Cor et Vasa Case Reports 1/2023

titulka_ico.jpgCor et Vasa Case Reports
Svazek | Volume 6 • Číslo | Number 1
Duben | April 2023

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Spontánní disekce koronární tepny jako příčina akutního koronárního syndromu 

M. Špalek, J. Václavík, M. Branny

Spontaneous coronary artery dissection (SCAD) is a non-traumatic separation of the coronary arterial wall with false lumen, which may compromise coronary flow by external compression and cause acute myocardial infarction. In our report we present one of possible ways of the treatment.

Konstriktivní perikarditida jako následek empyému hrudníku 

D. Balázsik, Z. Coufal, P. Kopřiva

We describe a case of a 59-year-old patient who was primarily treated for thoracic empyema, caused by group F beta-haemolytic streptococcus. Constrictive pericarditis has gradually developed as a result of intrathoracic infection, but dyspnea was repeatedly treated as exacerbation of chronic lung disease. It took two years after the onset of the signs and symptoms to diagnose constrictive pericarditis. The patient’s symptoms disappeared and the quality of life improved after the pericardectomy was performed. The work describes various manifestations of the disease with emphasis on the need for close cooperation between cardiologists and other medical specialists for the early diagnosis of constrictive pericarditis. It is important to perform pericardectomy in the initial stage of the disease, when calcifications between the pericardium and myocardium have not yet developed, so the patient has a significantly better prognosis.

Náhlá srdeční zástava u mladé zdravé pacientky na podkladě idiopatické komorové fibrilace 

D. Weissová, A. Linhart, J. Bělohlávek, J. Hřídel, J. Burešová, B. Rácz, A. Kotková

Ventricular fibrillation is a life-threatening condition that leads to sudden cardiac arrest. Without early initiation of adequate cardiopulmonary resuscitation, including administration of a defibrillation shock, this condition leads to sudden death. However, cardiopulmonary resuscitation, which in this case is the only option to save human life, often leads to various early post-resuscitation complications, often resulting from injuries to the chest wall or parenchymal organs of the chest or abdominal cavity. Idiopathic ventricular fibrillation is a rare subgroup of ventricular fibrillations. This malignant arrhythmia is diagnosed in patients who have survived ventricular fibrillation, have a resting ECG without pathology; subsequent examinations show no structural heart involvement and no channelopathy or other genetic mutation associated with arrhythmogenic syndromes is detected...

Trombóza dolní duté žíly u nemocné s puerperální sepsí 

R. Bánszky, R. Malý, J. Raupach, M. Solař

Gravidity and predominantly postpartum period is generally associated with a substantial risk of thromboembolic disease, and puerperal infections have an additional impact on this risk. Venous thrombosis in postpartum period is severe and potentially life-threatening complication. In the clinical management, it is important to balance risks associated with anticoagulation therapy and thromboembolic risks. If full anticoagulation therapy is contraindicated and the risk of massive pulmonary embolism is high, inferior vena cava filter implantation should be considered. We present a case of 31-year-old woman diagnosed with puerperal sepsis which was further complicated by extensive deep venous thrombosis of pelvic veins and inferior vena cava. Therapeutic plan was determined by multidisciplinary approach. Therapeutic options were limited regarding significant bleeding risk. The patient underwent abdominal hysterectomy because of an uncontrollable infection. Prior to the surgery an implantation of retrievable inferior vena cava filter as a prevention of massive pulmonary embolism during procedure was performed. This strategy led to successful management of infection and thromboembolism, but on the other hand it led to complications related to caval filter implantation.

Tromboembolické komplikace a paradoxní embolie u pacientky s nemocí covid-19 a s patentním foramen ovale 

D. Tavačová, J. Václavík, M. Branný, M. Pecuchová, J. Gloger

There are many clinical manifestations of COVID-19 disease; the more severe forms are associated with a hypercoagulable state and endothelial damage and, consequently, a higher risk of thromboembolic complications (VTE). VTE pathophysiologies are affected by intrinsic inflammation (through the release of pro-coagulant reactants in the acute phase and platelet activation) and endothelial damage during viral infection, as well as slow blood flow during bed rest. We present a case report concerning an 84-year-old patient who had suffered from covid-induced bilateral pneumonia, with subsequent deep vein thrombosis in the right lower extremity, pulmonary embolism and a large embolus embedded in the foramen ovale propagating through the mitral valve into the left ventricle. Given the high risk of a massive systemic embolisation, the condition was treated by emergent embolectomy. The patient was subjected to full anticoagulation therapy as a secondary prevention.

Geneticky podmíněná dilatační kardiomyopatie v rodině s kudrnatými vlasy a hyperkeratózou 

J. Stromská, A. Gřegořová, P. Hanzlíková, J. Václavík

We present the case of a 42-year-old patient with dilated cardiomyopathy and his younger 38-year-old brother who experienced ventricular flutter requiring cardiopulmonary resuscitation. Examination of the 42-year-old patient by cardiac magnetic resonance confirmed dilatation of the left chamber and subepicardial scar. Due to the risk family history, genetic testing was added. A probably pathogenic variant in the gene for desmoplakin was found in the genomic DNA of the patient and his younger brother. The desmoplakin gene shows both autosomal dominant and recessive inheritance for dilated cardiomyopathy, a syndrom involving wavy hair and palmoplantar keratoderma. Both brothers were secured by implantation of cardioverter-defibrillator.