Czynnościowa stenoza mitralna, migotanie przedsionków i niewydolność serca w następstwie ucisku przedsionka przez ograniczony krwiak okołoprzedsionkowy powstały podczas resuscytacji krążeniowej

A 53-year-old male patient was diagnosed with progressive dyspnoea after primary coronary intervention of circumflex lesion. Resuscitation was performed in the follow-up period due to the development of asystole. Control angiography showed patentstent without perforation signs and echocardiography revealed prominent compression of the left atrium by a periatrialmass. Magnetic resonance imaging (MRI) was performed for differential diagnosis. The MRI revealed an isolated periatrial haematoma compressing the left atrium and obliterating the mitral valve orifice. Haematoma formation had most probably occurred after resuscitation, since the initial echocardiogram was normal. After a one week follow-up, there had been no decrease in the size of the haematoma, and surgery was proposed. Left atrial compression by the formation of a periatrial haematoma related to resuscitation has not been reported before. It can cause atrial fibrillation and rapidly progressive heart failure. A more accurate diagnosis could be made using an MRI study

Acute myocardial infarction and pulmonary tuberculosis in a young female patient: a case report

Abstract Introductio

Obesity and uncontrolled diabetes predict depression in hf patients

Background and aim: Heart failure (HF) is a clinical syndrome associated with poor quality of life and prognosis, and premature mortality. The aim of this study was to assess the prevalence of depression and its risk factors in HF patients. Methods: The study included 151 HF patients (mean age of 66.6 ± 11 years, 52.3% female). Based on ejection fraction (EF), the study cohort was divided into the following two groups: group-I: HFpEF patients (EF ≥ 50%, n = 47) and group-II: HFrEF patients (EF < 40%, n = 104). For the enrolled patients, demographic, clinic and echocardiographic indices, and depression scale results were collected. Results: The patients with HF and depression were older, mostly females, more obese, and had a higher glycemic level and higher NYHA functional class compared with the patients without depression (p < 0.05 for all). The left ventricle (LV) and left atrial (LA) dimensions were larger, and EF was lower, in patients with depression compared to those without depression (p < 0.05 for all), while the right ventricle (RV) measurements did not differ (p > 0.05). The same parameters remained significantly different when the patients were divided into HFpEF and HFrEF. The depression scale correlated with glycemic level (r = 0.51, p = 0.01), obesity (rpb = 0.53, p = 0.001), age (r = 0.47, p = 0.02), and severity of NYHA class (rpb = 0.54, p = 0.001). On a multivariate model, BMI ≥ 30 kg/m2, OR 1.890 (1.199 to 3.551; 0.02) glycemic level ≥ 8.5 mmol/L, OR 2.802 (1.709 to 5.077; p = 0.01), and NYHA class > 2, OR 2.103 (1.389 to 4.700; p = 0.01), proved to be the most powerful independent predictors of depression, in the group as a whole. Obesity and uncontrolled diabetes predicted depression, irrespective of EF. Conclusions: In this modest cohort of HF patients, obesity and uncontrolled diabetes were independent predictors of depression, irrespective of LV systolic function. This emphasizes the important role of medical education for better control of such risk factors