(Issue of Cor et Vasa dedicated for the ninth time to case reports – contribution for the permanent education)

Michael Aschermann

Cor Vasa 2022, 64(5):496 | DOI: 10.33678/cor.2022.107  

Electrophysiological findings after bilateral thoracoscopic atrial fibrillation ablation using irrigated bipolar radiofrequency energy - a pilot study

Tomáš Skála, Vlastimil Černíček, Ondřej Moravec, Marek Vícha, Petr Šantavý, Andrea Steriovský, Jitka Skálová, Olga Klementová, Miloš Táborský

Cor Vasa 2022, 64(5):499-503 | DOI: 10.33678/cor.2022.055  

Background: Thoracoscopic atrial fibrillation ablation (TARAFS) using irrigated bipolar radiofrequency energy (Medtronic Cardioblate Gemini-S) should result in wide isolation of the pulmonary veins (PVs) and posterior left atrial (LA) wall (the box-lesion technique). Electrophysiological findings after this technique using this instrumentation are not known. Methods and results: 22 patients with AF recurrence after bilateral TARAFS for persistent AF had a radiofrequency catheter ablation (CA) at least three months after TARAFS. Results: Out of 22 patients, the box lesion was not completed in 15 (68.2%) patients. 12 had no endocardial signs of any prior...

Bilateral aggravation of CEAP score associated with obesity

Sergio Quilici Belczak, Rubiana Neves Ramos, Jose Maria Pereira de Godoy

Cor Vasa 2022, 64(5):505-508 | DOI: 10.33678/cor.2022.061  

Background: Chronic venous disease is common and causes discomfort, exerting a negative impact on quality of life and obesity is associated with a reduction in joint mobility and the aggravation of chronic venous disease. Aim: The aim of the present study was to evaluate the worsening of the CEAP score bilaterally with the increase in the body mass index (BMI). Method: Forty-five patients with varicose vein in the lower limbs and a BMI higher than 40 kg/m² were evaluated at the Belczak Clinic in the city of Maringá, Brazil. Patients with a clinical diagnosis of varicose veins and BMI higher than 40 kg/m² were divided into three...

(Illness perception and its connection with chosen characteristics in heart failure patients)

Katka Bobčíková, Radka Bužgová

Cor Vasa 2022, 64(5):510-516 | DOI: 10.33678/cor.2022.015  

Aim: The aim of this cross-sectional study was to determine the illness perception of the chronic heart fail- ure, and to describe its links with selected characteristics. Methods: Data were obtained with a questionnaire survey, data on NYHA classification were obtained from the patient's medical records. Illness perception was evaluated by The Brief Illness Perception Questionnaire (Brief-IPQ). The sample included 173 patients, and data were collected from July 2020 to November 2021 at the cardiovascular ward. Results: The overall Brief-IPQ score was 42.70 (SD = 9.95; min. 11; max. 70). Statistically significant rela- tionships were found between...

Culotte Stenting in the Acute Myocardial Infarction with Distal Left Main Thrombosis: A Case Report

Songül Usalp, Emine Altuntaş, Kanber Öcal Karabay

Cor Vasa 2022, 64(5):518-521 | DOI: 10.33678/cor.2021.099  

Background: The invasive treatment approach to unprotected distal left main bifurcation lesions (UDLMBL) is a difficult decision and requires experience in this regard. We present the successfully interventional treatment with culotte technique of UDLMBL of the patient presenting with acute ST-elevation myocardial infarction (STEMI). Case summary: A 66-year-old male patient admitted with typical chest pain, his ECG showed acute infero-posterolateral myocardial infarction. Coronary angiography revealed distal LM true bifurcation lesion. The successful culotte technique was performed. The patient was followed without events and discharged in a good condition....

Recurrent simultaneous two-vessel very late stent thrombosis

Emna Bennour, Ahmed Sghaier, Ali Khorchani, Ikram Kammoun, Afef Ben Halima, Zied Ibn ElHadj, Salem Kachboura

Cor Vasa 2022, 64(5):522-525 | DOI: 10.33678/cor.2021.110  

Background: Stent thrombosis is catastrophic. New-generation drug eluting stents (DES) had a significant improvement in the efficacy and especially safety. Very late stent thrombosis is a rare complication, however, even rarer is to have a simultaneous two-vessel very late stent thrombosis with second-generation DESs. Case presentation: A 43-year-old male was admitted to our hospital in 2018 because of non-ST elevation myocardial infarction (NSTEMI) due to significant lesions on the proximal left anterior descending (LAD) and the circumflex (Cx) arteries treated with the implantation of two drug eluting stents. After 2 years of wellbeing, he was readmitted...

Two uncommon complications of COVID-19 in same patient: MINOCA and pneumothorax

Ramazan Gunduz, Bekir Serhat Yildiz, İbrahim Halil Ozdemir, Mehmet Burak Ozen, Serpil Canan Erbuyun

Cor Vasa 2022, 64(5):526-529 | DOI: 10.33678/cor.2021.067  

COVID-19 has several clinical manifestations in the respiratory system and the cardiovascular system. Pneumothorax and myocardial infarction with nonobstructive coronary arteries (MINOCA) are two different clinical complications in COVID-19. However, pneumothorax and MINOCA have not been described yet in the same patient until now. A COVID-19 patient was admitted due to respiratory distress. He had pneumothorax and MINOCA. We report how we proceeded with diagnosis and treatment of pneumothorax and MINOCA. Respiratory and cardiovascular system manifestations of COVID-19 have made numerous clinical appearances. MINOCA and pneumothorax are rare clinical...

Low Oxygen Saturation Following Total Correction in a Patient with Tetralogy of Fallot and Persistant Left Superior Caval Vein - How Did We Diagnose and Manage?

Mehmet Turan Basunlu, Senay Coban, Gizem Sari, Turkay Saritas, Abdullah Erdem, Didem Melis Oztas, Metin Onur Beyaz, Emre Oteyaka, Yilmaz Yozgat, Murat Ugurlucan, Halil Turkoglu

Cor Vasa 2022, 64(5):530-532 | DOI: 10.33678/cor.2021.115  

Association of tetralogy of Fallot (TOF) with the other intracardiac pathologies such as atrial septal defect (ASD), atrioventricular canal defect or persistent left superior vena cava (PLSVC), absent pulmonary valve are well known pathologies. The associated pathologies require specific attention during surgical treatment. In this manuscript, we present management of a four-month-old girl who was diagnosed with TOF and PLSVC but the diagnosis of unroofed coronary sinus was missed in her. Association of unroofed coronary sinus with TOF is a very rare variant of TOF pathology.

Pregnancy-Associated Cardiomyopathy (PACM) in a Preeclamptic Woman with Twin Pregnancy: A Case Report

Bunga Novitalia, Esti Hindariati

Cor Vasa 2022, 64(5):533-537 | DOI: 10.33678/cor.2021.138  

Peripartum cardiomyopathy (PPCM) is an uncommon disease, a dilated cardiomyopathy type occurs in the final gestation month and within 5 months after giving birth. A related term, pregnancy-associated cardiomyopathy (PACM) occurs before it. The morbidity and mortality rates are high. Women with preeclampsia with twin pregnancies are at a markedly elevated risk of developing PACM/PPCM. A 40-year-old multiparous woman with twin pregnancy came to the emergency room at gestational week 20, exhibited cough, dyspnea, full bilateral rales, extremities edema, cardiomegaly, hypertension, proteinuria, and the left ventricular ejection fraction was 26%. She was...

Surgical treatment of simultaneous pulmonary and paradoxical embolism

Jaroslav Ilčišák, Jiří Ničovský, Petr Němec

Cor Vasa 2022, 64(5):538-541 | DOI: 10.33678/cor.2022.012  

We present a rare case of a patient with atypical symptoms regarding his diagnosis. Patient presented primarily with neurological symptoms. A computed tomography (CT) scan of this patient showed a simultaneous pulmonary and systemic embolism. A subsequent preoperative transesophageal echocardiography (TEE) revealed a persistent foramen ovale (PFO). It was apparently the way of systemic embolism which caused the neurological symptoms. In this case report we describe the therapy of a simultaneous pulmonary and paradoxical embolism.

(Cardiac involvement in a patient with idiopathic hypereosinophilic syndrome)

Benjamin Uwamahoro, František Toušek, Štěpánka Šindelářová, Aleš Mokráček, Pavla Vítková, Jiří Kubále

Cor Vasa 2022, 64(5):542-545 | DOI: 10.33678/cor.2022.011  

Hypereosinophilic syndrome (HES) is a rare disorder defined by a marked and persistent hypereosinophilia (HE) (˃1,5 × 10⁹/l), evidence of eosinophil-mediated organ damage, that is not the result of secondary (reactive) HE. HES is a part of a heterogeneous group of hypereosinophilic disorders. Cardiovascular involvement is present in 40-50% of patients with HES and is a major source of morbidity and mortality. Among its manifestations there are heart failure, intracardiac thrombosis, myocarditis, arrhythmias, and valve diseases. Fatal cardiogenic shock may be the first manifestation of the disease. We present a case report of a patient...

(Double orifice mitral valve)

Šárka Polcarová, Andrej Myjavec, Miroslav Brtko, Martin Voborník

Cor Vasa 2022, 64(5):546-548 | DOI: 10.33678/cor.2022.029  

Double orifice mitral valve (DOMV) is a rare congenital cardiac anomaly, generally associated with other congenital malformations. Isolated DOMV has been reported rarely. We present a case of a 58-year-old man without history of cardiovascular disease who underwent mitral annuloplasty due to severe mitral valve regurgitation and in whom DOMV was diagnosed perioperatively.

Atypical presentation of Takotsubo syndrome early after pacemaker implantation

Elisabetta Demurtas, Davide Restelli, Lorenzo Pistelli, Francesca Parisi, Alessia Perna, Paolo Vinciguerra, Rosalba De Sarro, Alessio Currò, Sergio Crosca

Cor Vasa 2022, 64(5):549-553 | DOI: 10.33678/cor.2022.001  

Background: Takotsubo syndrome is a form of acute stress-induced cardiomyopathy showing left ventricular dysfunction without, in most cases, obstructive coronary artery disease, although these can be present in 10-29% of cases. Even a low invasive procedure, representing a physical and emotional stress, could be associated with the onset of Takotsubo syndrome. Case presentation: We report the case of an 87-year-old woman with high pre-existing stress load who developed Takotsubo syndrome with uncommon symptoms after an uncomplicated placement of a permanent pacemaker. Conclusions: This case remarks that TTS should be considered as a potential complication...

Cough, a rare and not well recognized symptom of lead perforation

Francesca Parisi, Elisabetta Demurtas, Marta Allegra, Lorenzo Pistelli, Giuseppe Dattilo, Pasquale Crea

Cor Vasa 2022, 64(5):554-556 | DOI: 10.33678/cor.2021.111  

A 64-year-old woman was admitted to our department for dual-chamber pacemaker implantation. No complication apparently occurred during the procedure. An active fixation ventricular lead was positioned in right ventricular septal apex. Soon after implantation the patient started to suffer from non-productive cough, clearly related to ventricular stimulation. Transthoracic echocardiography revealed a small pericardial effusion along the apical segments. The patient underwent urgent contrast chest CT confirming pericardial effusion, and showing an intramyocardium placement of the right ventricular apical lead. Due to persistence of symptoms, we decided...

(Wellens syndrome - description of the case)

Jan Machura, Radek Pudil

Cor Vasa 2022, 64(5):557-559 | DOI: 10.33678/cor.2022.019  

Wellens syndrome is an electrocardiographic manifestation of a critical stenosis of the proximal left anterior descending coronary artery in patients with recent history of angina pectoris. Typical is normal or slightly elevated value of serum cardiac markers. We persent a case of 59-year-old man complaining of recurrent chest pain. The aim of our case report is to raise awareness of this electrocardiographic picture of a critical stenosis of the proximal left anterior descending artery.

Popliteal Adventitial Cystic Disease. Case Report

Vasil Chervenkov, Nikolay Dimitrov Valchev, Galina Kirova, Alexander Daskalov

Cor Vasa 2022, 64(5):560-563 | DOI: 10.33678/cor.2021.098  

Aim: We want to present a case of a patient who was diagnosed with the rare condition of popliteal adventitial cystic disease and to describe the diagnostic algorithm and the decision making process. Methods: We report a case of a 51-year-old female nurse complaining of rapidly progressing claudication involving the right calf during exercise. She was misdiagnosed at the beginning and endovascular procedure was scheduled. Only by performing CT-scan and MRI the right diagnosis was made and open surgery was performed. The adventitial cyst was excised and the adventitia was left open. No further reconstruction was needed due to healthy and presumably...

John R. Hampton. Joanna Hampton: EKG stručně, jasně, přehledně. Překlad 9. vydání

Prof. MUDr. Jan Petrášek, DrSc.

Cor Vasa 2022, 64(5):564 | DOI: 10.33678/cor.2022.103