Mexiletine as a one effective alternative for antiarrhythmic drugs and ablation resistant electrical storm – A case report
We present case of 78-year-old male transferred to our Department due to multiple episodes of malignant ventricular arrhythmias refractory to previous antiarrhythmic treatments (device settings optimization, amiodarone treatment, lidocaine infusion and optimal pharmacotherapy). Additionally, patient had ischemic end-stage heart failure and implanted CRT-D. We excluded secondary causes of electrical storm and due to inefficacy of medical therapy, we applied radiofrequency ablation. During 1st day after procedure life-threatening VT/VF recurred. As our last choice, we modified therapy and introduced mexiletine, what resulted...
Source: Cor et Vasa - July 10, 2018 Category: Cardiology Source Type: research
An anomalous case of S-ICD malfunctioning: A big trouble or a soap bubble?
Publication date: Available online 2 August 2017Source: Cor et VasaAuthor(s): Pasquale Crea, Angela Nicotera, Bruna Crea, Antonio Taormina, Giuseppe PiccioloAbstract12 h after the implant of a S-ICD the patient accused an inappropriate shock due to noise oversensing. ICD interrogation showed undersensing of ventricular signals on primary vector and significative noise on alternative vector. Surprisingly, 2 days full recovery of sensing of primary vector was observed. Trapped air was likely to be the cause of malfunctioning. (Source: Cor et Vasa)
Source: Cor et Vasa - July 10, 2018 Category: Cardiology Source Type: research
Recurrent infective endocarditis as a manifestation of Loeffler's endocarditis: The diagnostic importance of cardiac magnetic resonance imaging
We present a 60-year-old patient with a history of recurrent infective endocarditis due to different Streptococcus species. Transthoracic echocardiography (TTE) revealed a circumscript echodense structure near the apex of the left ventricle, suggestive of a vegetation. Positron emission tomography revealed increased activity at the same site of the left ventricle and showed no other abnormalities. The patient was treated with intravenous antimicrobial therapy for each episode of infective endocarditis (3x). The vegetation near the apex remained visible on follow-up TTE. Diagnostic cardiac magnetic resonance imaging (CMR) w...
Source: Cor et Vasa - July 10, 2018 Category: Cardiology Source Type: research
Transcatheter aortic valve replacement – Therapeutical option in a patient with complex heart disease
Publication date: Available online 26 August 2017Source: Cor et VasaAuthor(s): P. Zdráhal, J. Bis, P. Polanský, J. Dušek, J. ŠťásekAbstractAuthors are presenting a case report describing diagnostic and therapeutic approach in patient with severe dyspnoea. The dominant cause of the symptoms was combined aortic valve disease and monstrous obesity. The other findings were combined mitral valve disease and provoked midventricular obstruction of the left ventricle. A complex cardiac surgery was not recommended due to the aortic valve annulus size, massive calcification of both mitral and aortic valves and extreme obesity ...
Source: Cor et Vasa - July 10, 2018 Category: Cardiology Source Type: research
Rupture of free wall of left ventricle in a patient with takotsubo cardiomyopathy
Publication date: Available online 20 September 2017Source: Cor et VasaAuthor(s): Jan Hulka, Jiri SoukupAbstractTakotsubo cardiomyopathy (TTC) belongs to rare heart disease with symptoms imitating acute coronary syndrome with ST segment elevation. Usually, it occurs predominantly in postmenopausal women. In most cases, the disease has an uncomplicated course, but some patients may develop severe complications (e.g. cardiogenic shock, severe heart failure, malignant arrhythmia, thromboembolism or myocardial wall rupture). This case report describes an 82-year-old man with TTC complicated rupture of the left ventricular free...
Source: Cor et Vasa - July 10, 2018 Category: Cardiology Source Type: research
Dual-lumen catheter in coronary chronic occlusions
We report three CTO cases successfully treated using a dual-lumen catheter after other crossing strategies failed to cross the occlusion. This tool is easy and reliable to use and could be useful in similar situations in CTO cases. (Source: Cor et Vasa)
Source: Cor et Vasa - July 10, 2018 Category: Cardiology Source Type: research
The importance of a higher dose of a mineralocorticoid receptor antagonist in reducing risk of recurrent hospitalization in a patient with advanced chronic heart failure – A case report
Publication date: Available online 22 September 2017Source: Cor et VasaAuthor(s): G. Mairgani, V. Mála, F. MálekAbstractThe authors present the significance of a higher dose of a mineralocorticoid receptor antagonist in reducing the frequency of hospitalizations for decompensated heart failure in a 67-year-old patient suffering from advanced chronic heart failure. (Source: Cor et Vasa)
Source: Cor et Vasa - July 10, 2018 Category: Cardiology Source Type: research
Arrhythmogenic cardiomyopathy of left ventricle. A rare event, but possible
Publication date: Available online 23 October 2017Source: Cor et VasaAuthor(s): Michele Scarano, Germana Gizzi, Cesare MantiniAbstractArrhythmogenic right ventricular dysplasia (ARVD) is a form of inherited cardiomyopathy characterized by fibro-fatty substitution mainly right ventricular (RV). Affected patients may succumb to life-threatening ventricular arrhythmias and heart failure. It is even more common among athletes who experience sudden cardiac death (SCD). The disease involvement is not limited only to the RV, but the left ventricle (LV) can also be involved. We have reported a case of a 38 years-old man, with two ...
Source: Cor et Vasa - July 10, 2018 Category: Cardiology Source Type: research
Combined orthotopic heart transplantation followed by autologous stem cell transplantation in a patient with light chain amyloidosis and isolated cardiac involvement
We present a case of amyloidosis AL with isolated myocardial involvement. Because of a refractory heart failure picture, patient underwent orthotopic heart transplant (OHT). The replaced heart showed an important midwall infiltration. Ten months after he underwent autologous stem-cell transplantation (ASCT) with a favorable outcome. The case demonstrates that OHT followed by ASCT in highly selected patients with light chain amyloidosis is a life-saving procedure. (Source: Cor et Vasa)
Source: Cor et Vasa - July 10, 2018 Category: Cardiology Source Type: research
“Acute coronary syndrome” and heart failure caused by a large hiatal hernia
Publication date: Available online 11 November 2017Source: Cor et VasaAuthor(s): Jiří Holý, Pavel Červinka, Nedal Omran, Ján KoscelanskýAbstractUpside down stomach (UDS) as a severe form of hiatal hernia has various clinical scenarios. Patients could be asymptomatic or present with haemodynamic collapse due to mechanical compression of the mediastinum.We herein present a case of 71-year-old woman referred to our clinic due to acute coronary syndrome with acute onset of heart failure, which was treated accordingly. Throughout the diagnostic and therapeutic process, a diagnosis of an incarcerated UDS was established as...
Source: Cor et Vasa - July 10, 2018 Category: Cardiology Source Type: research
Ventricular fibrillation as a primary manifestation of Wolff–Parkinson–White syndrome
Publication date: Available online 20 November 2017Source: Cor et VasaAuthor(s): Tereza Eichlerová, Jiří Knot, Pavel OsmančíkAbstractWolff–Parkinson–White syndrome (WPW) is defined as a condition involving an accessory pathway associated with symptoms. A typical ECG pattern of a pre-excitation shows a short PQ interval, presence of delta wave and a broad QRS complex on surface ECG. The underlying mechanism involves an accessory pathway, which enables conduction of a depolarization wave from atria to ventricles bypassing the AV node and predisposes to arrhythmias and sudden cardiac death. The most common arrhythmia...
Source: Cor et Vasa - July 10, 2018 Category: Cardiology Source Type: research
An unrecognized combined congenital heart defect – Bicuspid aortic valve and ventricular septal defect as a cause of acute heart failure in adulthood
We report on a case of 51-year-old man with an unrecognized combined congenital heart defect: bicuspid aortic valve (with severe aortic insufficiency), a serious defect of ventricular septum (with pulmonary hypertension) and severe tricuspid valve insufficiency, presenting as an acute heart failure. (Source: Cor et Vasa)
Source: Cor et Vasa - July 10, 2018 Category: Cardiology Source Type: research
Giant-cell myocarditis – A case report and a brief review
Publication date: Available online 20 November 2017Source: Cor et VasaAuthor(s): Jan Látal, Miloslav Špaček, Jan Přeček, Zbyněk Tüdös, Martin Hutyra, Tomáš Tichý, Miloš TáborskýAbstractGiant-cell myocarditis is an extremely rare disease with high morbidity and mortality. In the majority of cases, the course of the disease is in the form of fulminant myocarditis. The cornerstone of the treatment is aggressive immunosuppresive therapy in addition to heart failure treatment, however the need for mechanical circulatory support or heart transplant is high. In our case report, we present a patient suffering from gi...
Source: Cor et Vasa - July 10, 2018 Category: Cardiology Source Type: research
Cardiac arrest in patient with significant pulmonary regurgitation after surgical valvulotomy at 10 years of age for isolated pulmonary stenosis
We present the case of a 46-year-old man with gradually progressing pulmonary regurgitation after surgical valvulotomy at 10 years of age. Despite regular follow-ups by the cardiologist, the patient was never referred to a specialized centre and cardiac arrest caused by ventricular fibrillation occurred after physical exercise. (Source: Cor et Vasa)
Source: Cor et Vasa - July 10, 2018 Category: Cardiology Source Type: research
Surgical resection of occluded abdominal stent graft followed by aorto-bi-iliac vascular reconstruction with Intergard Synergy vascular prosthesis
ConclusionWhen endovascular treatments of stent grafts’ branch occlusion fail, surgical treatment, despite its higher perioperative risks and technical challenges, remains the only treatment option. (Source: Cor et Vasa)
Source: Cor et Vasa - July 10, 2018 Category: Cardiology Source Type: research
