A case of a 66-year-old male hospitalised due to heart failure is presented. Echocardiography showed an abnormal structure in the right atrium resembling myxoma or thrombus. Abdominal ultrasonography revealed a right renal tumor. Finally, magnethic resonance imaging showed that the abnormal structure in the right atrium was a neoplasmatic plug continuously extending from renal carcinoma. The renal tumor and it’s metastatic plug were succesfully removed during surgery.
A case of a 44-year-old woman with left ventricular non-compaction which manifested in adulthood as dyspnea, fatique and NYHA class III heart failure, is described. She received treatment typical for heart failure and was offered heart transplantation and cardioverter-defibrillator implantation which she refused. Unfortunately, she died suddenly three months after the diagnosis was established.
Rupture of the interventricular septum is a serious complication of myocardial infraction (MI). It occurs in 1-3% of all MI cases, usually within 2 weeks after infraction. In 60% of the cases post-MI ventricular septal defects (VSD) are the result of completely occluded coronary artery supplying anterior wall of left ventricle and subsequent transmural MI. 50% of patients die within the first week after the rupture unless they are surgically treated. In this case report we describe an 87-year-old woman with post-MI VSD who was successfully operated (endocardial patch exclusion technique, proposed by David). In spite of a very high predicted risk (97% by Euroscore), calculated high risk should not be considered as the contraindication for life-saving operation.
We present a case of an 80-year-old female admitted to hospital because of recurrent syncope. The echocardiogram revealed a large thrombus in the left and right atria, entrapped in the patent foramen ovale, right heart enlargement and pulmonary hypertension. Magnetic resonance confirmed significant pulmonary embolism. The patient was successfully treated with fractioned heparin.
Studia Migracyjne – PrzeglÄ d Polonijny » 2018 (XLIV) » Nr 1(167) » DziaÅalnoÅÄ Å¼eÅskich zgromadzeÅ zakonnych wÅród Polonii chicagowskiej (1874–1899) A A A
Recent years have witnessed the increasing role of NT-proBNP as a prognostic tool in acute coronary syndrome (ACS).To evaluate prognosis of patients over 65 years of age with acute myocardial infarction (MI), based on NT-proBNP levels measured in the acute phase of MI.The study involved 161 patients aged 79+/-8 hospitalised with acute MI, either with or without ST segment elevation (STEMI/NSTEMI). The NT-proBNP levels in serum were measured and echocardiography with left ventricular ejection fraction (LVEF) was performed in all patients upon admission to hospital. These tests were repeated after six months with the patients additionally subjected to the 6-minute walk test (6MWT).The average NT-proBNP level in the studied patients at admission to hospital was 7058+/-9649 pg/ml and increased in proportion to the age of patients. The NT-proBNP level did not differ significantly in STEMI and NSTEMI patients. Fifty-three patients died during the 6-month follow-up period. Their NT-proBNP levels at admission were significantly higher than in patients who were alive at the end of follow-up: 12237+/-13035 pg/ml compared with 4606+/-6214 pg/ml (p=0.0001). The NT-proBNP level upon admission to hospital proved to be an independent predictor of death in the six-month period following MI. Six months after MI the average left ventricular ejection fraction in the studied group of patients was 49+/-10% and the average distance in the 6MWT was 361+/-151 m. There was a significant negative correlation between these two parameters and the initial NT-proBNP level determined upon admission to hospital.An increased NT-pro-BNP level, measured in the acute phase of MI, is a significant prognostic factor during six-month follow-up after MI in patients aged over 65.
