří Pudich, Martin Pleva, Jan Václavík

Cor Vasa 2023, 65(4):705-709 | DOI: 10.33678/cor.2023.031  

We present a case of a 32-year-old patient suffering from Löffler (Loeffler) endocarditis, respectively pancarditis, as a rare cause of heart failure. The patient was diagnosed with eosinophillic granulomatosis with polyangiitis as a secondary hypereosinophillic syndrome. Main diagnostic tool for cardiac damage was cardiac magnetic resonance which showed signs of pancarditis, decreased left ventricular ejection fraction, and apical thrombus. The patient needed treatment of acute heart failure, immunosuppressive and other therapy for multi-organ damage caused by the primary disease. We decided not to perform a cardiac biopsy due to high periprocedural...

(Development of sleep apnea syndrome in a patient with heart failure before and after orthotopic heart transplant)Case reports

Lujza Zikmund Galková, Jiří Hlásenský, Lenka Špinarová, Petr Němec, Jiří Vítovec, Jan Krejčí

Cor Vasa 2023, 65(4):698-704 | DOI: 10.33678/cor.2023.015  

This article shows different types of sleep apnea syndrome (SA) in a patient with severe heart failure before and after orthotopic heart transplant and the treatment of SA. Sleep apnea is an influenceable independent risk factor of cardiovascular diseases. Its main symptoms may be long-term fatigue and excessive daytime sleepiness, cognitive deficit including impaired short-term memory and concentration disorder, behavioral disorders such as moodiness, aggressivity, the lack of motivation and so-called nocturnal symptoms: ronchopathy (snoring), frequent sleep arousals accompanied by gasping, nycturia, fragmentation of sleep, mouth dryness after awakening...

(Extremely rare intrapericardial location of paraganglioma)Case reports

Jaroslav Zajíc, Aleš Mokráček, Ladislav Pešl, Jiří Haniš, Dita Schaffelhoferová

Cor Vasa 2023, 65(4):692-697 | DOI: 10.33678/cor.2023.002  

Cardiac paragangliomas are a very rare primary location of paraganglioma. Approximately 1-2% of paragangliomas occur in the chest, less than 0.3% are cardiac locations. We report the case of a patient with a cardiac paraganglioma, which was an accidental finding during an echocardiographic examination. As the tumor did not show signs of hormone production before the operation, this type of rare tumor was not thought of and the diagnosis was made only on the basis of histological examination.

(Spontaneous coronary artery dissection during a sightseeing flight)Case reports

Lucjan Rucki, Radim Špaček, Miroslav Hudec, Libor Škňouřil

Cor Vasa 2023, 65(4):688-691 | DOI: 10.33678/cor.2023.025  

Spontaneous coronary artery dissection is one of the causes of acute coronary syndrome. It is most common in young women and may occur after physical or emotional stress and may be associated with fibromuscular dysplasia or inflammatory diseases. Its treatment may be conservative and revascularization is indicated in case of ongoing myocardial ischemia, which is associated with the risk of iatrogenic coronary artery dis- section. In this case report, we present a young woman who developed coronary artery dissection during a sightseeing flight. Due to ongoing chest pain, the patient was indicated for PCI, which was complicated by left main coronary...

(EHRA clinical consensus statement on conduction system pacing implantation: endorsed by the Asia Pacific Heart Rhythm Society (APHRS), Canadian Heart Rhythm Society (CHRS), and Latin American Heart Rhythm Society (LAHRS). Translation of the document prepared by the Czech Society of Cardiology)Expert consensus statement

Haran Burri, Marek Jastrzebski, Oscar Cano, Karol Čurila, Jan de Pooter, Weijian Huang, Carsten Israel, Jacqueline Joza, Jorge Romero, Kevin Vernooy, Pugazhendhi Vijayaraman, Zachary Whinnett, Francesco Zanon, Miloš Táborský, Karol Čurila, Marián Fedorco, Josef Kautzner, Alan Bulava, Patrik Jarkovský, Rostislav Polášek, Miroslav Novák, Vít Gloger, Milan Kozák, Štěpán Havránek, Vlastimil Vančura, Alexandr Schee, Milena Kubíčková

Cor Vasa 2023, 65(4):656-687 | DOI: 10.33678/cor.2023.061

Conduction system pacing (CSP) has emerged as a more physiological alternative to right ventricular pacing and is also being used in selected cases for cardiac resynchronization therapy. His bundle pacing was first introduced over two decades ago and its use has risen over the last five years with the advent of tools which have facilitated implantation. Left bundle branch area pacing is more recent but its adoption is growing fast due to a wider target area and excellent electrical parameters. Nevertheless, as with any intervention, proper technique is a prerequisite for safe and effective delivery of therapy. This document aims to stan- dardize the...

(General and clinical neurocardiology)Commentary

Jan Galuszka

Cor Vasa 2023, 65(4):653-655 | DOI: 10.33678/cor.2023.016  

The article briefly summarizes the key publications of neurocardiology in foreign and domestic literature in the last forty years, deals with the definition of the term, the definition of general and clinical neurocardiology. It highlights the work of the pioneers of neurocardiology, John Andrew Armour and Jeffrey Laurence Ardell, the importance of the autonomic nervous system in the hierarchical control of cardiac activity. Final- ly, it recalls important documents of translational and clinical neurocardiology, the SPARC project and the potential of neuromodulation therapy in practice.

(Frailty syndrome, what should we know before cardiac surgery)Review articles

Petr Smolák, Ján Gofus, Martin Voborník, Martin Děrgel, Salifu Timbilla, Martin Maťátko, Samuel Marcinov, Jiří Manďák, Jan Vojáček

Cor Vasa 2023, 65(4):648-652 | DOI: 10.33678/cor.2023.026  

Frailty syndrome is a clinical syndrome in which three or more of the following criteria are present: an unintentional weight loss of 4.5 kg (10 lb) in the past year, patient-reported exhaustion, poor muscle grip strength, slow walking speed, and reduced physical activity. The prevalence of frailty in cardiac surgery patients ranges from 4.1% to 46% according to available studies. It is associated with the occurrence of sarcopenia and osteoporosis. The Edmonton Frail Scale tool, developed for non-geriatric specialists, is useful for diagnosis in cardiac surgery and provides information regarding the patient's dependence on the environment, knowledge...

(Gliflozins, chronic heart failure, and chronic kidney disease - a review and our initial experience)Review articles

Jakub Flašík, Miloš Táborský

Cor Vasa 2023, 65(4):643-646 | DOI: 10.33678/cor.2022.113  

While, as a class of drugs, gliflozins were originally developed as oral antidiabetic agents, these molecules have been shown in recent years to exert clinically significant effects also in indications such as chronic heart failure and chronic kidney disease. These beneficial actions of both empagliflozin and dapagliflozin have been documented in several studies irrespective of the presence or absence of type-2 diabetes. It were particularly their nephroprotective effects which were consistently observed regardless of the individual studies' primary goals. At present, the two gliflozins play an important role in the management of chronic heart failure...

Early-term results of coronary artery bypass grafting in renal transplant patientsOriginal research articles

Ali Aycan Kavala, Saygin Turkyilmaz, Yusuf Kuserli, Gülsüm Turkyilmaz, Mehmet Ali Yeşiltaş, Hasan Toz, Selim Tumkaya

Cor Vasa 2023, 65(4):636-642 | DOI: 10.33678/cor.2023.008  

Background: Cardiovascular disease is the most common cause of mortality and morbidity in kidney transplant patients. Many case reports and case series about coronary artery bypass grafting operation after renal transplantation have been presented. In this article, we aim to evaluate the patients undergoing coronary artery bypass surgery after renal transplantation. Methods: Among the 4330 patients who underwent CABG between January 2012 and December 2021, there were 11 patients who had a previous renal transplant. Seven patients (64.6%) were male and four (35.4%) were female. The median age of the included patients was 52 (42-66). Results: While ten...

Gender Differences in Indications and Findings of Ambulatory Electrocardiographic MonitoringOriginal research articles

May Al-Jorani, Moatamn Reda Skuk, Haitham Ali Abdullah Al-Sudani, Ali AbdulAmeer Al-Mosawi, Kasim Abbas Al-Iqabby, Zainab Atiyah Dakhil

Cor Vasa 2023, 65(4):631-635 | DOI: 10.33678/cor.2023.007  

Background: There are significant differences in electrocardiographic parameters between males and females. However, there is a lack of data regarding the gender-related differences in indications and findings of ambulatory electrocardiographic monitoring (AEM) especially in Middle Eastern population. Purpose: We sought to investigate the gender-related differences in the baseline ECG findings, indications, and findings of AEM in an Iraqi cohort of patients referred for AEM. Methods: Baseline ECG was analyzed for each patient, indications, and findings of AEM for each patient was documented. Results: n = 100 (53% were males and 47% were females). Patients...

Is there a relationship between aortic valve degeneration and left ventricle function?Original research articles

Aysel Akhundova, Murat Sunbul, Tarik Kivrak, Fuad Samadov, Bulent Mutlu

Cor Vasa 2023, 65(4):624-630 | DOI: 10.33678/cor.2022.143  

Purpose: The aim of the study was to explore the association between aortic valve (AV) degeneration and left ventricular (LV) functions and its relation with biomarkers. Methods: Forty-two consecutive patients with degenerative AV disease and 25 controls were included. Degenerative AV were divided into stenotic and sclerotic valves. All patients underwent a two-dimensional (2D) transthoracic echocardiography and 2D speckle tracking echocardiography (STE) before and after semi-supine bicycle exercise test. We also evaluated the association between aortic sclerosis and biomarkers such as galactine-3, high-sensitive (hs) troponin-T, C-reactive protein...

Can systolic pulmonary artery pressure be used as one of the criteria of risk stratification in acute pulmonary embolism?Original research articles

Habibe Hezer, Ayse Sule Ates, Idris Yakut, Hatice Kilic, H. Canan Hasanoglu

Cor Vasa 2023, 65(4):617-623 | DOI: 10.33678/cor.2023.020  

Background: In acute pulmonary embolism (PE), rapid diagnosis and treatment planning according to mortality risk classification are important. Objectives: To explore the effectiveness of systolic pulmonary artery pressure (sPAP) values in the risk stratification of the patients with acute PE. Methods: This study is a retrospective, cross-sectional clinical trial design. A total of 221 patients who were admitted to our hospital and diagnosed as acute PE by thorax computed tomography pulmonary angiography (CTPA) was included in the study. All patients were evaluated by echocardiography (ECHO) and sPAP was calculated by Bernoulli equation. The relationships...

Knowledge Upgrading of General Practitioners in the Community Health Cares in Surabaya after Joining Virtual Training of Early Cardiovascular Detection in Pregnancy: A Quasi-Experimental StudyOriginal research articles

Meity Ardiana, Andrianto, Denisa Nugrahita Asmarani, Ryan Enast Intan, Lukman Hakim Andira, Fita Triastuti

Cor Vasa 2023, 65(4):610-616 | DOI: 10.33678/cor.2023.001  

Aim: To assess the knowledge improvement of general practitioners of Surabaya community health centers about screening, recognizing, and managing cardiovascular disease in pregnancy after receiving interven- tion, formed as virtual training. Method: This study is a quasi-experimental study with one-group pretest-posttest design. Intervention, formed as educational training about heart disease detection in pregnancy, was given to the participants. Participants consisted of general practitioners practicing at Community Health Centers in Surabaya. Pre-test and post-test consisted of questions about training's curriculum was given to the participants....

The Usefulness of RDW as a Predictor of Atrial Fibrillation Recurrence after CryoablationOriginal research articles

Pinar Keskin, Halil Lutfi Kisacik, Sinan Inci, Murat Gul, Ozcan Ozeke, Serkan Topaloglu, Dursun Aras

Cor Vasa 2023, 65(4):604-609 | DOI: 10.33678/cor.2022.110  

Aim: Red cell distribution width (RDW) is known to be related to inflammation and has been associated with poor outcomes in patients with cardiovascular diseases. However, little is known about the role of RDW as a predictor of atrial fibrillation (AF) recurrence after cryoablation, and thus we aimed to investigate the relation between RDW and the recurrence of AF after cryoablation. Methods: We retrospectively analyzed the case records of 90 patients after cryoablation (mean age, 50.06±12.36) with symptomatic paroxysmal AF despite being prescribed at least one anti-arrhythmic drug. The patients were divided into two groups based on the recurrence...

(An assessment of quality of life, anxiety, and depression of the senior citizens with cardiovascular disease)Original research articles

Katka Bobčíková, Radka Bužgová, Radka Kozáková, Renáta Zeleníková

Cor Vasa 2023, 65(4):598-603 | DOI: 10.33678/cor.2022.106  

Aim: The aim of this cross-sectional study was to evaluate a quality of life, anxiety, and depression of the senior citizens with cardiovascular diseases living in the community. Their links with the subjective assessment of the state of health, with whether the senior lives alone in the household, with gender and age were also investigated. Methods: Quality of life was assessed by Older People's Quality of Life - Brief version (OPQOL-BRIEF), the Geriatric Anxiety Inventory (GAI) was used to assess anxiety and the Geriatric Depression Scale (GDS-15) was used to assess depression. The criteria for inclusion in the sample were: age over 60 years, an...

(24-hour physical behavior profile in heart failure patients with different physical fitness: a pilot study)Original research articles

Jan Vindiš, Jana Pelclová, Marcela Škvařilová, Renáta Aiglová, Denisa Nohelová, Jakub Flašík, Patrik Keprt, Miloš Táborský

Cor Vasa 2023, 65(4):590-597 | DOI: 10.33678/cor.2023.038  

24-hour physical behavior profile may take part in an important preventive role in patients with cardiovascular disease, including heart failure. A higher risk of adverse cardiac events is also associated with a lower level of physical fitness. Therefore, the aim of this study was to describe the 24-hour physical behavior profile of patients with heart failure regarding their different levels of physical fitness. Physical behavior was assessed using three accelerometers placed on different parts of the body (wrist, hip, and thigh). The measurement concerned 20 patients (67.7±6.34 years) with NYHA class II and II-III heart failure for seven consecutive...