No abstract

AbstractEuropean Society of Cardiology Guidelines cite results of meta-analysis that the use of calcium channel blockers results in fewer angina episodes per week vs. long-acting nitrates. Moreover, we listed 12 reasons more to prefer amlodipine over long-acting nitrates, especially in stable angina pectoris patients with arterial hypertension. It may be the way to decrease polypharmacy without loosing efficacy. Some important advantages of amlodipine versus long-acting nitrate(s) are: amlodipine also treats hypertension, it helps reducing hypertensive target organ damages (e.g. left ventricular hypertrophy) and prevents morning blood pressure surge. Moreover, amlodipine can be given once daily (which improves adherence), it produces neither tolerance nor rebound, it has less side effects.

Introduction. Kounis syndrome is a simultaneous manifestation of acute coronary syndrome with conditions associated with mast cell activation, such as allergies or anaphylactic reactions. We present early stent thrombosis in female with atopic constitution without previous aterosclerosis of coronary arteries. Case report. A 50-year-old female with typical anginal pain was addmited to Clinic for Cardiology, UCC Nis. She had passed by a linden tree in bloom, few hrs before, and immediately after felt chest pain, paresthesia and numbnes in her left hand, throat tightness, heaviness of the tongue, and swelling of the lips. Symptoms stopped for 60 min after taking 10 mg of loratadine. 30 min after addmision ECG showed ST elevation in D2, D3, aVF, V6. She underwent an emergency percutaneous coronary intervention (PCI) procedure. Occlusive thrombosis was seen in the ostium of the left anterior descending (LAD) coronary artery. Sirolimus-coated stent was placed with Thrombolysis in Myocardial Infarction (TIMI) 3 flow obtained. A few hrs later, patient reported a new onset of chest pain followed by ventrucular fibrilation (VF), DC shock and occurence of new ST segment elevation in aVR, V1-V3. Repeated angiography showed acute in-stent trombotic occlusion. Baloon angioplasty was performed which restored TIMI 3 flow in LAD. Anticoagulant and corticosteroid therapy was administered. Three days following an intervention, optical coherence tomography (OCT) imiging showed no signs of aterosclerosis and restenosis, adequate stent expansion and apposition. Conclusion. Coronary agiography proved type I Kounis syndrome after the exposure to an allergen, and type III Kounis syndrome developed shortly after stent placement. Newly described causes of acute and subacute stent thrombosis in type III Kounis syndrome are stent-associated hypersensitivity reactions.

No abstract

Klinički centar Niš, Klinika za kardiovaskularne bolesi NišPregledni rad Uvod S rčana insuicijencija predstavlja klinički sindrom do koga dovode različita oboljenja, a karakteriše se nesposobnošću srca da pumpa adekvatnu količinu krvi shodno potrebama organa i tkiva, u miru i naporu, i pored normalnog priliva krvi u srce. Kao jedna od češćih komplikacija akutnog koronarnog sindroma javlja se srčana insuicijencija.Prema mehanizmima nastanka, srčana insuicijencija može bii uzrokovana oštećenjem miokarda (infarktom miokarda), disfunkcijom drugih srčanih struktura (valvula), cirkulacijskim poremećajima (volumensko opterećenje srca u sklopu bolesi jetre i bubrega). U odnosu na anatomsku lokalizaciju, insuicijencija srca može bii insuicijencija levog i insuicijencija desnog srca, koja se uglavnom manifestuje sindromom kongesije plućnih vena ili sistemske kongesije. Termini ne moraju ukazivai na to koja je komora više oštećena.Brz oporavak komorske funkcije se vidi kod rane revaskularizacije arterije koja je dovela do infarkta, perkutanom koronarnom intervencijom ili trombolizom. Faktori koji dovode do srčane insuicijencije nakon infarkta miokarda su veličina infarktne zone, remodelovanje srca i prisustvo komplikacija. Srčana insuicijencija može bii posle-