Akutni infarkt miokarda u 58-godišnje žene s anomalnim polazištem lijeve koronarne arterije iz desnog Valsalvina sinusa

We report a case of a 58-year-old female with a history of hypertension, hypercholesterolemia and diabetes type 2, who was admitted to the coronary care unit with continuous substernal severe chest pain persisting for two hours. Her electrocardiogram showed ST-elevation acute myocardial infarction. ST-segment elevation was noted in leads I and aVL and ST-segment depression in leads II, III and V3-V5. The troponin-I level was elevated (1.97 ng/L). Coronary angiography showed anomalous origin of the left coronary artery from the right sinus of Valsalva and subocclusion in the proximal portion of the diagonal branch. In conclusion, primary percutaneous coronary intervention (PCI) of diagonal branch was performed with balloon dilatation and thrombolysis in myocardial infarction TIMI 3 flow was achieved. After PCI, she had no chest pain. At 5-year clinical follow-up, the patient was asymptomatic.Prikazujemo slučaj 58-godišnje žene koja boluje od hipertenzije, hiperkolesterolemije i dijabetesa melitusa tip 2 te koja je primljena u koronarnu jedinicu s bolovima u prsima u trajanju od dva sata. Elektrokardiogram je pokazivao infarkt miokarda sa ST elevacijom. Elevacija ST-segmenta bila je prisutna u I odvodu i aVL odvodu, a depresija ST-segmenta u odvodima II, III i V3-V5. Zabilježene su povišene vrijednosti troponina-I (1,97 ng/L). Koronarografija je pokazala anomalno polazište lijeve koronarne arterije iz desnog Valsalvina sinusa i subokluziju u proksimalnom dijelu dijagonalne grane. U zaključku, primarna perkutana intervencija (PCI) dijagonalne grane izvedena je balonskom dilatacijom uz postignut TIMI 3 protok. Nakon PCI bolesnica je bez bolova i u kliničkom praćenju od pet godina asimptomatska

Cardiovascular Implantable Electronic Devices and Electromagnetic Interference – Still a Hot Issue

U našemu svakodnevnom životu postalo je gotovo nemoguće ne biti u interakciji, aktivno ili pasivno, s različitim uređajima koji su izvori elektromagnetskih polja i kao takvi potencijalni uzroci elektromagnetske interferencije (EMI). Bolesnici s ugrađenim kardiovaskularnim implantabilnim uređajima (CIED) za liječenje aritmija čine specifičnu rizičnu skupinu na koju ovakvi signali mogu štetno utjecati. Valja imati na umu da je opseg ovoga problema (EMI u bolesnika s CIED-om) relativno malen – ali značajan; a kada se dogodi, u većini slučajeva, prolazne je prirode i lako se može izbjeći. No, ističe se važnost detaljnog razgovora s bolesnikom koji ima CIED, imajući na umu njegove specifične situacije i potrebe. Liječnici bi trebali biti svjesni i upoznati s najčešćim interakcijama EMI-ja i CIED-a.In our daily life it has become almost impossible not to interact, either actively or passively, with various devices that are sources of electromagnetic fields and thereby a potential cause of electromagnetic interference (EMI). Patients with cardiovascular implantable electronic devices (CIED) for treatment of arrhythmias represent a specific risk group that can be adversely affected by these signals. The scope of this problem (EMI in CIED recipients) is relatively small – but relevant, and when issues occur, in most cases they are of a transitory nature and can easily be avoided. However, it is of outmost importance to discuss the issue with patients that have a CIED, bearing in mind their specific situations and needs. Physicians should be aware of and familiarized with the most common interactions between EMI and CIED