Andrzej Gackowski

Life-threatening cardiac manifestations of primary antiphospholipid syndrome

We report a rare case of primary antiphospholipid syndrome (APS) in a 43-year-old man presenting as recurrent acute coronary stent thrombosis and complicated by three myocardial infarctions. As illustrated in this report, in APS patients recurrent life-threatening arterial thrombotic events may occur in spite of recommended anticoagulant therapy. We conclude that the APS should be considered as a potential cause of acute coronary syndrome, particularly in young individuals with a history of recurrent thrombotic events and/or with abnormal coagulation test results. Further studies are needed to determine the best therapeutic strategy for APS patients with acute coronary syndrome.

Trauma-induced acute myocardial infarction due to delayed dissection of the left anterior descending coronary artery

Acute myocardial infarction is a very rare, life-threatening complication of blunt chest trauma. A 27-year-old man with no previous medical history was admitted to the emergency department due to multiple trauma following a car accident. After 48h following the accident, the patients condition rapidly deteriorated, with severe dyspnea at rest, tachycardia, and increasing chest pain. A 12-lead ECG showed a sinus tachycardia at 120bpm with significant ST-segment elevation in leads V1 to V5, pathologic Q wave in I, aVL, and QS complex in leads V1 to V4. Bedside echocardiography disclosed akinesis of the anterior and lateral walls, apex, and anterior septum with severely decreased left ventricular ejection fraction of 30%. Urgent coronary angiography revealed an occlusive dissection of the proximal left anterior descending coronary artery. Primary percutaneous coronary intervention with a Biolimus A9™-eluting stent implantation were successfully performed. The further course was uneventful. At 12-month follow-up, the patient has remained asymptomatic with no recurrence of cardiovascular symptoms.

Imaging in organic mitral regurgitation. Expert consensus statement of the Polish Clinical Forum for Cardiovascular Imaging

Polskie Kliniczne Forum Obrazowania Serca i Naczyń: Edyta Płońska-Gościniak, Piotr Szymański, Magdalena Kostkiewicz, Tomasz Miszalski-Jamka, Andrzej Szyszka, Piotr Lipiec, Andrzej Gackowski, Tomasz Kukulski, Mirosław Dziuk, Janusz Kochanowski, Piotr Scisło, Mariusz Skowerski, Zbigniew Gąsior, Jerzy Walecki, Mieczysław Pasowicz, Cezary Kępka, Katarzyna Mizia-Stec, Krystian Wita, Anna Klisiewicz, Piotr Hoffman, Piotr Podolec, Piotr Pruszczyk, Jarosław D. Kasprzak, Mirosław Kowalski, Adam Torbicki