Cor et Vasa Case Reports
Svazek | Volume 4 • Číslo | Number 2
Červen | June 2021
Cor et Vasa Case Reports
Svazek | Volume 4 • Číslo | Number 2
Červen | June 2021
K. Hořáková, M. Radvan, L. Koc, J. Sedmík, J. Hustý, P. Kala
Thrombembolic events are common and threatening complications of COVID-19. Deep vein thrombosis and pulmonary embolism may present both during and after the acute phase of the disease. The risk of thromboembolism increases with the severity of the course of the disease, but even mild forms are in danger. We present the case of a 58-year-old woman who, ten days after the end of isolation for COVID-19 infection, developed a rapid deep vein thrombosis extending into the inferior vena cava, which was clinically presented with phlegmasia of the left lower limb. After implantation of a caval filter into the inferior vena cava to prevent embolization of thrombotic masses, endovascular treatment with local thrombolysis was performed, which early led to recanalization of the venous bed and normalization of the clinical finding of the left lower limb.
D. Buchta, et al.
The sticky platelet syndrome (SPS) is a congenital disorder increasing the risk of development of thrombotic events. Although it is considered as a rare disease, it occurs in up to 20% of patients suffering from thrombotic events without a clear cause. Acetylsalicylic acid is used for treatment, with doses of less than 100 mg/day normalizing aggregation in a vast majority of patients; rarely, however, normalization is only observed after doses of up to 320 mg/day. This case report presents a case of a patient with probable SPS (that can however not be definitely diagnosed due to the presence of coronary stenting and thus due to the impossibility of discontinuing antiaggregation therapy) in whom even doses as high as 400 mg/day of acetylsalicylic acid combined with ticagrelor and later prasugrel failed to completely normalize the aggregation and who has over the five year of treatment suffered from further 7 acute myocardial infarctions of the 4b type.
V. Brázdil, M. Hudec, L. Koc, T. Ondrúš, M. Poloczek, J. Kaňovský, R. Štípal, P. Jeřábek, O. Boček, P. Kala
Takotsubo cardiomyopathy (TTC) is a life-threatening condition in cardiology with an increasing incidence that often mimics acute coronary syndrome. Typical chest pain, dyspnoea, or syncope represent the common clinical manifestation of the disease. However, TTC patients mostly reveal non-obstructive coronaries and typical left ventricular dysfunction extending beyond a single coronary artery territory. The myocardial dysfunction recovers in vast majority of patients within days or weeks. In spite of recent intense research, exact pathogenesis of TTC has not been uncovered. Many plausible pathogenetic mechanisms have been discussed in which activation of sympathetic nervous system plays a role. In this case report, we refer 72-year-old female with typical symptoms of acute myocardial infarction, following a stressful condition. Coronary angiography disclosed only non-significant changes in coronary arteries. Left ventricle angiography showed apical dyskinesia. The subsequent functional measurement did not reveal significant impairment of coronary epicardial bed but disclosed microvascular dysfunction. Typical clinical course together with the results of all completed investigations resulted in the diagnosis of TTC.
M. Mikulica, Z. Coufal, J. Šťastný
We herein describe a case of a 74-year-old polymorbid patient with severe kyphoscoliosis who was referred by her general practitioner for an urgent coronary angiography for acute ST-elevation myocardial infarction (STEMI) of the inferior and posterior wall of the left ventricle. Coronary angiography of the right coronary artery (RCA) was performed via the right radial artery and showed an occlusion of its mid-portion. The left coronary artery had to be visualized through the left radial artery due to an extremely tortuous aorta and the spinal deformity. Extensive dissection with a retrograde flow to the ascending aorta occurred during probing the RCA using a guide catheter. We managed the case by implanting drug stents into the proximal and distal segments of the RCA; another stent was implanted into the ostium of the RCA, thus covering the residual dissection of the RCA and at the same time closing the entrance of the dissection of the ascending aorta. The deposit of the contrast agent in the ascending aorta remained constant and without progression. We considered consulting the department of cardiac surgery; however...