Waldemar Elikowski

Szpital im. Józefa Strusia - Poznan · Dept. of Internal Medicine

Cardiovascular complications of the COVID-19 comprise cardiac arrhythmias, including sinus bradycardia (SB). The authors present clinical data of 19 hospitalized patients (12 males), aged 20-73 years, with marked (less than 45/min during daily hours) self-limiting SB. None of them had SB at admission or earlier, none had used cardiovascular medicat...

Funding Acknowledgements Type of funding sources: None. Introduction Cardiovascular involvement during SARS-CoV-2 infection has been described previously in hospitalized patients mainly. The percentage of patients vulnerable after coronavirus infection disease 2019 (COVID-19) is still being under discussion. What remains unknown is the impact of c...

Although Slavic populations account for over 3.5% of world inhabitants, no centralized, open source reference database of genetic variation of any Slavic population exists to date. Such data are crucial for either biomedical research and genetic counseling and are essential for archeological and historical studies. Polish population, homogenous and...

In the course of COVID-19 pandemic, many patients with diagnosed or suspected disease do require echocardiography. At the same time, when it comes to the echocardiographers, there is a fear of their being exposed to contamination. At COVID-19-dedicated hospital examinations are bedside, and in some patients hand-held or tablet-based echocardiograph...

Mitral valve prolapse (MVP) is diagnosed by auscultation and echocardiography in about 2-3% of the general population and takes rather a benign course. However, in some patients, ventricular arrhythmia and sudden cardiac death (SCD) occur, which is linked to mitral annular disjunction (MAD). MAD is defined as distinct separation of the mitral valve...

Background: Coronavirus disease-19 (COVID-19) is a great medical challenge provoking acute respiratory distress, pulmonary manifestations, and cardiovascular (CV) consequences. Aims: This study compares cardiac injury in COVID-19 myocarditis patients with non-COVID myocarditis patients. Methods: Patients who recovered from COVID-19 were schedu...

Takotsubo syndrome (TTS) has been reported in various clinical conditions. Coronary artery fistula (CAF) is diagnosed in 0.2- 0.4% of patients undergoing coronary angiography. Pathologic communication between coronary artery (e.g., left anterior de¬scending coronary artery - LAD) and cardiac chambers (e.g., left ventricle - LV) is cameral type of C...

Mechanical heart compression, including that from mediastinal tumor, may cause Brugada-like ECG pattern. Such ECG pattern might also be observed in intracardiac tumor obstructing the right ventricular out"ow tract (RVOT). Eight cases with Brugada-like ECG and tumors involving RVOT have been described so far; 4 growing in the mediastinum (with one e...

Brugada syndrome (BrS) is an inherited channelopathy characterized on ECG by coved (type 1) or saddle-back (type 2) ST-segment elevation (STE) of 2 or more mm in the right precordial leads and is associated with an increased risk of malignant ventricular arrhythmias. The term Brugada phenocopy (BrPh) indicates conditions that may reversibly induce...

Native heart valve thrombosis (NHVT) is a rare valvular pathology, usually associated with prothrombotic state or disturbed intracardiac blood flow related to structural valve abnormalities. While different venous and arterial thromboembolic complications of COVID-19 have been widely described, so far NHVT has not been reported in the context of th...

Arterial thromboembolic events (ATE) in COVID-19 similarly as venous thromboembolism (VTE), are observed mainly in severely ill patients. ATE include brain, heart, aortic, and peripheral ischemic complications which usually aggravate a course of the disease leading to life-threatening conditions. The authors describe a case of a 53-year-old male wi...

Although Slavic populations account for over 4.5% of world inhabitants, no centralised, open-source reference database of genetic variation of any Slavic population exists to date. Such data are crucial for clinical genetics, biomedical research, as well as archeological and historical studies. The Polish population, which is homogenous and sedenta...

COVID-19 patients, particularly those with severe pulmonary involvement, are at an increased thromboembolic risk related, among various causes, to the cytokine storm and excessive activation of the coagulation cascade and platelets. Different intensity of anticoagulation for them is proposed, mainly with low molecular weight heparins (LMWHs); in a...

Optical betablockers (BBs), including nonselective BB timolol, are commonly used for the management of primary open angle glaucoma and ocular hypertension. About 80% of topically administered timolol is systemically absorbed, which can rarely induce such complications as bradycardia, bronchospasm and depression. A case report. The authors describe...

Coronavirus disease-2019 (COVID-19) and legionnaires disease (LD) caused by Gram-negative water-born bacteria Legionella pneumophila show certain similarities, including a predisposition to pulmonary involvement and extrapulmonary manifestations in some of the patients infected. One disease can mimic the other, both can rarely coexist. The authors...

Musical hallucinations (MHs), a kind of auditory hallucinations (AHs), are a rarely observed phenomenon of abnormal perception of sound in the absence of an external auditory source. MHs are characterized by perception of melodies, music, or songs. AHs/MHs can be associated with hypoacusis, psychiatric or neurological diseases, intoxication and adv...

Zajęcie układu sercowo-naczyniowego występuje u znamiennej części chorych z COVID-19. W rozważaniach nad patomechanizmem uszkodzenia serca uwzględnia się bezpośrednie działanie koronawirusa, systemową odpowiedź zapalną organizmu, burzę cytokinową, zaburzenia mikrokrążenia oraz hipoksemię wtórną do uszkodzenia płuc. W swojej praktyce klinicznej w sz...

SCN5A gene mutations are described in 2% of patients with dilated cardiomyopathy (DCM) and different rhythm disturbances, including multifocal ectopic Purkinje‐related premature contractions. Recent data indicate that sodium channel blockers are particularly effective monotherapy in carriers of the R222Q SCN5A variant. Our purpose is to describe th...

The prevalence of takotsubo syndrome (TTS) in patients with subarachnoid hemorrhage (SAH) is much higher than in the general population. Clinical and experimental observations confirm secondary to brain damage catecholamine-mediated cardiac injury resulting in reversible left ventricular (LV) dysfunction. However, other triggers can also be involve...

Background: Pulmonary embolism (PE) is the third most common potentially life-threatening cardiovascular disease. Pulmonary Embolism Response Team (PERT) approach has been introduced to provide rapid multidisciplinary assessment and treatment of patients with PE. However, there is a lack of detailed institutional experience and clinical outcomes d...

Extrapulmonary manifestations of Legionnaires' disease (LD) include, inter alia cardiac, brain, abdominal, joints and skin involvement. A case report: The authors describe a case of a 41-year-old immunocompetent female admitted due to a high fever, chills and fatigue. She negated cough and chest or abdominal pain. Initial chest X-ray was normal....

Transient left ventricular hypertrophy or thickening (TLVH/T) is a phenomenon rarely observed in some patients with myocarditis and stress-induced takotsubo syndrome (TTS). Initial presentation on echocardiography can mimic hypertrophic cardiomyopathy (HCM), sometimes with a decreased ejection fraction (EF). A case report: The authors describe TL...

Legionella pneumophila infection (legionellosis) usually presents as a multisystemic disease, predominantly affecting the lungs (Legionnaires' disease - LD). Immunodeficiency, chemotherapy or chronic steroids use increase the risk of developing LD. Extrapulmonary manifestations of LD include cardiac complications: myocarditis, pericarditis or endoc...

Some endocrine disorders, including primary and secondary adrenal insufficiency (AI), predispose to takotsubo syndrome (TTS). Hyponatremia is a frequent feature seen in adrenal crisis; however, TTS cases preceded by low serum sodium associated with other diseases are also reported. A case report: The authors describe a case of a 72-year-old femal...

Among patients with takotsubo syndrome (TTS), reverse TTS (rTTS) constitutes 1-23% of all cases reported in the literature. The highest prevalence of rTTS is observed in intracranial hemorrhage, pheochromocytoma and severe infections. A case report: The authors describe a case of a 65-year-old female with advanced multiple myeloma in whom rTTS wa...

Takotsubo syndrome (TTS) is rarely diagnosed following valvular and nonvalvular cardiac surgery. Only several such cases, including 12 after mitral valve replacement (MVR) or plasty (MVP) and 2 after coronary artery bypass grafting (CABG) have been reported so far. A case report: The authors describe a case of a 75-year-old female in whom TTS occ...

The term takotsubo syndrome (TTS) is derived from a comparison of left ventricular (LV) appearance in its apical form to the shape of the pot which is a trap used for octopus catching. In the classical animal model on rats, its occurrence can be triggered by experimental immobilization (IMO). Former observations of capture myopathy, seen in animals...

Influenza is associated with a high prevalence of cardiac complications, including myocarditis and exacerbation of ischemic heart disease or heart failure (HF). However, only four cases of stress-induced takotsubo cardiomyopathy (TC), all of them triggered by virus A influenza, have been reported so far. Another two TC cases after anti-influenza va...

Anorexia nervosa (AN) is characterized by very low body mass index (BMI), related to obsessive fear of gaining weight, resulting in food restriction. In AN various cardiac complications may occur: hypotension, bradycardia, life-threatening ventricular arrhythmias, pericardial effusion, reduction of left ventricular mass and impairment of its functi...

Treatment of intracardiac thrombi (ICTs) with direct-acting oral anticoagulants (DOACs) constitutes a new challenge for this group of medications. Left ventricular thrombi (LVTs) occur mainly in patients with severe left ventricular dysfunction. Advanced heart failure is characterized by a high prevalence of chronic kidney disease (CKD). Apixaban h...

The associations between stress-induced takotsubo cardiomyopathy (TC) and cancer or its therapy have been studied with increasing interest in recent years. Different mechanisms of TC development in neoplastic disease are suggested, including a decreased threshold for stress stimuli or aggravated heart adrenoreceptors sensitivity. The action of cyto...

Left ventricular thrombi (LVTs) develop most often in patients with post-myocardial left ventricular dysfunction and in cardiomyopathies, particularly in dilated cardiomyopathy (DCM). They constitute a danger of systemic embolization. So far, direct-acting oral anticoagulants (DOACs), including apixaban - a selective inhibitor of active Factor X, h...

Rationale: To analyze cardiovascular risk factors and comorbidity of acute unilateral visual loss due to combined central retinal vein occlusion (CRVO) and cilioretinal artery occlusion (CLRAO). Patient concerns: Among patients with retinal vein or artery occlusion hospitalized at the Department of Ophthalmology between January 2011 and August 2...

Case report: The authors describe a case of an 80-year-old female with a past history of aortic valve replacement, mitral annuloplasty and pacemaker implantation admitted to hospital due to weakening, subfebrile state and chills. In transesophageal echocardiography vegetations on the aortic valve bioprosthesis were found, while pacemaker electrode...

Bupivacaine is a long-acting local anesthetic (LA) used for cutaneous infiltration, peripheral nerve blocks, epidural and spinal anesthesia. However, its application may result in cardiovascular complications such as: hypotension, bradycardia, cardiac arrest and toxic myocardial injury. The authors describe a 53-year-old male with a history of ciga...

Acute acalculous cholecystitis (AAC) is a necroinflammatory disease of the gallbladder with no gallstones present. ACC is known to be a serious, even potentially lethal complication observed mainly in patients with various severe underlying conditions including trauma, burn and sepsis. Infection of cardiac implantable electronic devices may lead to...

Abstract Chronic hypocalcemia, irrespectively of its etiology, can lead to severe impairment of the left ventricular (LV) contractility manifesting as dilated cardiomyopathy, usually defined as hypocalcemic cardiomyopathy (hypocaCM). This rarely diagnosed type of heart failure (HF), can be completely reversible, when treated properly with calcium a...

Abstract Among diverse triggering factors of stress-induced takotsubo cardiomyopathy (TC), a viral or bacterial infection is rarely observed. Sepsis is an exception, regardless of the etiologic pathogen, in which case an excess of catecholamines may result in acute left ventricular dysfunction. TC precipitated by Clostridium difficile infection (CD...

A case report: The authors describe a case of a 58-year-old, otherwise healthy female, with TC which occurred after intravenous injection of 1 mg of epinephrine against cardiac arrest provoked by pneumoperitoneum performed before planned laparoscopic cholecystectomy. She was admitted 3 days earlier due to biliary colic following a dietary mistake....

Infective endocarditis of the tricuspid valve (TVE) occurs predominantly in selected groups of patients including intravenous drug users (IVDUs). The most often cultured pathogen in IVDUs is Staphylococcus aureus. Eikenella corrodens, normally existing as a commensal in the mouth and the upper respiratory tract, is identified as an etiologic pathog...

In about one quarter of patients with stress-induced takotsubo cardiomyopathy (TC) concomitant involvement of right ventricle (RV) can be observed. Opposite to this biventricular form of TC, isolated right ventricular takotsubo cardiomyopathy (RVTC) was described only in a few cases and so far has not been listed as a specific type of TC. The autho...

Case report: The authors present a case of a 40-year-old male with DCM and RVT located in the apex, which was imaged in echocardiography, magnetic resonance and multislice computed tomography. During treatment with rivaroksaban (2x15 mg: 4 weeks; 1x20 mg: 4 months) diminishing of RVT was not observed. After 2 months of VKA use complete resolution...

In typical takotsubo cardiomyopathy (TC) apical transient left ventricular dysfunction with concomitant ECG changes mimicking acute anterior myocardial infarction can be observed. Reverse TC (RTC) characterized by contractile disturbances in all basal and often simultaneous mid-ventricular segments is definitely less frequent. ECG pattern of RTC is...

The authors describe the presentday possibilities of routine and molecular microbiologic diagnostics of infective endocarditis (IE). Routine diagnostics employs automated microbial growth and biochemical detection systems. Molecular methods are based on polymerase chain reaction (PCR) and matrix assisted laser desorption/ ionization time of flight...

Takotsubo cardiomyopathy (TC) is characterized as an acute, reversible left ventricular dysfunction which may be triggered by mental or physical stress. In the case of a 32-year-old woman severe heart failure was observed after a traffic accident with blunt chest trauma. ECG showed ST changes mimicking acute myocardial infarction; although, echocar...

Non-bacterial thrombotic endocarditis (NBTE) is characterized by presence of sterile vegetations that develop from fibrin and platelets on heart valves. The main conditions predisposing to NBTE are malignancy, autoimmune diseases and other hypercoagulable states. The authors describe a case of a 25-year-old male, in whom NBTE was diagnosed on the b...

The varicella zoster virus (VZV) belongs to cardiotropic viruses, although the frequency of cardiac complications during VZV infection is low. Diagnosis of myocarditis or myopericarditis is rare during varicella - primary infection of VZV and sporadic in zoster - reactivation of latent VZV. Only few such cases have been described. The authors prese...

Our aim was the assessment of the prognostic significance of right heart thrombi (RiHT) and their characteristics in pulmonary embolism in relation to established prognostic factors. 138 patients (69 females) aged (mean±SD) 62±19 years with RiHT were included into a multicenter registry. A control group of 276 patients without RiHT was created by...

Atrial fibrillation and heart failure are factors predisposing to locally formed intracardiac thrombosis, which is usually localized in left-sided chambers. A case report. The authors present a case of a 50-year-old male with permanent atrial fibrillation and dilated cardiomyopathy in whom recurrent right atrial thrombus was observed. Initially, th...

Rivaroxaban, a selective inhibitor of active factor X, is metabolized by cytochrom P450 3A4 (CYP3A4) and is a substrate for transporter protein--P-glycoprotein (P-gp). Amiodarone, an antiarrhytmic agent, is classified as moderate CYP3A4 and P-gp inhibitor. A CASE REPORT: A 75-year-old male, who underwent lobectomy for bronchiectasis many years ago...

Typical complications of arrhythmogenic right ventricular cardiomyopathy (ARVC) are heart failure and ventricular arrhythmias which may lead to sudden cardiac death. Intracardiac thrombosis is diagnosed only in 2-4% of patients. The authors present a case of a 50-year-old male admitted to hospital due to symptomatic ventricular tachycardia. Echocar...

There is no doubt that venous thromboembolism (VTE) is a complex and multicausal disease. Tuberculosis (TB) itself is found to have thrombogenic potential. There is an association between tuberculosis and VTE. We present a case of a 31-year-old male diagnosed with TB after a 2-month delay. He was treated with an anticoagulant for pulmonary embolism...

Infective endocardits of the tricuspid valve (TVIE) occurs mainly in addicted-intravenous drug users, in the presence of intracardiac electrodes or central venous catheters, and in some congenital heart diseases; rarely, in other conditions. The authors present a case of a 61-year-old male with TVIE as a result of complicated transurethral resectio...

Background: Although right heart thrombi (RIHT) are generally regarded as indicators of unfavorable outcome in patients with acute pulmonary embolism (APE), the optimal management of patients with RIHT is still under discussion. Therefore, multicentre, multinational RIHT European Registry (RIHTER) has been organized in order to assess the prognosti...

Stress-induced cardiomyopathy is characterized by transient regional left ventricular (LV) dysfunction that may involve, in different forms, midventricular, apical or basal segments. The authors describe a case of a 41-year-old woman with reversible, but global LV systolic dysfunction, complicated with apical thrombi. Clinical symptoms of dilated c...

Of all kinds of neoplasms, malignant melanoma has the highest propensity of metastasising to the heart. Clinical symptoms of cardiac involvement appear rather late, usually in advanced stage of the disease. The authors describe a case of a 54-year-old woman admitted to the hospital with symptoms of cardiac tamponade. During pericardial drainage, 16...

Cardiac metastases are detected in a small percentage of patients with neoplastic disease; in testicular cancer mainly in intracavitary location. The authors describe a case of a 31-year-old man with mixed germ tumor diagnosed in an advanced stage, with diffuse retroperi-toneal, pulmonary and mediastinal metastases. The patient died on day two afte...

The authors present a case of a 70-year-old woman in whom clinical picture of an acute coronary syndrome with ST segment elevation was suggestive of takotsubo cardiomyopathy (TC). Chest pain, extensive ECG changes and typical TC left ventricular contraction pattern were preceded by emotional and physical stress, while in coronary angiography no ath...

Background: Efficacy and safety of radiofrequency (RF) ablation in patients with atrial fibrillation (AF) strongly depend on the possibility of three-dimensional (3D) visualisation of atria as well as the ostia of pulmonary veins. Current angiographic systems allow 3D visualisation of anatomical heart structures using rotational angiography. Aim:...

Tricuspid valve (TV) injury is a rare complication of blunt chest trauma, most commonly as a result of a traffic collision. The authors describe a case of massive TV regurgitation due to a rupture of the chorde tendinae to the anterior and septal leaflets in a 21-year-old man, the victim of a car crash. Concomitant organ injuries included, among ot...

Anticoagulation therapy with vitamin K antagonist (VKA) or heparin, even properly applied, may lead to occurrence of differently localized hematomas, including rectus sheath hematoma (RSH). This uncommon complication of anticoagulation is often misdiagnosed. In the presented case of a 72-year-old man, with a history of VKA use for permanent atrial...

Introduction: There are limited Polish evaluation data on the frequency of administration and the factors determining the choice of the aldosterone antagonists (AA) in patients with post-myocardial infarction (MI) heart failure (HF). Aim of the study: The aim of the study was to assess the degree of doctors' conformity with cardiological societies'...

The etiology of takotsubo cardiomyopathy (TC), defined as a transient left ventricular dysfunction in the absence of significant coronary artery stenoses, still reminds unclear. Its onset is often associated with emotional stress or progression in the course of various disorders (including gastrointestinal ones), miscellaneous diagnostic and therap...

The associations between depression and coronary heart disease, especially via platelet hyperactivity, have been widely described. The relationships between depression and venous thromboembolism are less clear. We present three cases of pulmonary embolism (PE) in patients with previously diagnosed depression and discuss possible, depression-related...

Immobility due to sitting position during traveling is a well-known risk factor for venous thromboembolism (VTE). Beasley et al. (2003) first proposed the name "eThrombosis" for a case in which VTE was related to prolonged seated immobility at computer. We present clinical and laboratory data of six patients with "eThrombosis". As this kind of immo...

Although regular sports activities decrease the risk of venous thromboembolism (VTE), VTE cases have been observed among professional and amateur athletes practicing various disciplines. The authors describe a case of a 25-year-old-woman in whom calf pain, as popliteal vein thrombosis manifestation--preceding pulmonary embolism, occurred after she...

It is a popular belief, that marijuana smoking is not harmful to health. Some publications, however, suggest its possible association with mental, respiratory and cardiovascular complications, but not with venous thromboembolism. The authors describe a case of severe pulmonary embolism in a mildly obese, 22 year-old marijuana and tobacco smoker. Af...

The authors described a case of a 30 year-old man with chronic hepatitis C (G1,S1) complicated by pulmonary embolism (PE), preceded by symptoms of respiratory system infection, which occurred after 6 months of combination therapy with pegylated interferon-α and ribavirin. Right sided nonbacterial thrombotic endocarditis as a source of segmental/sub...