Der Internist
-
A 39-year-old male patient presented with dyspnea and palpitations. The electrocardiogram (ECG) showed a first degree atrioventricular (AV) block and frequent atrial extra systoles. ⋯ The serological proof of antibodies confirmed the diagnosis of Lyme carditis and antibiotic treatment with ceftriaxon i.v. was initiated. Normal AV conduction finally resumed and the symptoms subsided completely without any further clinical consequences.
-
Case Reports
[Acute coronary lithotripsy in an 83-year-old man with syncope and acute coronary syndrome].
An 83-year-old male presented with syncope and acute coronary syndrome. An electrocardiogram (ECG) suggested left main (LM) coronary artery stenosis; angiography confirmed a heavily calcified tight LM stenosis. ⋯ Intravascular lithotripsy is a new and easily applicable method for heavily calcified coronary lesions. Cost-effectiveness and long-term results will define its future role.
-
The coronavirus disease 2019 (COVID-19) pandemic has also resulted in substantial challenges for nephrology worldwide. Patients with chronic kidney diseases are a particularly vulnerable patient group in this context and in severe courses of COVID-19 the kidneys are most frequently affected by organ failure after the lungs. ⋯ Immediate consequences for hygiene measures in dialysis institutions as well as vaccination strategies and vaccination prioritization for this patient group and the personnel treating them can be derived from the high mortality in dialysis patients. A consequence of the frequent involvement of the kidneys during infections with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) in patients who had not previously suffered from advanced kidney disease should be the consistent nephrological aftercare.
-
Since the beginning of 2020 the coronavirus disease 2019 (COVID-19) pandemic has extensively impacted medical care in Germany and worldwide. Germany is currently facing the so-called third wave of the COVID-19 pandemic. This is exacerbated by emerging severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) mutants with increased virus transmission and severe courses of disease. ⋯ This article provides a current overview of proposed restructuring measures in German hospitals as well as the accompanying triage and prioritization algorithms. Moreover, it is necessary to adapt existing treatment algorithms to the pandemic situation. Due their special importance this is sketched using cardiovascular diseases as an example.