Diagnosis and treatment complications of primary cardiac lymphoma in an immunocompetent 28-year old man: a case report.

BACKGROUND: Primary cardiac lymphomas (PCL) represent extremely rare cardiac tumors which are accompanied by poor prognosis, unless they are timely diagnosed and treated. CASE PRESENTATION: Herein we present a 28-year-old, immunocompetent man who presented to our hospital due to progressively worsening symptoms and signs of superior vena cava syndrome. Multi-modality imaging demonstrated a large intracardiac tumor, which was proven, by biopsy, to be a PCL. The patient received targeted chemotherapy which led to total remission of his disease, with no relapse over a 15-month follow-up period. CONCLUSIONS: Although PCLs are rare, they should always be kept in mind in the differential diagnosis of cardiac tumors. Timely diagnosis of PCLs and appropriate chemotherapy, alone or in combination with radiotherapy, seems to provide the best results.

Attitudes of healthcare professionals involved in cardiology practice towards key points of contemporary guidelines on resuscitation.

Hellenic J Cardiol. 2014; 55: 378-385. At the request of the authors, the name of the second author of this Original Research article has been changed from Athanasios Patialakas to Athanasios Patialiakas.

Attitudes of healthcare professionals involved in cardiology practice towards key points of contemporary guidelines on resuscitation.

INTRODUCTION: Cardiopulmonary resuscitation (CPR) is not always executed in compliance with contemporary guidelines and the quality of CPR may differ among hospitals within the same country or among categories of healthcare providers and medical specialties. The aim of this study was to assess attitudes of cardiology healthcare professionals towards CPR guidelines. METHODS: An anonymous questionnaire was posted online during 2009. Responders were asked about their age, gender, occupation, and training/experience in CPR. Responders' attitudes towards CPR were assessed using 7 questions regarding the accuracy of their opinions about the automated external defibrillator, public defibrillation programs, CPR performance, and therapeutic hypothermia. A score (0 to 7) was formed by assigning grade 1 to answers that accorded with European Resuscitation Council (ERC) guidelines and grade 0 to all other answers. The reliability analysis for this score yielded a Cronbach's alpha of 0.78. RESULTS: There were 544 responders (158 females), median age 34 years (30, 40). Median score was 5 (3, 6). Attending an ERC resuscitation course (beta=0.33, SE beta=0.05, p<0.001), age (beta=-0.15 SE beta=0.05, p=0.002), involvement in >10 CPRs /year (beta=0.19, SE beta=0.05, p<0.001), and being a physician (beta=0.17, SE beta=0.05, p=0.001) were all independent predictors of score. Attendance at an ERC course (OR: 2.7 [1.5 to 4.7]), being a physician (OR: 2 [1.3 to 5]) and involvement in >10 CPRs /year (OR: 1.7 [1.1 to 2.7]) were also independent predictors for attitudes that accorded with contemporary guidelines regarding therapeutic hypothermia. CONCLUSIONS: Attending an ERC resuscitation course, frequent involvement in CPR attempts, younger age, and being a physician were all independent predictors for more positive attitudes towards the guidelines. These factors, with the exception of age, were also associated with positive attitudes towards the implementation of therapeutic hypothermia.

Acute myocardial infarction in a patient with coronary artery aneurysm and Crohn's disease.

Crohn's disease is a chronic inflammatory disorder of unknown cause involving the gastrointestinal tract. Complications from the cardiovascular system seem to be uncommon in patients with Crohn's disease. We present a case of a 37-year-old man with a known history of Crohn's disease, who was admitted to our hospital with acute myocardial infarction. An aneurysm of a totally occluded circumflex coronary artery was revealed during the attempt at primary intervention. The artery was successfully opened and the aneurysm was sealed with the use of 2 covered stents.

Rapid desensitisation of patients with aspirin allergy who undergo coronary angioplasty.

INTRODUCTION: Although aspirin is the cornerstone of medication in patients with coronary artery disease, a minority of these patients have aspirin sensitivity. The aim of this study was to evaluate the efficacy and safety of an aspirin desensitisation protocol in patients scheduled for coronary angioplasty and stenting. METHODS: We used a challenge-desensitisation protocol in 11 patients (6 men, mean age 56 ± 9.6 years) who reported allergy to aspirin and were to undergo percutaneous coronary intervention with stent implantation. Eight had a history of cutaneous sensitivity, 1 had rhinitis, 1 reported urticaria and rhinitis, while another patient showed a respiratory response in the form of an asthma attack after taking aspirin in the past. Eight successive doses of aspirin were given (0.1, 0.3, 10, 30, 40, 81, 162, 325 mg) at intervals of 15-25 min over a total period of 2 h 15 min. RESULTS: All patients with aspirin sensitivity completed the desensitisation therapy successfully, without adverse effects, and subsequently underwent angioplasty and stenting. During follow up, the patients continued to take aspirin over 6-19 months without any problems. CONCLUSIONS: Rapid aspirin desensitisation is an effective and safe procedure for patients with aspirin allergy who are to undergo coronary angioplasty and stenting, allowing them to receive the optimum treatment.