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Systemic lupus erythematosus with multiple organ complications

Author: Katarína Demková

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Systemic lupus erythematosus (SLE) is an autoimmune disease, mostly with a chronic course, that can affect almost all important organs, most commonly skin, joints, heart and vessels, kidneys, central nervous system and lungs. The disease is characterized by B-lymphocyte hyperactivity, which leads to the formation of autoantibodies predominantly directed against non-specific antigens. This case study describes a case of SLE with multiple organ complications in a 29-year-old female patient.

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Parainfectious myocarditis

Author: Katarína Demková

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Myocarditis is an acute inflammatory condition that can have an infectious, toxic or autoimmune aetiology. Myocarditis can complicate many infections in which inflammation may be due directly to infection of the myocardium or the effects of circulating toxins. The clinical picture ranges from a symptomless disorder, sometimes recognised by the presence of an inappropriate tachycardia or abnormal ECG, to fulminant heart failure. Myocarditis may be heralded by an influenza-like illness. In most patients, the disease is self-limiting and the immediate prognosis is excellent. However, death may occur due to a ventricular arrhythmia or rapidly progressive heart failure. Myocarditis has been reported as a cause of sudden and unexpected death in young athletes. Some forms of myocarditis may lead to chronic low-grade myocarditis or dilated cardiomyopathy. The case report describes a case of parainfectious myocarditis in a 20-year-old patient.

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Morbus Crouzon and severe Obstructive Sleep Apnoea

Author: Ivana Trojová

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Obstructive sleep apnoea (OSA) is a highly prevalent sleep disorder that affects 2% of female and 4% of male population. The major risk factors for OSA is obesity. Less common causes of OSA may be various congenital craniofacial anomalies. The presented case report has introduced an adult male patient with Crouzon syndrome (CS), rare genetic disease leading to craniofacial deformities, who was referred to sleep laboratory with the suspicion of sleep disordered breathing.

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Mitral valve replacement and MAZE procedure because of mitral valve stenosis and paroxysmal atrial fibrillation

Author: Tomáš Toporcer

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The case report describes the hospitalization of a 63-year-old patient admitted to the Department of heart surgery for mitral valve stenosis with diagnosed atrial fibrillation. The patient underwent mitral valve replacement and MAZE procedure. At the postoperative period, paroxysm of atrial fibrillation was successfully detected with a successful version. On the tenth postoperative day, the patient was placed in outpatient care.

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Aortic valve replacement because of aortic valve stenosis, repair of tricuspid valve because of regurgitation

Author: Tomáš Toporcer

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The case study describes the hospitalization of women with aortic valve stenosis and secondary regurgitation of the tricuspid valve. The patient underwent aortic valve replacement by bioprosthesis and repair surgery of the tricuspid valve. The postoperative course was complicated by pneumohorax on the right side. Drainage was performed. The patient was placed in outpatient care on the eighth postoperative day.

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Obstructive sleep apnoea in extremely obese patient

Author: Ivana Paraničová

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Obstructive sleep apnoea (OSA) is characterized by repetitive episodes of interruption of breathing during sleep due to partial or complete collapse of pharynx. Prevalence of mild OSA is about 9-24%, clinically significant disease is present in about 4% men and 2% women. Morphology of upper airways and body weight are important factors for development of OSA. Approximately 70% of OSA patients are overweight and 40% obese patients suffer from OSA.

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Chronic Respiratory Failure due to Kyphoscoliosis

Author: Ivana Trojová

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Kyphoscoliosis is a well-recognized cause of respiratory failure. Kyphoscoliosis is a chronic disease, occurring in 2-3% of the general population, which leads to a distorted spinal curvature and chest wall deformity. As a consequence, respiratory function is impaired due to reduced chest wall compliance and restrictive lung function pattern arises. The development of noninvasive ventilation (NIV) has made it an accepted standard modality of care at the present time for patients with chronic respiratory failure caused by kyphoscoliosis. The presented case report describes a 49-year-old female with idiopathic kyphoscoliosis who developed chronic hypercapnic respiratory failure with the need of noninvasive ventilatory support.

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Constrictive pericarditis, reoperation

Author: Tomáš Toporcer

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The case report describes the hospitalization of a 50-year-old man who underwent surgery for a constrictive pericarditis at a younger age. Current CT and ultrasonographic findings confirmed the recurrence of this disease. Partial pericardectomy was performed with the release of the left ventricular diaphragm wall in particular. The postoperative period was complicated by ventricular fibrillation with high speed response of chambers. After successful cardioversion, the patient was released to outpatient care on the seventh postoperative day.

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Aortocoronary bypass

Author: Tomáš Toporcer

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The case report describes the hospitalization of a 58 year old male admitted to our department for documented ischemic heart disease with affection of three coronary arteries. The patient underwent a cardiac surgery with the formation of one bypass with arterial graft and one bypass with venous graft. In the postoperative period, fibrillation of atrial fibrillation with successful cardioversion was noted. The patient was admitted to outpatient care on the seventh postoperative day.

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Mitral valve reconstruction because of Barlow's disease with mitral insufficiency, perioperative SAM (systolic anterior motion)

Author: Tomáš Toporcer

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The case report describes the hospitalization of a 26 year old male with M. Barlow. The mitral valvuloplasty was performed. However, the peroperative ultrasonographic finding documented prolapse of the anterior cusp of the mitral valve into the outflow tract of left ventricle. The surgery was supplemented with a suture of the A2-PA segments of mitral valve. The subsequent finding was satisfactory. No more serious postoperative complications were noted. The patient was admitted to outpatient care on the eighth postoperative day.

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