Cor et Vasa Case Reports 1/2021

titulka_ico-1-2021.jpgCor et Vasa Case Reports
Ročník | Volume 4 • Číslo | Number 1
Březen | March 2021

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Postup při dvojitém zauzlení diagnostického katétru při koronarografii prováděné radiálním přístupem – kazuistika 

J. Zápeca, M. Gřiva, P. Kopřiva

Coronary angiography is a widely used method in diagnosis of coronary artery disease. Although it is an invasive procedure, there is only a small amount of complications. One of them is catheter kinking. There are many methods that can be used to catheter retrieval. In this case report we will describe them and present our course of action.

Sub acute myocardial perforation following permanent pacemaker insertion 

B. A. Myint, A. Mohammad

Myocardium perforation after implantable cardiac electronic devices (IECDs) is a rare (~1%)1 but potentially fatal complication if not recognized early. It often occurs acutely after insertion although it can range from days to years. Here, we report a 73-year-old gentleman presented with an acute onset of chest pain after 48 hours of permanent pacemaker insertion for symptomatic bradycardia. Due to the overlapping symptoms of acute myocardial infarction and dynamic ECG changes, the patient was evaluated for acute coronary syndrome and ruled out after the serial cardiac Troponin(s) within the normal range. The patient was found to have early signs of pericardial tamponed with the right ventricular lead perforating the myocardium on the transthoracic echocardiogram. The patient was treated with pericardial drain and emergency lead extraction.

Retrospektivně stanovená diagnóza pravděpodobné tako-tsubo kardiomyopatie 

M. Holek, A. Reichenbach, W. El-Husseini

Tako-tsubo cardiomyopathy is unclassified cardiomyopathy, which typically imitates acute coronary syndrome. It is diagnosed per exclusionem in the absence of significant coronary disease or myocarditis/pheochromocytoma. However, sometimes presentation of the Tako-tsubo cardiomyopathy is atypical and the diagnosis can be assessed retrospectively as in a presented case including critical evaluation of diagnostic and therapeutic process.

Tropheryma Whipplei jako původce infekční endokarditidy 

M. Hudec, V. Brázdil, M. Radvan, L. Koc, J. Kaňovský, R. Gál, J. Sekerka, P. Kala

Tropheryma whipplei is the cause of the very rare Whipple’s disease. There are both classical and atypical forms described and both of them can affect heart valves. The disease belongs to the group of blood-culture negative infective endocarditis (BCNIE), because it’s difficult to cultivate the pathogen. However, percentage of BCNIE in total amount of infective endocarditis is not negligible. There is a relatively small number of documented cases in literature. It might be easily omitted in clinical practice. Moreover, diagnosis is very difficult as it is crucial to think about the possibility of the disease. In most cases, surgical resection of valve is necessary and consequential long-term antibiotic therapy is administered. The described case report is one of the few in our region and aims to raise awareness of this IE agent.

Katecholaminergní polymorfní komorová tachykardie jako neobvyklá příčina výskytu četných komorových extrasystol ve vyšším věku 

L. Savková, I. Andršová, T. Novotný, M. Alexová, I. Cetlová, P. Kala

Premature ventricular complexes (PVCs) are often considered benign, nevertheless they can be a sign of serious disease. In the assessment of frequent PVCs the first step is to rule out structural heart disease while left ventricular systolic dysfunction is one of the risk factors for sudden cardiac death. In the absence of a serious structural heart disease, PVCs are considered benign. However, more than...

Recidivující hluboká žilní trombóza léčena opakovaně lokální trombolýzou 

M. Nociar, M. Radvan, A. Floriánová, J. Hustý, J. Kamelander, P. Kala, O. Toman

Deep vein thrombosis is a disease that can lead to serious acute and chronic complications. In the cases of proximal deep vein thrombosis local thrombolysis is one of the therapeutic options. In our case report, we describe a case of a young woman with proximal deep vein thrombosis of right lower extremity that was successfully treated by local thrombolysis. Consequently, the patient had relapse of deep vein thrombosis in the other leg. The relapse was also treated with the use of local thrombolysis. The objective of this paper is to present an interesting case of relapsing proximal deep vein thrombosis and use of local thrombolysis as one way of treatment.