Kardiol Pol
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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.
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Pandemic influenza particularly often is associated with symptoms of acute respiratory failure, and in case of refractory hypoxemia patients may have indications for the extracorporeal membrane oxygenation (ECMO). The paper presents a case of a pandemic influenza virus infection, where classical indications for veno-venous ECMO occured. Practical aspects of this kind of treatment in the intensive care unit are discussed.
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B-type natriuretic peptides (BNP) are acknowledged markers of acute and chronic heart failure. Insufficient data exist, however, regarding their diagnostic usefulness in cardiac surgery, particularly in coronary patients. ⋯ Preoperative assessment of NT-proBNP level in CABG patients could be a valuable diagnostic method for predicting several postoperative complications, especially pulmonary outcomes and requirement for haemodynamic support, and it correlated with the length of ICU stay and hospital stay.
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In systemic sclerosis (SSc), changes in the lungs and pulmonary hypertension (PH) are complications most adversely affecting the prognosis. Given the availability of specific treatment, early diagnosis of PH is very important. Exercise echocardiography, by increasing the patient's cardiac output, makes it possible to identify patients with elevated pulmonary artery pressure (PAP) during exercise. The diagnostic role of exercise echocardiography is still unclear, mainly because of the lack of prospective studies. ⋯ Exercise echocardiography is a safe and useful screening tool for PH diagnosis in patients with SSc. It enables to identify patients with normal systolic PAP at rest but a significant increase during exercise. The final confirmation of PH and differentiation between precapillary arterial and postcapillary venous PH requires RHC.
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Acute heart failure (HF) is an emerging problem in clinical practice, associated with high in-hospital mortality and a high short-term readmission rate. ⋯ In our registry, in-hospital mortality in patients admitted due to acute HF was slightly higher compared to other reports. Baseline values of some parameters (e.g. blood pressure, serum Na(+), renal function) as well as their changes during hospitalisation (e.g. serum K(+), renal function, plasma NT-proBNP) can help identify acute HF patients at a higher risk of in-hospital mortality.