The patient database at the First Department of Internal Medicine in Martin, the Central Slovak Institute for Cardiac and Vascular Diseases in Banska Bystrica, and the National Slovak Institute of Cardiovascular Diseases in Bratislava was searched to identify patients with benign tumors of the heart seen during the 5-year period between 2011 and 2016. Forty-one patients with primary cardiac myxomas were identified and their medical records were reviewed for details pertaining to presenting symptoms, staging modalities, treatment approaches, and outcomes. Most of the studied patients were diagnosed with echocardiography (n = 35, 85%). The occurrence of the tumor was higher in the female population (n = 25, 61%). The most common presenting symptoms were dyspnoea (n = 17, 42%), chest pain (n = 3, 7%), or pain and paraesthesia of the limbs (n = 2, 5%). Acute embolic event due to embolization of tumor fragments resulted in cerebral stroke (n = 5, 12%). All patients were treated by resection. Only one comorbid patient died due to multiple-organ dysfunction syndrome two weeks after the resection. The most common postoperative complication was bleeding (n = 2, 5%) and infection (n = 2, 5%). The early diagnosis and appropriate treatment are often curative, with very low risk of recurrence. Postoperative survival is high.

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I. interná klinika, Univerzitná nemocnica a JLF UK v Martine Akútna disekcia aorty typu A je život ohrozujúci stav a významnou príčinou morbidity a mortality. Jej typickým symptómom je náhle vzniknutá bolesť na hrudníku, ktorá sa vyskytuje u viac ako 85% pacientov. Akútna bolesť na hrudníku vedie k podozreniu na akútny koronárny syndróm a ak zmeny na elektrokardiograme naznačujú možnú ischémiu, pacientom je podaná antitrombotická liečba. U niektorých pacientov bolesť na hrudníku nemusí byť prítomná, môže byť prítomný ložiskový neurologický deficit, ktorý sa objavuje ako jedna z komplikácií šírenia dissekcie na veľké artérie. Autori v práci popisujú troch pacientov s akútnou disekciou aorty typu A. Dvaja z nich nemali akútne bolesti na hrudniku, dominoval u nich ložiskový neurologický deficit. Tretí pacient mal typické akútne bolesti na hrudníku, na elektrokardiograme suspektné ischemické zmeny, čo viedlo k podozreniu na akútny koronárny syndróm. Autori prezentujú, že akútna disekcia aorty typu A môže byť ľahko prehliadnutá, preto je potrebné na túto diagnózu myslieť, aby sa včas diagnostikovala a bola zahájená okamžitá adekvátna liečba.Kľúčové slová: aorta, akútny koronárny syndróm, cievna mozgová príhoda, disekcia aorty typu A. Dissection of ascending aorta, a diagnosis needs to remember about itAcute type A aortic dissection is a life-threating condition, and is associated with significant morbidity and mortality. Patients typically present with the acute onset of chest pain, which occurs in up to 85% of cases. Acute chest pain may lead to the suspicion of acute coronary syndrome, and as the electrocardiogram may indicate ischaemia, patients are given anti-thrombotic treatment. Some patients can present without chest pain, but with focal neurological deficits, which can occur with involvement of the great vessel. The authors described three patients with acute type A aortic dissection. Two of them did not present with the acute onset of chest pain, but with focal neurological deficits. Third patient presented with the acute onset of chest pain and the electrocardiogram indicated suspected ischaemia, which led to the suspicion of acute coronary syndrome. The authors presented, that diagnosis of acute type A aortic dissection can be easily overlooked and a high index of suspicion is needed to obtain a timely diagnosis such that appropriate initial therapy can be instituted promptly.

Úvod: Pľúcna embólia je relatívne časté a nebezpečné ochorenie s variabilnou manifestáciou od benignej až po fatálnu. Autori v retrospektívnej štúdii prezentujú, ako sa počas posledných 25 rokov menil výskyt, diagnostika a liečba pľúcnej embólie. Metódy: Autori vychádzali z dokumentácie 860 (432 mužov) pacientov s potvrdenou pľúcnou embóliou, ktorí boli hospitalizovaní v čase od januára 1996 do decembra 2020 na I. internej klinike univerzitnej nemocnice v martine. Zamerali sa na výskyt, rizikové faktory, diagnostiku a liečbu pľúcnej embólie v jednotlivých rokoch v tomto časovom období. Výsledky: Pacienti s potvrdenou pľúcnou embóliou tvorili 1,04 % zo všetkých hospitalizovaných pacientov v uvedenom časovom období s priemerným vekom 63,9 (SD -16,98). Priemerný vek mužov 59,6 (SD -14,71) bol oproti ženám 68,4 (SD -16,88) nižší. na základe rizikovej stratifikácie podľa odporučení európskej kardiologickej spoločnosti pacienti s pľúcnou embóliou a vysokým rizikom tvorili 13,2 %, so stredným rizikom 40,9 % a nízkym rizikom 45,9 %. Zdroj pľúcnej embólie bol odhalený u 42,6 % a rizikové faktory žilového tromboembolizmu u 52,4 % pacientov a systémová trombolýza bola podaná u 19,5 % zo všetkých pacientov s pľúcnou embóliou. Intrakraniálne krvácanie ako komplikácia systémovej trombolýzy sa vyskytla u 1,1 % pacientov. Včasná (hospitalizačná) mortalita na pľúcnu embóliu bola 6,9 %. Záver: Autori potvrdili narastajúcu incidenciu pľúcnej embólie, klesajúcu incidenciu pľúcnej embólie s vysokým rizikom, znižujúcu sa včasnú mortalitu na pľúcnu embóliu, nepotvrdili narastajúci priemerný vek pacientov s pľúcnou embóliou.

International Journal of Case Reports and Images (IJCRI) is an international, peer reviewed, monthly, open access, online journal, publishing high-quality, articles in all areas of basic medical sciences and clinical specialties.Aim of IJCRI is to encourage the publication of new information by providing a platform for reporting of unique, unusual and rare cases which enhance understanding of disease process, its diagnosis, management and clinico-pathologic correlations.IJCRI publishes Review Articles, Case Series, Case Reports, Case in Images, Clinical Images and Letters to Editor. Website: www.ijcasereportsandimages.comChronic thromboembolic pulmonary hypertension, a disease frequently misdiagnosed Margita Belicová, Veronika Jankovičová, Marian Mokáň ABSTRACT Introduction: Chronic thromboembolic pulmonary hypertension results from incomplete resolution of a pulmonary embolus, leading to pulmonary hypertension and progressive right heart failure and death. Contemporary pharmacological and especially surgical treatment possibilities offer hope for the patient's full recovery, but an early diagnosis is crucial for success. Case Report: A 56-year-old white female, who despite thrombolytic therapy and next appropriate anticoagulation, was re-hospitalized six years after acute pulmonary embolism for severe pulmonary hypertension, due to chronic thromboembolic pulmonary hypertension. Before the diagnosis was established, she underwent lungs biopsy because of suspected interstitial lung disease and a bone marrow aspirate and biopsy because of progressive polycythemia. After chronic thromboembolic pulmonary hypertension was established, she underwent successful pulmonary endarterectomy. Conclusion: Chronic thromboembolic pulmonary hypertension is frequently misdiagnosed in clinical practice. This report aims to increase the awareness of clinicians towards an accurate diagnosis of the disease, which is necessary for the early referral of chronic thromboembolic pulmonary hypertension patients for operability, pulmonary endarterectomy.