Kardiol Pol
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Case Reports
[Patient with purulent pericarditis caused by Salmonella enteritidis complicated by tamponade].
We report a case of a 64-year-old male patient with a history of advanced chronic heart failure, who was admitted to our hospital with symptoms of decompensated right heart failure. Chronic tamponade was diagnosed and conservative treatment was administered. Due to the lack of improvement, surgical drainage of the pericardial sack was performed and Salmonella enteritidis was cultured from the pericardial fluid. After a month the patient fully recovered and was discharged.
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Case Reports
[Acute coronary syndrome following massive pulmonary embolism in a 81-year-old woman with thrombophilia].
A 81-year-old woman was referred to the emergency department after having syncopal episode two days earlier. A chest computed tomography demonstrated a right main pulmonary artery embolism. ⋯ Cardiac angiography showed stenosis of left anterior descending coronary artery which was successfully treated with angioplasty and stent implantation. This case illustrates the coincidence and the importance of clinical suspicion for the early diagnosis and treatment of acute coronary syndrome during massive pulmonary embolism.
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Cardiac resynchronisation therapy (CRT) has become a valuable therapeutic tool in patients with advanced chronic heart failure (CHF). The search for optimal methods for the assessment of CRT efficacy is still underway. ⋯ Cardiac resynchronisation therapy improves exercise tolerance measured by means of CPX and 6MWT, improves respiratory system efficiency and restores its adaptive mechanisms during exercise in patients with advanced CHF. Better exercise adaptation after CRT may be objectively measured with CPX parameters, and correlates with improvement of clinical symptoms. CPX seems to be a very helpful tool in assessing the results of CRT.
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Myocardial infarction (MI) is one of the most serious challenges of contemporary cardiology. Among biochemical markers, heart-type specific fatty acid binding protein (h-FABP) has a high potential as a marker for the early diagnosis of acute MI. The h-FABP is released early to the bloodstream and may be useful for both rapid confirmation and exclusion of infarction. As opposed to patients with ST segment elevation MI (STEMI), patients with unstable angina (UA)/non-ST segment elevation MI (NSTEMI) present a heterogeneous group in which the confirmation of MI often meets diagnostic difficulties. A rapid, qualitative immunoenzymatic 'point of care' type test, revealing h-FABP in blood, has recently been made available (CardioDetect med). ⋯ Qualitative h-FABP test (CardioDetect med) showed excellent sensitivity, higher than measurements of CK-MB mass, CK-MB, and cTnT on hospital admission, and high specificity in the patient group with NSTE ACS. The h-FABP seems to be an excellent biochemical cardiac marker for diagnosing NSTEMI, especially in its early phase, allowing exclusion of myocardial necrosis.