(Issue of Cor et Vasa dedicated for the seventh time to case reports )

Michael Aschermann

Cor Vasa 2020, 62(5):443 | DOI: 10.33678/cor.2020.094  

Subacute myocardial infarction in the patient with giant coronary artery aneurysm

Petr Novotný, Roman Panovský, Ladislav Groch, Věra Feitová

Cor Vasa 2020, 62(5):445-447 | DOI: 10.33678/cor.2020.018  

Coronary artery aneurysms are rare conditions with estimated incidence of 0.3% to 5.3% threatening the patient with severe complications including myocardial infarction, thromboembolism and rupture. Optimal treatment of this condition still remains subject of discussion. Quite few reports of the coronary artery aneurysm treatment have been published, thus we would like to introduce a case of giant coronary artery aneurysm diagnosed in our hospital.

(Coronaro-subclavial steal syndrome as a rare cause of circulatory arrest)

Eva Bernotová, Jana Sedláková, Tomáš Roubíček, Lukáš Jaworski, Miroslav Šercl, Rostislav Polášek

Cor Vasa 2020, 62(5):448-450 | DOI: 10.33678/cor.2020.007  

Coronaro-subclavial steal syndrome may develop as a rare complication of cardiac surgical revascularisation of the myocardium. Severe myocardial ischaemia may develop under certain circumstances if the internal mammary artery (IMA) is used as an arterial graft in aortic-coronary bypass surgery in the presence of haemodynamically significant subclavian stenosis. This is caused by the reversal of blood flow from LIMA to the subclavian artery. The authors present a case report of this syndrome in a patient with ventricular fibrillation as the first manifestation of this diagnosis.

(An anomalous origin and course of left anterior descending artery)

Simona Zahradníková, Tomáš Buděšínský, Jiří Knot

Cor Vasa 2020, 62(5):452-456 | DOI: 10.33678/cor.2020.009  

Congenital anomalies of coronary arteries are rare diseases, often diagnosed randomly during selective coronarography. They occur in approximately 1% of the adult patient population undergoing coronarography from another indication. They are divided into anomalies of origin, course or termination. These congenital anomalies may be clinically silent or present with various symptoms such as angina pectoris, ventricular ar- rhythmia, syncope or sudden cardiac death.^1,2 The article describes a case report of a 56-year-old man with anomalous origin of left anterior descending artery (LAD), manifested by exertional stenocardia. Selective coronarography...

(Use of intracoronary epinephrine in a patient with noflow phenomenon in cardiogenic shock - case report)

Milan Dragula, Ivana Ságová, Miloš Kňazeje, Jurina Sadloňová

Cor Vasa 2020, 62(5):457-460 | DOI: 10.33678/cor.2019.062  

Early reperfusion therapy in ST elevation myocardial infraction (STEMI) has been consistently shown to improve outcome. Despite early reperfusion therapy it has been reported that in a significant number of pa- tients cardiac tissue fails to perfuse normally despite opening of the occluded coronary vessel. This is known as noflow phenomenon and today remains an elusive therapeutic target. The presence of noflow is a serious prognostic sign. Noflow can result in poor healing of the infarct and adverse left ventricular remodeling, increasing the risk of major adverse cardiac events, including congestive heart failure and death. In our case we describe...

(Coronary vasospasm as the cause of acute coronary syndrome with ST elevation and the third-degree atrioventricular block - case report)

Jiří Fismol, Libor Škňouřil, Kamil Zeman

Cor Vasa 2020, 62(5):462-465 | DOI: 10.33678/cor.2020.014  

Coronary vasospasm may be the cause of the acute coronary syndrome (ACS) in patients without obstructive atherosclerosis of coronary arteries. In majority of cases it is not diagnosed, because it is rarely occurring situation to perform coronary angiography at the time of symptoms. We are introducing the case of a female patient with ACS with ST elevation (STEMI) where the vasospasm of the right coronary artery was established during the acute phase of the disease.

Aortic Reconstruction with Cryopreserved Human Allograft in a Hemodialysis Patient with Abdominal Aortic Aneurysm after Surgical Treatment of Liver Abscess

Ivan Kopolovets, Peter Berek, Vladimir Sihotsky, Jan Rosocha

Cor Vasa 2020, 62(5):466-469 | DOI: 10.33678/cor.2020.084  

Background: Infection remains one of the major challenges facing vascular surgery, while patients with comorbidities have an increased risk of infectious complications irrespective of treatment approach. One of the challenges is abdominal aortic graft infection, when the radical treatment option is the removal of the infected material followed by in situ reconstruction, while the other one are patients with infection signs who require primary aortic reconstruction without postponing surgery. Case presentation: We present a case of effective surgical treatment of abdominal aortic aneurysm in a polymorbid 78-year-old woman with chronic kidney...

Atrial fibrillation and thrombophilia. DOAC as a valid alternative? A clinical case

Claudia Morabito, Matteo Casale, Pasquale Crea, Silvia Morabito, Luca Zappia, Roberto Licordari, Nunzio Antonio Giovanni Fichera, Arianna D'Angelo, Alessandro Migliorato, Francesco Luzza, Giuseppe Dattilo

Cor Vasa 2020, 62(5):470-472 | DOI: 10.33678/cor.2020.067  

Oral anticoagulation is a milestone in the management of atrial fibrillation (AF). In complex settings, involving some kinds of thrombophilia, a condition predisposing to higher risk of thromboembolism, warfarin can be ineffective. Direct oral anticoagulants (DOACs) demonstrated to be a valid therapeutic option; in particular edoxaban proved to be effective and safe. We show the case of a man with AF and thrombophilia who developed a thrombus in the left atrial appendage (LAA) despite anticoagulant therapy with warfarin, subsequently treated with edoxaban.

(Super-responder to His-bundle pacing - case report)

Ondřej Süssenbek, Oana Raluca Ioniţă, Michaela Rýzlová, Petr Štros, Radka Procházková, Pavel Osmančík, Karol Čurila

Cor Vasa 2020, 62(5):474-478 | DOI: 10.33678/cor.2020.012  

We present a case of a 62-year-old male with significantly reduced ejection fraction and heart failure who underwent resynchronization therapy. During the procedure a left bundle branch block was corrected with His bundle pacing. A dramatic improvement of echocardiographic parameters and symptoms has been observed 6 weeks after the procedure.

Sacubitril/Valsartan and implantable cardioverter- -defibrillators: evolving therapeutic strategies. A case report

Claudia Morabito, Marianna Gigliotti De Fazio, Michele Scarano, Vito Maurizio Parato, Giuseppe Dattilo, Matteo Casale

Cor Vasa 2020, 62(5):479-482 | DOI: 10.33678/cor.2020.026  

Heart failure is a major public health concern, being one of the most common reasons for hospitalization. Its prognosis is poor and the optimal management to date represents a continuous challenge. This case report describes a 67-year-old man with chronic heart failure with reduced ejection fraction (HFrEF), remaining symptomatic despite optimal medical therapy and refusing an implantable cardioverter-defibrillator (ICD) as a prevention for sudden cardiac death. We introduced Sacubitril/Valsartan and after 3 months of treatment we observed a significant improvement in symptoms with reduction of arrhythmic burden and, after six months even of echocardiographic...

Long QT Syndrome and Electrical Storm: Is Implanted Cardiac Defibrillator the Final Destination in Long QT Syndrome Management?

Ali A. Al-Mossawi, Kasim A. Ismail, Zainab A. Dakhil

Cor Vasa 2020, 62(5):483-485 | DOI: 10.33678/cor.2020.076  

Electrical storm is a life-threatening medical emergency and in the context of implantable cardiac defibrillators it is defined as three or more appropriate detections of ventricular arrhythmia in prior 24 hours leading to implantable cardiac defibrillator shocks. Sympathetic stimulation is the forefront player for initiation and maintenance of ventricular arrhythmia. We are reporting a case from an emerging country who has long QT syndrome with implanted cardiac defibrillator and presented with electrical storm, this case highlights the challenges that we face in daily practice during managing this population.

(Reverse Takotsubo syndrome, a rare form of "Broken Heart" syndrome)

Zdenko Stelmach, Oana Raluca Ioniţă, Tomáš Buděšínský, Pavel Gregor

Cor Vasa 2020, 62(5):486-491 | DOI: 10.33678/cor.2019.091  

The reverse Takotsubo syndrome is one of the less frequent variants of acute syndrome, characterized by reversible basal akinesis of the left ventricle and the hypercontraction of its apical part. The following case report deals with a patient with a history of anxiety disorder that has been accepted for ongoing chest pain and signs of left ventricular heart failure. The examinations performed did not show any other etiology of difficulty than the reverse Takotsubo syndrome. After managing an acute condition, the patient had a rapid withdrawal of difficulties and a relatively rapid repair of the myocardial disorder.

Giant Germ Tumor Retroperitoneal Lymphadenopathy Encapsulating the Infrarenal Aorta and Inferior Vena Cava: Case Report

Róbert Novotný, Libor Janoušek, Květoslav Lipar, Jaroslav Chlupáč, Jakub Křístek, Michal Kudla, Jiří Froněk

Cor Vasa 2020, 62(5):492-494 | DOI: 10.33678/cor.2020.005  

Introduction: Testicular germ cell tumour (GCT) is the most common malignant solid tumour among Caucasian men with the highest incidence between 15-45 years. GCT had shown an increasing incidence in the past 30 years. Method: The procedure was performed through the midline laparotomy. Massive retroperitoneal lymphadenopathy (RL) was found in the abdomen. The infrarenal aorta (IA) and inferior vena cava (IVC) were carefully dissected and entirely freed from the RL. Part of the left renal vein (LRV) showed suspicious infiltration by the RL. Therefore we performed a partial LRV resection. The residual LRV was short, the reanastomosing to the IVC was not...

Iatrogenic Ascending Aortic Pseudoaneurysm: A Scarcy Bomb After Coronary Artery Bypass Surgery

Murat Gul, Sinan Inci, Ibrahim Izgu, Emir Kalyoncu, Cengiz Yilmaz

Cor Vasa 2020, 62(5):495-496 | DOI: 10.33678/cor.2020.064  

Aortic pseudoaneurysm is rare but life-threatening complication occurring several months or years after aortic surgery. Although cardiac surgery is the most common cause, it may rarely develop after trauma and infection. Clinical presentation can vary from asymptomatic to catastrophic outcomes. The diameter and size of the aortic pseudoaneurysm may increase over the years, which could consequently increase the risk of sudden rupture and hemorrhage. We present a case of an ascending aortic pseudoaneurysm developed 13 months after coronary artery bypass grafting that were successfully managed by surgical repair. It is essential to diagnose the aneurysm...

(Percutaneous closure of iatrogenic injury of arteria)

Iva Stehlíková, Martin Hajšl, Martin Malý

Cor Vasa 2020, 62(5):497-500 | DOI: 10.33678/cor.2020.006  

Inadvertent catheterization of arterial system during placement of a central venous catheter is a rare, how- ever, potentially severe complication. Puncture of arteria subclavia within cannulation of subclavian vein can occur due to anatomical relation of both vessels. We report a case, where the iatrogenic injury of the artery was resolved by an endovascular closure device Angio-Seal, which reaches hemostasis by a mechanical method, supplemented with coagulation attributes of collagen. In experienced hands, it seems to be a solid alternative to an invasive surgical solution and it could be a life support method.

(Ventricular tachycardia as the first manifestation of cardiac sarcoidosis)

Yassin Nagib Yassin, Tomáš Roubíček, Jakub Lípa, Rostislav Polášek

Cor Vasa 2020, 62(5):501-505 | DOI: 10.33678/cor.2019.072  

Sarcoidosis is a multiorgan granulomatous disease of unknown etiology. Cardiac sarcoidosis is clinically manifested in about 5% of patients with systemic sarcoidosis, but autopsy findings and modern imaging methods indicate significantly higher incidence of asymptomatic cardiac involvement (20-25%). Cardiac involvement is a sign of a worse prognosis and can be life-threatening. Cardiac sarcoidosis has 3 major manifestations - atrioventricular conduction disorders, ventricular arrhythmias, and heart failure. Diagnosis of cardiac sarcoidosis is difficult, especially in the scenario of minimal extracardiac involvement. We present a case of a 63-year-old...

Pericardial necrosis - a rare clinical condition case report

Iveta Tasheva, Ivo Petrov, Zoran Stankov, Jivka Stoykova, Iana Simova, Maria Dotseva, Galina Georgieva, Silvia Pavlova

Cor Vasa 2020, 62(5):506-508 | DOI: 10.33678/cor.2020.058  

Chest pain in its varieties is a major reason for searching medical help. A 53-year-old woman was admitted to the hospital with complaints of atypical angina and shortness of breath. A series of imaging, invasive and non-invasive investigations were done to reach the right diagnosis - pericardial necrosis.

An easily dismissed suspect of heart failure

Helder Santos, Hugo Miranda, Mariana Santos, Inês Grácio Almeida, Lurdes Almeida

Cor Vasa 2020, 62(5):510-512 | DOI: 10.33678/cor.2020.057  

Constrictive pericarditis is a rare pathology with several potential clinical manifestations. Its presence can be discovered as an incidental finding or as a primary cause of other manifestations or diseases. The pericardiectomy is the only curative measure; however, it could lead to some complications and we should always measure the pro and cons of the procedure. We present a case of a female patient admitted for typical atrial flutter and heart failure symptoms. Etiology investigation revealed a rare cause of heart failure - idiopathic constrictive pericarditis - after several investigations' exams.

Isolated Unroofed Coronary Sinus without Persistent Left Superior Vena Cava

Tomáš Toporcer, Ján Luczy, Miroslav Gbur, Gabriel Valočík, Adrián Kolesár, František Sabol

Cor Vasa 2020, 62(5):513-516 | DOI: 10.33678/cor.2020.002  

Unroofed coronary sinus (UCS) represents the rarest type of atrial septal defect, with incidence less than 1% of all atrial septal defects, or less than 0.1% of all congenital heart anomalies. A case report of a 57-year-old man with four years of misdiagnosed UCS is presented. The patient showed dyspnoea, angina pectoris, and a new onset of atrial fibrillation. The diagnosis of UCS was finally established on the basis of right-sided cardiac catheterization, echocardiography, and computer tomography. Defect roofing with redirection of the coronary sinus into the left atrium was performed. UCS is in 75% of cases associated with other heart anomalies,...

Enterococcus faecalis infective endocarditis associated with colorectal cancer: A case report

Soheil Ebrahimpour, Mohammad Reza Hasanjani Roushan, Zeinab Mohseni Afshar, Arefeh Babazadeh

Cor Vasa 2020, 62(5):517-519 | DOI: 10.33678/cor.2019.089  

Several studies have presented Enterococcus faecalis ( E. faecalis) endocarditis is the third leading source of infective endocarditis (IE). Besides, there have been several evidence in favor of relation between enterococcal IE and colorectal cancer (CRC). We report a patient with E. faecalis endocarditis associated with CRC. A 71-year-old male known to have a fever, dyspnea, orthopnea, cough, mild hemoptysis, intermittent rectorrhagea, pale conjunctivae, fine crackle, and typical sound of the artificial valve. He was diagnosed to have E. faecalis bacteremia and subsequent endocarditis. Also, colonoscopy was performed for him that...

(Sodium glucose co-transporter-2 inhibitors in heart failure: beyond glycaemic control. The Position Paper of the Heart Failure Association of the European Society of Cardiology - summary of the document prepared by ČKS)

Miloš Táborský, Aleš Linhart, Jan Pyszko, Jindřich Špinar, Filip Málek, Michal Vrablík, Marie Lazárová, Jiří Vítovec, Lenka Špinarová, Jan Bělohlávek

Cor Vasa 2020, 62(5):521-526 | DOI: 10.33678/cor.2020.090  

Heart failure (HF) is common and associated with a poor prognosis, despite advances in treatment. Over the last decade cardiovascular outcome trials with sodium-glucose co-transporter 2 (SGLT2) inhibitors in patients with type 2 diabetes mellitus have demonstrated beneficial effects for three SGLT2 inhibitors (empagliflozin, canagliflozin and dapagliflozin) in reducing hospitalisations for HF. More recently, dapagliflozin reduced the risk of worsening HF or death from cardiovascular causes in patients with chronic HF with reduced left ventricular ejection fraction, with or without type 2 diabetes mellitus. A number of additional trials in HF patients...

Společné odborné stanovisko Sekce sportovní kardiologie České asociace preventivní kardiologie ČKS, Sekce sportovní kardiologie České společnosti tělovýchovného lékařství, České asociace ambulantních kardiologů ČKS, České pneumologické a ftizeologické společnosti ČLS JEP

Vladimír Tuka, Bogna Jiravská Godula, Otakar Jiravský, Ivan Karel, Jana Kociánová, Martin Matoulek, Kryštof Slabý, Jiří Beran, Eliška Sovová

Cor Vasa 2020, 62(5):529-532 | DOI: 10.33678/cor.2020.086  

During the COVID-19 pandemic, some investigations were restricted, including exercise stress tests. However, exercise stress tests are often irreplaceable in the diagnostic algorithm. On the other hand, their implementation may pose an increased risk of transmitting infectious diseases. The following recommendations aim to suggest possible solutions to perform exercise stress tests as safely as possible for patients and healthcare professionals, even at times of increased risk of communicable infections. The epidemic situation can change dynamically, and it is necessary to follow the recommendations of the epidemiologists.

Michael Želízko slaví v letošním roce životní jubileum

Michael Aschermann

Cor Vasa 2020, 62(5):534  

HOT lines na sjezdu ČKS 2020

Jindřich Špinar, Karel Lábr, Jiří Vítovec, Lenka Špinarová

Cor Vasa 2020, 62(5):535  

B. Brett Finlay, Ph.D. & Jessica M. Finlayová, Ph.D.: Mikrobiom lidského těla Praha: Stanislav Juhaňák – TRITON, 2020, 348 s.

Václav Petr.

Cor Vasa 2020, 62(5):540