Viral Nucleic Acids in the Serum Are Dependent on Blood Sampling Site in Patients with Clinical Suspicion of Myocarditis.

BACKGROUND: The meaning of viral nucleic acids in the myocardium in many cases is difficult for clinical interpretation, whereas the presence of viral nucleic acids in the serum is a marker of active infection. We determined the diagnostic value of viral nucleic acids in ventricular serum and peripheral serum samples in comparison with endomyocardial biopsy (EMB) specimens in patients with clinically suspected myocarditis. METHODS: The viral nucleic acid evaluation was performed in serum samples and EMB specimens by real-time PCR in 70 patients (age: 47 ± 16 years). The biopsy specimens were examined by histo- and immunohistochemistry to detect inflammatory response. RESULTS: The viral nucleic acids were detected in ventricular and peripheral serum, and EMB samples of 10 (14%), 14 (20%), and 32 (46%) patients, respectively. Notably, viral nucleic acids of the same virus as in the EMB sample were present more often in ventricular than in peripheral serum (60 vs. 7%, p = 0.01). A significant concurrence was observed between the positive and the negative results of viral nucleic acids present in EMB and ventricular serum (p = 0.0001). CONCLUSIONS: The detection of the same viral nucleic acid type in the myocardium and in ventricular serum being significantly more frequent than in the peripheral serum may suggest that the site of the blood collection is important for more precise and reliable confirmation of the active viral replication in the heart.

Transcatheter aortic valve implantation complicated by acute pericardial tamponade.

Transcatheter aortic valve replacement (TAVR) is now an accepted standard of care for patients with symptomatic severe aortic stenosis who are not candidates for surgery or have high surgical risk. Despite its more widespread adoption as a treatment option and increasing experience of centers, TAVR is still associated with several complications. We therefore report a case of TAVR complicated by acute pericardial tamponade, one of the most severe potential complications of this procedure. We describe the way we approached the problem and we try to give a potential take-home message for others who might encounter such a situation in their own cath lab.

[Arrythmogenic right ventricular cardiomyopathy in patient with abnormal origin of right coronary artery and ventricular tachycardia during exercises]. / Arytmogenna kardiomiopatia prawej komoryu chorego z anomalia tetnic wiencowychi czestoskurczem komorowym wywolanymwysilkiem fizycznym.

A 18-year-old patient with abnormal origin of right coronary artery and ventricular tachycardia during exercises is presented. Myocardial biopsy revealed arrhythmogenic right ventricular cardiomyopathy.

[Heart failure in female patient in peripartum period - how to determine the aetiology?]. / Niewydolnosc serca u chorej w okresie okoloporodowym ­ jak okreslac etiologie?

Peripartum cardiomyopathy (PPM) is an acquired disease of increasing incidence. Its diagnosis and treatment is often problematic. We report a case of 31-year-old woman who was diagnosed with PPM three weeks after delivery and died nine months later despite proper therapy.

[Reentrant ventricular tachycardia treated with RF ablation delivered through coronary sinus - a case report]. / Burza elektryczna w przebiegu ustawicznego nawrotnego czestoskurczu komorowego o lokalizacji epikardialnej skutecznie leczonego ablacja RF z dojscia przez zatoke wiencowa.

A case of a 58 year-old man with epicardially located reentrant ventricular tachycardia treated with RF ablation delivered through coronary sinus is presented. Based on multiple electrophysiological parameters (surface ECG, electroanatomical map collected from the endocardium, bipolar and unipolar endocardial recordings, and unsuccesful ablation attempts from the endocardial side) the tachycardia loop was found to be located epicardially. This allowed for successful ablation approach.