Kardiol Pol
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The clinical picture of acute pulmonary embolism (APE) is often uncharacteristic and may mimic acute coronary syndrome (ACS) or lung diseases, leading to misdiagnosis. In 50% of patients, APE is accompanied by chest pain and in 30-50% of the patients markers of myocardial injury are elevated. ⋯ One third of patients with APE may present with all the manifestations (pain, elevated troponin and ECG changes) suggestive of ACS. The ECG changes suggestive of myocardial ischaemia are observed in 70% of the patients with ST-segment depression in V4-V6 and ST-segment elevation in V1 and aVR being significantly more common in high-risk vs non-high-risk patients.
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Case Reports
[Coronary-cameral fistulae drained into left ventricle causing acute coronary syndrome?].
Coronary-cameral fistulae are rare and predominantly congenital communication between the coronary arterial circulation and the chambers or great vessels of the heart, accounted for less than 0.4% of all congenital heart abnormalities. We presented a case of 47 year-old female with troponin positive acute coronary syndrome admitted to our coronary care unit in whom we diagnosed coronary-cameral fistulae which could cause myocardial ischaemia.
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Acute kidney injury (AKI) is a serious complication of heart failure (HF). Continuous venovenous haemodiafiltration (CVVHDF) is a widely accepted method for treating this complication. However, the optimal time of its initiation has not been established. ⋯ An early introduction of CVVHDF significantly diminished the need to use mechanical ventilation and indicated a positive trend in the reduction of in-hospital mortality in patients with HF complicated by AKI.
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A case of a 19 year-old woman in the third trimester of her second pregnancy admitted due to suspected of acute pulmonary embolism (PE) is presented. The diagnosis was confirmed by transthoracic echocardiography (TTE) which revealed an immobile wall-adherent thrombus in the left pulmonary artery. A complete regression of the thrombus was obtained after antithrombotic treatment. We conclude that TTE examination can be useful in diagnosing of PE and may be safely used during pregnancy.