Pouzdanost kompjuterizovanih kefalometrijskih predviđanja rezultata hirurške korekcije mandibularnog prognatizma

Introduction. A successful treatment outcome in dentofacial deformity patients commonly requires combined orthodontic-surgical therapy. This enables us to overcome functional, aesthetic and psychological problems. Since most patients state aesthetics as the primary motive for seeking therapy, cephalometric predictions of treatment outcome have become the essential part of treatment planning, especially in combined orthodontic-surgical cases. Objective. The aim of this study was to evaluate the validity and reliability of computerized orthognathic surgery outcome predictions generated using the Nemotec Dental Studio NX 2005 software. Methods. The sample of the study consisted of 31 patients diagnosed with mandibular prognathism who were surgically treated at the Hospital for Maxillofacial Surgery in Belgrade. Investigation was done on lateral cephalograms made before and after surgical treatment. Cephalograms were digitized and analyzed using computer software. According to measurements made on superimposed pre- and postsurgical cephalograms, the patients were retreated within the software and the predictions were assessed by measuring seven angular and three linear parameters. Prediction measurements were then compared with the actual outcome. Results. Results showed statistically significant changes between posttreatment and predicted values for parameters referring to lower lip and mentolabial sulcus position. Conclusion. Computerized cephalometric predictions for hard-tissue structures in the sagittal and vertical planes, as well as the VTO parameters, generated using the Nemotec Dental Studio NX 2005 software are reliable, while lower lip and mentolabial sulcus position predictions are not reliable enough.Uvod. Radi postizanja što boljih krajnjih rezultata, osobe sa dentofacijalnim deformitetima najčešće se leče kombinovanom ortodontsko-hirurškom terapijom. Na taj način rešavaju se funkcionalni, estetski i psihološki problemi. Kako najveći broj pacijenata navodi estetsku promenu kao primarni motiv lečenja, kefalometrijsko predviđanje ishoda je važan deo planiranja terapije, posebno kod složenih slučajeva. Cilj rada. Cilj rada je bio da se proceni preciznost i pouzdanost predviđanja ishoda hirurške korekcije mandibularnog prognatizma razvijenih u okviru kompjuterskog softvera Nemotec Dental Studio NX 2005. Metode rada. Ispitan je 31 pacijent s mandibularnim prognatizmom koji je operisan na Klinici za maksilofacijalnu hirurgiju Stomatološkog fakulteta Univerziteta u Beogradu. Istraživanje je izvedeno na profilnim teleradiogramima snimljenim pre i posle hirurške intervencije. Nakon digitalizacije snimaka izvršena je kompjuterizovana kefalometrijska analiza. Na osnovu merenja određenih horizontalnih i vertikalnih rastojanja na preoperacionim i postoperacionim radiogramima, urađena je simulacija hirurških korekcija i na njima izmerena vrednost sedam angularnih parametara i tri linearna parametra, čija je vrednost upoređena s vrednostima na postoperacionim radiogramima. Rezultati. Ustanovljene su statistički značajne razlike između postoperacionih i predviđenih vrednosti za parametre koji govore o položaju donje usne i mentolabijalnog sulkusa. Zaključak. Kompjuterizovana kefalometrijska predviđanja položaja čvrstotkivnih struktura u sagitalnoj i vertikalnoj ravni, kao i VTO parametara, dobijena u okviru korišćenog programa su pouzdana, dok su predviđanja položaja donje usne i mentolabijalnog sulkusa nedovoljno pouzdana

Terapijski efekti tri vrste funkcionalnih aparata u lečenju malokluzija II skeletne klase - sagitalne i vertikalne promene

Introduction/Objective Class II malocclusions are sagittal malocclusions characterized by a distal relationship of posterior teeth. Depending on the underlying problem, Class II malocclusions can be skeletal or dentoalveolar. Class II malocclusion treatment modality will depend on the cause, severity, and age. Growth modification is the best treatment option in growing patients with skeletal Class II malocclusions. The aim of this study was to establish and compare sagittal and vertical skeletal and dental changes in patients treated with the 'M block' appliance, the Frankel functional regulator, and the Balters' bionator. Methods The sample consisted of 70 patients diagnosed with skeletal Class II malocclusions (ANB > 4°) and mandibular retrognathism (SNB lt 80°). The patients were divided into three groups according to the type of appliance. All the patients went through the standard diagnostic procedure (anamnesis, clinical and functional analysis, study model, panoramic radiograph, and cephalometric analysis), and dental and skeletal age was determined. Treatment effects were analyzed on study models and cephalograms at the end of treatment. Results All the appliances led to significant mandibular anterior movement and sagittal growth, which reduced the ANB values. All three groups of patients presented with neutral growth pattern, upper incisor retrusion, and lower incisor protrusion at the end of treatment. Conclusion The results of this study indicate efficacy of all three appliances in skeletal Class II malocclusion treatment.Uvod/Cilj rada Malokluzije II klase su sagitalne nepravilnosti zagrižaja koje karakteriše distalni odnos bočnih zuba. U zavisnosti od toga koje strukture su u nepravilnom odnosu, dele se na skeletne i dentoalveolarne. Terapija II klase zavisi od uzroka, izraženosti i uzrasta. Najbolji vid terapije ukoliko pacijenti i dalje rastu je modifikacija rasta. Cilj ove studije bio je da se utvrde i uporede sagitalne i vertikalne promene na skeletnim i dentalnim strukturama u toku lečenja M blok-aparatom, Frenklovim regulatorom funkcije tip I i bionatorom po Baltersu tip I. Metode Sedamdeset ispitanika sa dijagnozom skeletnog distalnog zagrižaja (ANB > 4°) i mandibularnog retrognatizma (SNB lt 80°), prema vrsti aparata, podeljeni su u tri grupe. Svi su prošli kroz standardnu dijagnostiku (anamneza, klinička i funkcionalna analiza, analiza studijskih modela, ortopantomografskog i profilnog telerendgenskog snimka). Terapijski efekti i promene analizirani su na studijskim modelima i profilnom snimcima po završetku terapije. Rezultati Sva tri aparata dovela su do značajnog mezijalnog usmeravanja i sagitalnog rasta mandibule, što je smanjilo ANB ugao. U sve tri grupe je utvrđen neutralni rast, kao i retruzija gornjih i protruzija donjih sekutića. Zaključak Rezultati studije ukazuju na efikasnost sva tri ispitivana aparata u lečenju skeletnih malokluzija II klase

Hyperbaric oxygenation in prevention of amputations of diabetic foot

Background/Aim. Diabetic foot is the term for the pathological changes on foot in patients with diabetes. It is caused by diabetic angiopathy, polyneuropathy and osteoarthropathy. The treatment is complex and long-term and often leads to the loss of the extremity. The appliance of hyperbaric oxygen therapy (HBOT) has a lot more important place in adjuvant treatment of this disease. The aim of this study was to determine the influence of HBOT on the wound healing in comparison with the conventional treatment, the possibility of shortening the time of the treatment in patients with diabetic foot. Methods. In a five-year period a retrospective-prospective multicentric study, involving 60 patients with diabetic foot divided into two groups, was performed. The first group (group A) consisted of 30 patients treated by combined therapy (with medications, surgical therapy and HBOT). All the patients were receiving HBOT in the Special Hospital for Hyperbaric Medicine, CHM Hollywell-Neopren in Belgrade. The control group (group B) also consisted of 30 patients treated with medications and surgical therapy, but without HBOT. Results. The demographic data, the types of diabetes, as well as the Wagner classification stage of diabetic ulcers and radiography scans of changes in bones were equal in both groups. The median healing time of the Wagner grade III ulcer in the group A was 37.36 days [mean +/- standard deviation (SD) = 65.6 +/- 45.8 days], and in the group B 99.78 days (mean +/- SD = 134.8 +/- 105.96 days) and it was statistically significant (p = 0.074). The median time of recovery in patients of the group A with the Wagner grade IV was 48.18 days (mean +/- SD = 49.7 +/- 33.8 days), and in the group B 85.05 days (mean +/- SD = 86.7 +/- 71.6 days) and that was statistically significant (p = 0.121). The foot amputations were performed in both groups in 3 (10%) patients. In the group A there were no high amputations, whereas in the group B there were 4 (13.33%) below-knee amputations and 4 (13.33%) above-knee amputations which was highly statistically significant (p lt 0.0001). Conclusion. In this study, HBOT definitely showed positive adjuvant role in the treatment of diabetic foot. For the good treatment result it is essential the timely and successful surgical treatment of the ulcer and the use of bandage with the healing dressings. In case of the clear signs of local infection, the antibiotic therapy according to the antibiogram is necessary

Hipodoncija i mutacija WNT10A gena - prikaz slučaja

Tooth agenesis is common dentofacial malformation in humans. Its etiology is still not clear. Hypodontia has been regarded as a multifactorial condition influenced by gene function, environmental interaction and developmental timing. More than 300 genes have been related with patterning, morphogenesis and cell differentiation in teeth. According to data WNT10A gene is considered to have an important role in odontogonesis. The aim of this study was to show mutation status in WNT10A gene in a family with two members with diagnosis of hypodontia/oligodontia. In the reported family (father, mother, son, daughter) children were diagnosed with congenital tooth agenesis (son-2 teeth, daughter-11 teeth), while parents negated congenital absence of teeth. We identified a heterozygous missense mutation, c.682T>A (p.Phe228Ile) within the exon 3 of WNT10A in mother and father and the same homozygous mutation was detected in the same region of WNT10A gene in daughter and son. Observed differences in our study, from no symptoms to mild/severe hypodontia, could be the consequence of genetic influence of c.682T>A(p.Phe228Ile) mutation, but also the contribution of many environmental factors during odontogenesis.Urođeni nedostatak zuba predstavlja jednu od najčešćih dentofacijalnih anomalija kod čoveka. Etiologija hipodoncije i dalje nije potpuno definisana i smatra se da su za njenu etiologiju odgovorni brojni genetski i sredinski faktori koji deluju u različitim fazama razvoja zuba. Preko 300 gena povezuje se sa morfogenezom i ćelijskom diferencijacijom u toku razvoja zuba, a prema podacima WNT10A gen je jedan od gena koji ima veoma bitnu ulogu u kontroli odontogeneze. Cilj ovog rada bio je da se prikaže mutacioni status WNT10A gena u porodici sa dijagnostikovanom hipodoncijom/oligodoncijom. U prikazanoj porodici (otac, majka, sin i ćerka) kod dva člana dijagnostikovan je urođeni nedostatak zuba (sin - dva zuba, ćerka - 11 zuba), dok kod roditelja ovaj nedostatak nije zabeležen. Kod svih članova porodice, u okviru egzona 3 WNT10A gena detektovana je mutacija c.682T>A (p.Phe228Ile). Kod majke i oca ova 'missense' mutacija je bila u heterozigotnom obliku, dok je kod sina i ćerke utvrđeno prisustvo iste mutacije u homozigotnom obliku. Zabeležene razlike u analiziranoj porodici, od odsustva simptoma do blage hipodoncije i izrazite oligodoncije, mogu biti posledica prisustva c.682T>A (p.Phe228Ile) mutacije, ali takođe i uticaja faktora sredine u toku odontogeneze

Direct correlation between compression stockings and venotonics (Diosmins) and flow vein diseases in stomatology students

Diseases of veins are considered one of the most common diseases of modern man, right after caries of teeth. Those diseases usually come to exist as a result of genetic and/or other pre-dispositioning factors, however, in most cases, those factors can be effectively tamed through preventive and therapeutic methods. Two studies were carried out on randomly selected third and fourth year stomatology college students. In the first study, we solely focused on the effects of monotherapy compression stockings. The second study was a continuation of the first and the respondents were asked to take venotonic Diosmin (Detralex 1000 mg) in addition to wearing compression stockings. In the group of 30 patients, 49% had positive family history of the disease, and in total, 70% showed signs of discomfort and diseases related to venous system. Ten respondents who showed major problems or pathological changes, were given custom made Sigvaris graduated compression stockings, which they wore for eight weeks. Final results of the first study showed that the feeling of heaviness in the legs reduced in 55.55% of respondents, while 66.66% patients recorded reduced pain in legs when standing for a long time. Issues of swelling of the bottom of the feet and lower legs disappeared for all patients. In the second study, which included adding a dose of Diosmin in addition to compression stockings, 66.66% of the patients saw signs of heaviness feeling in the legs improve, 77.77% recorded that pain in the legs when standing for a long time decreased and 100% of patients saw swelling of the bottom of the feet and lower legs disappear. This eight week study was too short to show significant signs of improvement in varicose, however, we expect that in six months, patients will begin to show signs of improvement in varicose altered veins. When comparing the results of the first and second study, we concluded that the three-month combination therapy of compression stockings and Diosmin yielded 12.5% better results of reduction of the following symptoms: feeling of heaviness in the legs, pain in the legs when standing for a long time, then when just using the compression socks (study 1).Oboljenja vena spadaju u najučestalije bolesti savremenog čoveka,odmah posle kariesa zuba. Na njihov nastanak utiču nasledni i stečeni faktori. Stečeni fatori rizika najčešće su okidač za aktiviranje naslednih faltora (predispozicije) na koje se može efikasno delovati, kako preventivno tako i terapijski. U Hirurškoj klinici KBC Zvezdara, nastavnoj bazi Stomatološkog fakulteta Univerziteta u Beogradu, sprovedene su dve studije na studentima IV i V godine slučajnim izborom ispitanika. U prvoj studiji su opservirani efekti monoterapije kompresivnim čarapama na tok oboljenja vena, druga studija je nastavak prve i ispitanici su pored kompresivnih čarapa uzimali i venotonik Diosmin (Detralex 1000 mg). U grupi od 30 ispitanika znake oboljenja vezane za venski sistem pokazalo je 70% ispitanika, a pozitivnu porodičnu anamnezu je imalo 49% ispitanika. Deset ispitanika je imalo značajne tegobe ili patološke promene koje su zahtevale neku terapiju i dobili su graduisane kompresivne čarape po meri firme Sigvaris, koje su nosili 8 nedelja. Završni rezultati prve studije pokazali su da je poboljšanje osećaja težine u nogama osetilo 55,55% ispitanika, smanjenje bolova u nogama pri dužem stajanju zabeleženo je kod 66,66% ispitanika, otoke stopala i potkolenica nije imao više nijedan ispitanik (smanjenje tegoba 100%) U drugoj studiji, u kojoj je pored kompresivnih čarapa bio uključen i venotonik nakon osam nedeljne primene kombinovane terapije poboljšanje simptoma osećaja težine u nogama osetilo je 66,66% ispitanika, bolove kod dužeg stajanja 77,77%, dok se i u ovoj studiji pokazalo da otoke stopala i potkolenica na kraju studije nije imao nijedan ispitanik (100% poboljšanje). Za povlačenje varikoziteta je studija bila suviše kratka ali posle 6 meci je za očekivati i poboljšanje stanja varikozno izmenjenih vena. Komparacijom rezultata prve i druge studije došli smo do zaključka da je tromesečna kombinovana terapija kompresivnim čarapama i venotonikom dala bolje rezultate za 12,5% u smanjenju simptoma osećaja težine u nogama i bolova u nogama pri dužem stajanju u odnosu na monoterapiju samo kompresivnim sredstvima

Terapija malokluzija III klase u ranoj mešovitoj denticiji - prikaz dva slučaja

Class III malocclusion is orthodontic anomaly where mandibular arch is in mesial position to maxillary arch. Reasons for Class III malocclusion can be found in mandibular prognathism, maxillar retrognathism or combination of these two. In most cases of mandibular prognathism, it is necessary to postpone the treatment until the growth ceases. However, if certain conditions are accomplished it is possible to start early treatment of class III malocclusion to improve occlusal relations and provide more favorable environment for future growth. The aim of this study was to present treatment of two patients with Class III maloclussion in early mixed dentition, using two different appliances: Delaire mask and Frankel functional regulator type 3. The treatment with Delaire mask resulted in rotation of maxilla downward and forward due to the angle of extraoral part of the mask to the occlusal plane that was modified to be almost 45°. At the end of the treatment facial esthetics was significantly improved. Moving maxilla forward resulted in straight profile, whereas moving maxilla downward lead to coordination of upper, middle and lower facial third. The result of the treatment in patient who used Frankel functional regulator was correction of anterior crossbite by premaxilla development and incisors protrusion. Significant differences in SNA, SNB and ANB angle values at the beginning and at the end of the treatment were not found suggesting that most changes were dental but not skeletal.Skeletna malokluzija III klase je nesklad u međusobnom odnosu gornje i donje vilice, jer je donja vilica postavljena mezijalnije u odnosu na gornju. Uzrok nastanka skeletne malokluzije III klase može biti mandibularni prognatizam, maksilarni retrognatizam ili kombinacija ova dva uzroka. U slučaju isuviše razvijene donje vilice najčešće je potrebno sačekati završetak rasta, kako bi se primenilo konačno lečenje. Međutim, ako su ispunjeni određeni uslovi, moguće je primeniti ranu terapiju III klase, da bi se poboljšali okluzalni odnosi i obezbedila dobra osnova za dalji rast. Cilj ovog rada bio je da se prikaže terapijski efekat dva slučaja malokluzije III klase u ranom uzrastu pomoću različitih ortodontskih aparata: Delerove maske i Frenklovog regulatora funkcije tip 3. Kod pacijentkinje koja je tokom lečenja nosila Delerovu masku gornja vilica je zarotirana unapred i nadole, jer je ugao delovanja sile modifikovan da bude skoro 45 stepeni. Na kraju lečenja postignut je znatno bolji izgled lica. Pomeranjem gornje vilice unapred postignut je prav profil, dok je pomeranje nadole dovelo do usklađivanja visine srednje trećine lica sa gornjom i donjom. Kod pacijenta kod kojeg je tokom lečenja primenjena terapija Frenklovim regulatorom funkcije tip 3 do korekcije obrnutog preklopa sekutića došlo je kombinacijom razvijanja premaksile i protruzije sekutića. Značajne promene u vrednostima uglova SNA, SNB i ANB nisu zabeležene na kraju terapije u odnosu na početak, što bi ukazivalo na to da su postignute promene uglavnom dentalne, a ne skeletne

The treatment of class III malocclusion in early mixed dentition: Two case reports

Class III malocclusion is orthodontic anomaly where mandibular arch is in mesial position to maxillary arch. Reasons for Class III malocclusion can be found in mandibular prognathism, maxillar retrognathism or combination of these two. In most cases of mandibular prognathism, it is necessary to postpone the treatment until the growth ceases. However, if certain conditions are accomplished it is possible to start early treatment of class III malocclusion to improve occlusal relations and provide more favorable environment for future growth. The aim of this study was to present treatment of two patients with Class III maloclussion in early mixed dentition, using two different appliances: Delaire mask and Frankel functional regulator type 3. The treatment with Delaire mask resulted in rotation of maxilla downward and forward due to the angle of extraoral part of the mask to the occlusal plane that was modified to be almost 45°. At the end of the treatment facial esthetics was significantly improved. Moving maxilla forward resulted in straight profile, whereas moving maxilla downward lead to coordination of upper, middle and lower facial third. The result of the treatment in patient who used Frankel functional regulator was correction of anterior crossbite by premaxilla development and incisors protrusion. Significant differences in SNA, SNB and ANB angle values at the beginning and at the end of the treatment were not found suggesting that most changes were dental but not skeletal

Uticaj graduisanih kompresivnih čarapa i venotonika (diosmina) na tok oboljenja vena kod studenata stomatologije

Diseases of veins are considered one of the most common diseases of modern man, right after caries of teeth. Those diseases usually come to exist as a result of genetic and/or other pre-dispositioning factors, however, in most cases, those factors can be effectively tamed through preventive and therapeutic methods. Two studies were carried out on randomly selected third and fourth year stomatology college students. In the first study, we solely focused on the effects of monotherapy compression stockings. The second study was a continuation of the first and the respondents were asked to take venotonic Diosmin (Detralex 1000 mg) in addition to wearing compression stockings. In the group of 30 patients, 49% had positive family history of the disease, and in total, 70% showed signs of discomfort and diseases related to venous system. Ten respondents who showed major problems or pathological changes, were given custom made Sigvaris graduated compression stockings, which they wore for eight weeks. Final results of the first study showed that the feeling of heaviness in the legs reduced in 55.55% of respondents, while 66.66% patients recorded reduced pain in legs when standing for a long time. Issues of swelling of the bottom of the feet and lower legs disappeared for all patients. In the second study, which included adding a dose of Diosmin in addition to compression stockings, 66.66% of the patients saw signs of heaviness feeling in the legs improve, 77.77% recorded that pain in the legs when standing for a long time decreased and 100% of patients saw swelling of the bottom of the feet and lower legs disappear. This eight week study was too short to show significant signs of improvement in varicose, however, we expect that in six months, patients will begin to show signs of improvement in varicose altered veins. When comparing the results of the first and second study, we concluded that the three-month combination therapy of compression stockings and Diosmin yielded 12.5% better results of reduction of the following symptoms: feeling of heaviness in the legs, pain in the legs when standing for a long time, then when just using the compression socks (study 1).Oboljenja vena spadaju u najučestalije bolesti savremenog čoveka,odmah posle kariesa zuba. Na njihov nastanak utiču nasledni i stečeni faktori. Stečeni fatori rizika najčešće su okidač za aktiviranje naslednih faltora (predispozicije) na koje se može efikasno delovati, kako preventivno tako i terapijski. U Hirurškoj klinici KBC Zvezdara, nastavnoj bazi Stomatološkog fakulteta Univerziteta u Beogradu, sprovedene su dve studije na studentima IV i V godine slučajnim izborom ispitanika. U prvoj studiji su opservirani efekti monoterapije kompresivnim čarapama na tok oboljenja vena, druga studija je nastavak prve i ispitanici su pored kompresivnih čarapa uzimali i venotonik Diosmin (Detralex 1000 mg). U grupi od 30 ispitanika znake oboljenja vezane za venski sistem pokazalo je 70% ispitanika, a pozitivnu porodičnu anamnezu je imalo 49% ispitanika. Deset ispitanika je imalo značajne tegobe ili patološke promene koje su zahtevale neku terapiju i dobili su graduisane kompresivne čarape po meri firme Sigvaris, koje su nosli 8 nedelja. Završni rezultati prve studije pokazali su da je poboljšanje osećaja težine u nogama osetilo 55,55% ispitanika, smanjenje bolova u nogama pri dužem stajanju zabeleženo je kod 66,66% ispitanika, otoke stopala i potkolenica nije imao više nijedan ispitanik (smanjenje tegoba 100%) U drugoj studiji, u kojoj je pored kompresivnih čarapa bio uključen i venotonik nakon osam nedeljne primene kombinovane terapije poboljšanje simptoma osećaja težine u nogama osetilo je 66,66% ispitanika, bolove kod dužeg stajanja 77,77%, dok se i u ovoj studiji pokazalo da otoke stopala i potkolenica na kraju studije nije imao nijedan ispitanik (100% poboljšanje). Za povlačenje varikoziteta je studija bila suviše kratka ali posle 6 meci je za očekivati i poboljšanje stanja varikozno izmenjenih vena. Komparacijom rezultata prve i druge studije dosli smo do zaključka da je tromesečna kombinovana terapija kompresivnim čarapama i venotonikom dala bolje rezultate za 12,5% u smanjenju simptoma osećaja težine u nogama i bolova u nogama pri dužem stajanju u odnosu na monoterapiju samo kompresivnim sredstvima

ODGOĐENA MANIFESTACIJA MIOKARDITISA NAKON COVID-A

: Myocardial involvement of coronavirus disease 2019 (COVID-19) varies and is considered to be more serious in patients with severe COVID-19 clinical presentation. Although myocarditis is usually recognized in the setting of acute SARS-CoV-2 infection, delayed manifestations are recognized as well. Case report. A 51-year-old male patient was admitted due to the clinical signs of congestive heart failure, two months after moderate clinical expression of COVID-19 pneumonia, treated as an outpatient. Transthoracic echocardiography (TTE) revealed dilated cardiomyopathy with the presence of diffuse left ventricular (LV) hypokinesia, severely reduced ejection fraction (EF 18%) and diastolic dysfunction with increased left atrial filling pressure. Baseline laboratory tests revealed elevated hs-troponin I, NT-proBN. Diagnostic workout excluded coronary artery disease. Cardiac magnetic resonance imaging strongly pointed in the direction of unrecognized post-COVID myocarditis. The patient was treated according to current guidelines for heart failure with reduced EF. Eight months after discharge, the patient had no limitations of physical activity and TTE showed significant improvement in the systolic function of the left ventricle, EF was 47%, with normal LV filling pressure. Conclusion: Myocarditis is not an infrequent manifestation of COVID-19 infection, especially in hospitalized patients with severe clinical presentation, and commonly manifests within the first week after initial symptoms. Our case report represents an example that also patients with mild form of COVID-19 treated as outpatients can have delayed onset of heart failure as a consequence of COVID-19-induced myocarditis. Therefore, COVID-19 patients deserve a comprehensive approach with systematic clinical and echocardiographic follow-up in order to establish a timely diagnosis, provide appropriate treatment, and prevent serious complications.Zahvaćenost miokarda koronavirusnom bolešću 2019 (COVID-19) varira i smatra se ozbiljnijom u bolesnika s teškom kliničkom slikom COVID-19. Iako se miokarditis obično prepoznaje u okruženju akutne infekcije SARS-CoV-2, prepoznaju se i odgođene manifestacije. Prikaz slučaja: Bolesnik u dobi od 51 godine primljen je zbog kliničkih znakova kongestivnog zatajenja srca dva mjeseca nakon umjerene kliničke manifestacije pneumonije COVID-19, liječen ambulantno. Transtorakalna ehokardiografija (TTE) otkrila je dilatiranu kardiomiopatiju s prisutnošću difuzne hipokinezije lijevog ventrikla (LV), ozbiljno smanjenu ejekcijsku frakciju (18%) i dijastoličku disfunkciju s povećanim osjećajem tlaka u lijevom atriju. Osnovni laboratorijski testovi otkrili su povišen hs-troponin I, NT-proBN. Dijagnostička vježba isključila je koronarnu bolest. Magnetska rezonancija srca snažno je pokazala u smjeru neprepoznatog miokarditisa nakon COVID-a. Bolesnik je liječen prema važećim smjernicama za zatajenje srca sa smanjenom ejekcijskom frakcijom. Osam mjeseci nakon otpusta bolesnik nije imao ograničenja tjelesne aktivnosti, a TTE je pokazao značajno poboljšanje sistoličke funkcije lijeve klijetke, ejekcijska frakcija je iznosila 47%, uz normalan tlak punjenja LV. Zaključak. Miokarditis nije rijetka manifestacija infekcije COVID-19, osobito u hospitaliziranih pacijenata s teškom kliničkom slikom, i obično se manifestira unutar prvog tjedna nakon početnih simptoma. Naš prikaz bolesnika je primjer da i pacijenti s blagim oblikom COVID-19 koji se liječe ambulantno mogu imati odgođeni početak zatajenja srca kao posljedicu miokarditisa izazvanog COVID-19. Stoga bolesnici s COVID-19 zaslužuju cjelovit pristup uz sustavno kliničko i ehokardiografsko praćenje kako bi se pravodobno postavila dijagnoza, omogućilo odgovarajuće liječenje i spriječile ozbiljne komplikacije