[The Bland-White-Garland syndrome detected during qualification for surgery, due to significant mitral regurgitation]. / Zespól Blanda-White'a-Garlanda ujawniony w trakcie badan diagnostycznych u chorego kwalifikowanego do operacji z powodu duzej niedomykalnosci mitralnej.

A case of a 57-year-old patient admitted to the hospital due to aggravation of heart failure symptoms is presented. In ECHO examination severe mitral insufficiency was found. During coronary angiography ostium of left coronary artery from pulmonary trunk was found. The patient underwent cardiosurgery: artificial mitral valve implantation, bypass LIMA-LAD grafting and natural opening left coronary artery ligation.

[Suspected acute coronary syndrome in a patient with systemic scleroderma]. / Podejrzenie ostrego zespolu wiencowego u pacjentki z twardzina ukladowa.

We present a case of a 53-year-old female with systemic scleroderma who was admitted to the hospital due to suspected acute coronary syndrome. Coronary angiography revealed normal coronary arteries.

[The floating structure connected with endocavitary electrode--thrombus or bacterial vegetation?]. / Balotujaca struktura na elektrodzie endokawitarnej--skrzeplina czy wegetacja bakteryjna?

A case of a 52-year-old woman with complete atrioventricular block, treated with pacemaker implantation, is presented. During the control transthoracic echo exam we observed floating structure connected with the endocavitary electrode. After diagnostic examinations bacterial vegetation was excluded and thrombus was diagnosed. The therapy with unfractionated heparin and warfarin was successfully performed.

[Acute coronary syndrome in a female patient with multilevel atherosclerosis]. / Ostry zespól wiencowy u kobiety z wielopoziomowa miazdzyca.

A case of 74-years-old woman who was admitted to Department of Interventional Cardiology due to acute coronary syndrome is presented. The multilevel atherosclerosis was diagnosed. The patient was successfully treated with two-stage percutaneous coronary and peripheral revascularisation. During 6-months follow-up patient was in good condition.

[Borreliosis--simultaneous Lyme carditis and psychiatric disorders--case report]. / Borelioza--jednoczesne zajecie serca oraz zaburzenia psychiczne--opis przypadku.

Borreliosis is a multisystemic disease transmitted by ticks. Its diagnosis still remains a challenge because of the varied clinical picture and of difficulties in detection of the etiological agent (Borrelia burgdorferi). We report a case of a 53-years-old woman admitted to the Clinic of Cardiology due to life-threatening arhythmias with simultaneous deficits in concentration and memory. A suspicion of borreliosis was driven from the presence of cardiac symptoms as well as of psychiatric and from the case histories of a tick bite. The diagnosis was confirmed both by specific serological test and endomyocardial biopsy which revealed spirochetes. The patient responded to treatment with doxycyclin and ceftriaxone. Cardiologic disorders retreated entirely, while cognitive deficits did only partly.

[Lyme carditis--a bitter lesson or a delayed diagnostic success--a case report]. / Borelioza serca - gorzka lekcja czy spózniony sukces diagnostyczny? Opis przypadku.

Lyme carditis is a well known disorder; however, its diagnosis still remains a challenge because of varied clinical picture, low incidence rate and difficulties in detection of the aetiological agent (Borrelia burgdorferi). We report a case of a 60-year-old man with a 2.5-year history of dilated cardiomyopathy, recurring episodes of acute heart failure and arrhythmias which finally were diagnosed as Lyme carditis. The diagnosis was confirmed by endomyocardial biopsy that revealed spirochetes as well as by serological tests which showed complexed Borrelia antibodies. The patient responded to treatment with ceftriaxone and doxycycline.

Threshold parameters of left main coronary artery stem stenosis based on intracoronary ultrasound examination.

INTRODUCTION: The left main coronary stem (LMS) provides blood supply to the left ventricle, and its stenosis is associated with serious clinical consequences. The accurate assessment of LMS stenosis determines appropriate treatment and long term prognosis. So far no criteria have been established to correctly estimate the magnitude of problematic lesions as indicated by quantitative angiography (QCA). AIM: An attempt to establish intracoronary ultrasound (ICUS) threshold values of significant LMS stenosis. METHODS: The studied group consisted of 197 patients (mean age 69.72+/-8.51) who underwent percutaneous coronary intervention (PCI) of the left coronary artery. Group 1 (G1) consisted of 99 patients who had LMS diameter reduction (%DS) of less than 30%. Group 2 (G2) consisted of 77 patients with %DS between 30% and 50%, and the remaining 21 patients with %DS higher than 50% were classified as Group 3 (G3). The quantitative angiography (QCA) analysis included lumen diameter (Ldmin) which was LMS lumen diameter at the most stenotic segment as well as LMS diameter reduction (%DS). The parameters that were analysed during ICUS study included maximum plaque burden (%) (Pbmax), minimal lumen area (LAmin) and lumen stenosis (%LS) calculated according to the formula: (LAmin/LAref) x 100%. Additionally, correlations between the corresponding parameters measured using QCA and ICUS were investigated. RESULTS: Both diagnostic techniques showed the most advanced degree of atherosclerosis in G3. All the G3 patients and 5 G2 patients had MLD values less than or equal to 2 mm. In G1 LAmin values exceeded 9 mm(2) in all patients, whereas among G2 patients 12 (15.5%) had LAmin lower than 6 mm(2), 29 pts. (37.66%) within the range of 6-9 mm(2) and in the remaining 36 pts. (46.75%) it exceeded 9 mm(2). In G3 LAmin values in 17 pts. (80.95%) did not exceed 6 mm(2) and in the remaining 4 pts. (19.05%) were slightly higher. Lumen reduction higher than 50% was noted in all G3 patients and 3 G2 patients (in all these 3 G2 patients LAmin values were lower than 6 mm(2)). All G3 pts. and 3 G2 pts. with LAmin value <6 mm(2) and %LS >50% had angina and a positive stress ECG test. All of these patients (n=24) underwent LMS stent implantation. CONCLUSIONS: 1. Minimal lumen diameter of LMS < or = 2 mm in quantitative angiography indicates a very high probability of significant stenosis of this vessel. 2. Ultrasound data analysis shows that besides LMS lumen area (<9 mm(2)) stenosis significance is determined by lumen reduction of more than 50%.

[Right ventricular and tricuspid insufficiency following two ventricular pacemaker implantation]. / Prawokomorowa niewydolnosc serca z istotna niedomykalnoscia trójdzielna jako powiklanie implantacji stymulatora dwujamowego.

A case of a 76-year-old woman with a right ventricular failure and severe tricuspid insufficiency following permanent pacemaker implantation is presented.

[Acute myocardial infarction in pregnant woman]. / Ostry zawal serca u kobiety w ciazy.

The article presents a case of 30-year-old patient at her 30th week of pregnancy who was admitted to our clinic with non-ST elevation myocardial infarction resulting from coronary artery embolism. A successful recanalisation of the occluded artery by balloon angioplasty was performed.

[Tako-tsubo cardiomyopathy in a patient with hypertrophic cardiomyopathy with obstruction]. / Kardiomiopatia tako-tsubo u pacjentki z kardiomiopatia przerostowa z zawezaniem sródkomorowym lewej komory.

A 74 year-old patient was admitted to Invasive Cardiology Department. Non-ST elevation myocardial infarction was suspected. Patient has typical chest pain after strong stress. The normal coronary artery was found in coroangiography. The apical ballooning and almost closure in ½ of left ventricle cavity were found in ventriculography. The echocardiography shown asymmetric hypertrophy of heart walls and left ventricle outflow obstruction. The cardiac magnetic resonance was performed because of heart tumour was suspected.