Pandemie covid-19 z pohledu kardiologa

Jan F. Vojáček

Interv Akut Kardiol. 2021;20(2):67-68 | DOI: 10.36290/kar.2021.009  

Pathology of covid-19

Václav Stejskal, Ivo Šteiner, Monika Manethová

Interv Akut Kardiol. 2021;20(2):69-72 | DOI: 10.36290/kar.2021.022  

In covid-19, the basic lesion is interstitial pneumonia presenting as diffuse alveolar damage. However, unlike DAD/ARDS from other causes, there are several rather specific histopathological features: in the lung parenchyma, there is frequently a combination of all stages of DAD - acute, subacute, and chronic; platelet, and fibrin-rich thrombi are found in all types of pulmonary vessels - microcirculation, arteries, and veins, with formation of lung infarctions; the inflammation has a marked hemorrhagic character - alveolar bleeding; presence of atypical activated type II pneumocytes; unusual ("naked") megakaryocytes within the microvasculature; presence...

Pathogenesis of covid-19: principles of viral infection and immune response

Jiří Beneš, Dana Nováková

Interv Akut Kardiol. 2021;20(2):73-77 | DOI: 10.36290/kar.2021.023  

SARS-CoV-2 infection manifests itself with several clinical forms, from an asymptomatic course to a life-threatening multiple-organ dysfunction. In terms of pathogenesis, these clinical forms can be divided into a group of mucosal infections (respiratory tract infections, gastroenteritis) and internal organ infections (especially pneumonia). Of particular concern is the dysregulated immune response associated with the production of proinflammatory cytokines (IL-1, IL-6, TNFα) which is otherwise typical of severe bacterial infections. Knowledge of the pathogenetic context allows for better interpretation of the virological and serological findings...

Cardiovascular complications and covid-19 infection

Petr Pařízek

Interv Akut Kardiol. 2021;20(2):78-80 | DOI: 10.36290/kar.2021.024  

Although the covid-19 disease predominantly affects the respiratory system, its negative effect on the cardiovascular system is also well known. The aim of this article is to present the causes and pathophysiological mechanisms of cardiovascular abnormalities during and after a covid-19 infection.

Covid-19 and myocardial infarction

Jaroslav Dušek, Josef Bis, Josef Šťásek

Interv Akut Kardiol. 2021;20(2):82-85 | DOI: 10.36290/kar.2021.025  

The worldwide pandemic caused by the novel acute respiratory syndrome coronavirus 2 has resulted in a new lethal disease termed coronavirus disease 2019 (covid-19). Although there is an association between cardiovascular disease and covid-19, the majority of patients who require cardiovascular care for the management of ischemic heart disease may not be infected with this novel coronavirus. Cardiovascular manifestations of covid-19 are complex with patients presenting with acute myocardial infarction, myocarditis simulating an ST-elevation myocardial infarction (STEMI), stress cardiomyopathy, non-ischemic cardiomyopathy, coronary spasm, or nonspecific...

Overview of cardiovascular inolvement in patients with covid-19 infection

Martin Radvan, Martin Kameník, Lumír Koc, Svatopluk Richter, Petr Kala

Interv Akut Kardiol. 2021;20(2):86-90 | DOI: 10.36290/kar.2021.026  

Coronavirus disease 2019 (covid-19) is an infectious disease caused by a novel coronavirus, named severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). The mortality increases in patients older than 60 years. Younger patients with underlying serious chronic diseases are endangered by a fatal course of this infection as well. Cardiovascular manifestations of SARS-CoV-2 infection are diverse and include acute coronary syndromes, myocarditis, heart failure, arrhythmias, pericardial effusion, and thromboembolic complications. Direct and indirect myocardial injury is common in moderate and severe disease course. Troponin elevation is a marker of...

Problems of care for STEMI patients in coronavirus pandemic

Stanislav Šimek

Interv Akut Kardiol. 2021;20(2):93-97 | DOI: 10.36290/kar.2021.027  

The covid-19 pandemic negatively affects time-dependent care and the course of STEMI in several aspects: Conclusion: It is apparent that STEMI in covid-19 infected patients is not the same disease process as STEMI that without covid-19 infection. Patients with STEMI and covid-19 have a higher risk of heart failure, cardiac arrest, cardiogenic shock, greater intracoronary thrombosis and stent thrombosis, resulting in higher cardiac and non-cardiac mortality. Aggressive antithrombotic treatment is recommended. Even in the covid era it is essential to insist on timely treatment of STEMI. Training of cardiac catheterization personnel on how to use personal...

Thrombotic complications of covid-19: a brief review of current opinions

Jan F. Vojáček

Interv Akut Kardiol. 2021;20(2):98-101 | DOI: 10.36290/kar.2021.028  

Thrombotic complications in covid-19 patients affect the vessels of the lungs, limbs, spleen, heart, brain and/or kidneys (1). These complications are typically associated with multiple organ failure and a high mortality rate. Pulmonary embolism and deep vein thrombosis are the most frequent thrombotic events in covid-19 (1). The risk of venous thromboembolism remains high in hospitalized patients in spite of anticoagulation prophylaxis. Cytokines, protein proinflammatory mediators serving as a key signalling pathway, are responsible for a shift of endothelial function from homeostatic to defensive mode. A critical covid-19 stage usually involves a...

Mid-term results of percutaneous treatment of severe mitral regurgitation with MitraClip in patients with heart failure

Michaela Červinková, Jiří Hlaváček, Petr Vojtíšek, Martin Kvašňák, Pavel Červinka

Interv Akut Kardiol. 2021;20(2):102-105 | DOI: 10.36290/kar.2021.029  

Objective: The authors present mid-term results of percutaneous treatment of mitral insufficiency using the MitraClip system (Abbott Vascular, Santa Clara, CA, USA). Methodology: The group consists of 59 patients with severe mitral regurgitation and heart failure in whom cardiac surgery was contraindicated (EuroScore II 8.1 %). The average age was 71 years (± 13), most of which were male (56 %). The left ventricular ejection fraction was 32.5 ± 6.5 %, the majority (79 %) of patients were NYHA class 3/4. Results: The procedure was technically successful in 100 % of cases. Immediately after the procedure, the mean mitral regurgitation was reduced...

Pětileté výsledky po STEMI v éře primární PCI

Viktor Klančík, Viktor Kočka

Interv Akut Kardiol. 2021;20(2):106-110 | DOI: 10.36290/kar.2020.048  

Tento přehledový článek shrnuje informace dostupné z dlouhodobého sledování pacientů po infarktu myokardu s elevacemi ST úseku (STEMI) v éře primární perkutánní koronární intervence (p-PCI). Jeho hlavním cílem je poskytnout přehled o dlouhodobé celkové mortalitě, kardiální mortalitě a závažných nežádoucích kardiovaskulárních příhodách (MACE). Vyhledali jsme a analyzovali studie s pětiletým a delším obdobím sledování publikované od ledna 2001 do prosince 2019. Do přehledu jsme zařadili pouze studie týkající se p-PCI. Celková mortalita v pěti letech sledování byla 9,3-23,3 % a roční celková mortalita se v letech, které následovaly po uplynutí prvního...

What antithrombotic treatment is required in a patient after TAVI in the year 2021?

Andrea Širáková, Petr Toušek, Hana Línková, Viktor Kočka

Interv Akut Kardiol. 2021;20(2):111-115 | DOI: 10.36290/kar.2021.001  

Transcatheter aortic valve implantation (TAVI), as is the case with all bioprosthetic valves, requires the use of antithrombotic therapy to minimise thromboembolic and ischaemic events while keeping the incidence of bleeding complications low. Periprocedural and long-term antithrombotic strategy after TAVI was, from the beginning, empirically based on the treatment administered after percutaneous coronary interventions. Current guidelines for antithrombotic therapy after TAVI are based on experience and consensus of experts; however, there are significant practice variations among different hospitals and countries. This article aims to provide an overview...

Úspěšná sklerotizace perikardu bleomycinem u plicního adenokarcinomu s masivním recidivujícím perikardiálním výpotkem

Ivana Purnama Dewi, Ismail Damanik, Dita Aulia Rachmi, Kristin Purnama Dewi, Rochmad Romdoni

Interv Akut Kardiol. 2021;20(2):116-120 | DOI: 10.36290/kar.2021.004  

Úvod: Závažnou komplikací u několika typů rakoviny je maligní perikardiální výpotek (MPV). Ten může mít za následek srdeční tamponádu, život ohrožující stav s nutností urgentní drenáže. I když prostá perikardiocentéza přináší úlevu od příznaků, pokud nepodnikneme další kroky, dochází často k recidivě MPV. Nejčastěji zvažovanými postupy jsou trvalá drenáž, talkáž antineoplastickými léky nebo chirurgické vytvoření pleuroperikardiálního okénka. Popis případu: Muž, 53 let, stěžující si na dušnost dva týdny před přijetím do nemocnice. Den před příjmem se jeho obtíže údajně ještě zhoršily. Pacient má v anamnéze plicní adenokarcinom a během posledního 1,5...

Initial experience with Amplatzer™ Trevisio™ delivery cable in atrial septal defect closure in a child in the Czech Republic

Ondřej Materna, Jan Kovanda, Michal Jičínský, Petr Tax, Oleg Reich

Interv Akut Kardiol. 2021;20(2):121-122 | DOI: 10.36290/kar.2021.012  

We report our initial experience with atrial septal defect closure using the new Amplatzer™ Trevisio™ delivery cable in the Czech Republic. The difference in angulation of the device during implantation using a standard delivery cable and the new Trevisio™ cable was compared on fluoroscopic images.