Pacjent z zawałem serca i zespołem metabolicznym

Na zespół metaboliczny składa się wiele zaburzeń metabolicznych, takich jak: otyłość trzewna, zaburzenia lipidowe, podwyższone ciśnienie tętnicze oraz hiperglikemia. Wiąże się on z podwyższonym ryzykiem rozwoju cukrzycy typu 2, predysponuje do rozwoju miażdżycy oraz chorób układu krążenia. Przedstawiony przypadek dotyczy 52-letniego otyłego pacjenta z zawałem serca i z kumulacją wielu czynników ryzyka, u którego w ostrym okresie zawału stwierdzono nieprawidłowe wartości glikemii

Myocardial infarction in a 24-year-old woman with secondary antiphospholipid syndrome - a case report

Myocardial infarction in a 24-year-old woman with secondary antiphospholipid syndrome - a case report: A case of a 24-year-old female patient with a secondary antiphospholipid syndrome is described. She had a history of pulmonary embolism occurring after miscarriage. One month later she was admitted to the hospital due to acute myocardial infarction. Coronary angiography revealed distal occlusions in the left anterior descending and left circumflex coronary arteries. Angioplasty was not effective. She received thrombolysis, heparin and finally improved after administration of high doses of corticosteroids. She was discharged from hospital, however, died four weeks later. The treatment and complications of the antiphospholipid syndrome are discussed

Chorzy trudni typowiPodejrzenie oporności na klopidogrel u chorego z nawracającą zakrzepicą w stencie

We desribe a case of an 81-year-old man with acute ST-elevation myocardial infarction (STEMI), who received a loading dose of clopidogrel (300 mg) and aspirin (ASA) (300 mg) prior to primary coronary intervention of critical left anterior descending coronary artery stenosis. Three days later he developed recurrent acute STEMI due to the in-stent thrombosis and a second stent implantation was performed. The dose of clopidogrel (75 mg) remained unchanged, while the dose of ASA was increased from 75 mg to 150 mg. Three days later the patient had an other STEMI due to the in-stent thrombosis and additional stent implantation with IIb/IIIa blocker was performed. Clopidogrel resistance was suspected. Therefore, clopidogrel was replaced by ticlopidine, the dose of ASA was increased and low-molecular heparin was administered. Since then, the patient has been clinically stable. Our case indicates the existence of a subgroup of patients with combined clopidogrel and ASA resistance