Joanna Syska-Sumińska

Prevalence of Erectile Dysfunction in Atrial Fibrillation Patients: A Cross‐Sectional, Epidemiological Study

Sexual dysfunctions, especially erectile dysfunction (ED), are a major problem in cardiovascular patients. They are caused by cardiovascular risk factors including low‐grade inflammation process, endothelial dysfunction, oxidative stress, and hemodynamic and vascular alterations. The same mechanisms are some of the main causes and/or consequences of atrial fibrillation (AF). To this day, literature provides no cross‐sectional data on the prevalence of sexual dysfunction in AF. The study aimed to determine the prevalence of sexual dysfunction in consecutive, young male patients with AF.

Cardiac tumors: leiomyosarcoma – a case report

We present a case report of a 60-year-old woman with a long history of leiomyosarcoma in different locations. She was admitted to the clinic due to a left ventricular tumor diagnosed in ECHO examination. The patient was qualified for radical tumor resection. The early postoperative period was complicated due to low cardiac output syndrome and bradyarrhythmia requiring temporary cardiac pacing. Optimized pharmacological therapy resulted in a gradual reduction of symptoms and a clinical improvement of congestive heart failure (NYHA III – NYHA II). Due to the radical nature of the surgery, the patient was not referred for supplementary treatment. The follow-up currently exceeds 12 months – no new metastases have been found. This case provides an example of how to diagnose and treat heart tumors.

STEMI in a 26-year-old man after the use of mephedrone

In recent years there has been an increase in the number of acute coronary syndromes (ACS) as a direct consequence of the use of psychoactive drugs. While knowledge of cardiovascular complications after the use of ‘classic narcotics’ is quite extensive, knowledge about the harmful effects of new psychostimulants, so-called ‘bath salts’, is little. ‘Bath salts’ is a colloquial name for different kinds of products that contain psychoactive substances that are consumed in order to give effects characteristic of narcotics. A 26-year-old man with a medical history of hypertension and smoking was transferred to our Department from a District Hospital, presenting with severe retrosternal chest pain. The pain had begun at night immediately after drinking alcohol and insufflating mephedrone. His blood pressure (BP) was 190/120 mm Hg and his heart rate was 90 bpm. The electrocardiogram revealed sinus rhythm with 2 to 3-mm ST-segment elevations in leads V2–V5 (Fig. 1). In the emergency room he received aspirin, clopidogrel and 5,000 U of heparin IV. The patient was taken for an emergent cardiac angiography, which revealed total occlusion of the midsegment of the left anterior descending (LAD) artery. Circumflex and right coronary artery were patent (Fig. 2). Primary percutaneous coronary intervention was performed. The initial restoration of patency of the artery revealed a small atherosclerotic plague with thrombus in the place of the previous occlusion (Fig. 3). The patient was given abciximab, and a drug-eluting stent was deployed in the midsegment of the LAD. The result of the procedure was good and TIMI 3 grade flow was restored (Fig. 4). The rest of his hospital course was unremarkable. Echocardiography revealed hypokinesis of the anterior wall and left ventricular ejection fraction of 55%. The patient was discharged after 6 days. Mephedrone is an organic derivative of cathinone used as a stimulant and empathogen. It has been illegal in the European Union since 2010 but is still available on the black market in the form of crystals, powder, tablets, or capsules. The typical side effect of mephedrone is activation of the sympathetic nervous system, characterised by increased BP and tachycardia. Case reports exist of cerebrovascular accident, aortic aneurysm rupture, and sudden deaths in association with mephedrone use. So far there have been no publications proven by coronary angiography of ACS being the immediate consequence of the use of mephedrone. Our case highlights the potential health hazards associated with mephedrone. Taking into account the growing popularity of psychoactive substances, in the coming years we can expect more cardiovascular complications in people who use “bath salts”. People with asymptomatic atherosclerosis are in a particularly high-risk group. Figure 1. Electrocardiogram on admissionIn recent years there has been an increase in the number of acute coronary syndromes (ACS) as a direct consequence of the use of psychoactive drugs. While knowledge of cardiovascular complications after the use of ‘classic narcotics’ is quite extensive, knowledge about the harmful effects of new psychostimulants, so-called ‘bath salts’, is little. ‘Bath salts’ is a colloquial name for different kinds of products that contain psychoactive substances that are consumed in order to give effects characteristic of narcotics. A 26-year-old man with a medical history of hypertension and smoking was transferred to our Department from a District Hospital, presenting with severe retrosternal chest pain. The pain had begun at night immediately after drinking alcohol and insufflating mephedrone. His blood pressure (BP) was 190/120 mm Hg and his heart rate was 90 bpm. The electrocardiogram revealed sinus rhythm with 2 to 3-mm ST-segment elevations in leads V2–V5 (Fig. 1). In the emergency room he received aspirin, clopidogrel and 5,000 U of heparin IV. The patient was taken for an emergent cardiac angiography, which revealed total occlusion of the midsegment of the left anterior descending (LAD) artery. Circumflex and right coronary artery were patent (Fig. 2). Primary percutaneous coronary intervention was performed. The initial restoration of patency of the artery revealed a small atherosclerotic plague with thrombus in the place of the previous occlusion (Fig. 3). The patient was given abciximab, and a drug-eluting stent was deployed in the midsegment of the LAD. The result of the procedure was good and TIMI 3 grade flow was restored (Fig. 4). The rest of his hospital course was unremarkable. Echocardiography revealed hypokinesis of the anterior wall and left ventricular ejection fraction of 55%. The patient was discharged after 6 days. Mephedrone is an organic derivative of cathinone used as a stimulant and empathogen. It has been illegal in the European Union since 2010 but is still available on the black market in the form of crystals, powder, tablets, or capsules. The typical side effect of mephedrone is activation of the sympathetic nervous system, characterised by increased BP and tachycardia. Case reports exist of cerebrovascular accident, aortic aneurysm rupture, and sudden deaths in association with mephedrone use. So far there have been no publications proven by coronary angiography of ACS being the immediate consequence of the use of mephedrone. Our case highlights the potential health hazards associated with mephedrone. Taking into account the growing popularity of psychoactive substances, in the coming years we can expect more cardiovascular complications in people who use “bath salts”. People with asymptomatic atherosclerosis are in a particularly high-risk group. Figure 1. Electrocardiogram on admission

ST elevation myocardial infarction in a 26-year-old man after the use of mephedrone.

In recent years there has been an increase in the number of acute coronary syndromes (ACS) as a direct consequence of the use of psychoactive drugs. While knowledge of cardiovascular complications after the use of ‘classic narcotics’ is quite extensive, knowledge about the harmful effects of new psychostimulants, so-called ‘bath salts’, is little. ‘Bath salts’ is a colloquial name for different kinds of products that contain psychoactive substances that are consumed in order to give effects characteristic of narcotics. A 26-year-old man with a medical history of hypertension and smoking was transferred to our Department from a District Hospital, presenting with severe retrosternal chest pain. The pain had begun at night immediately after drinking alcohol and insufflating mephedrone. His blood pressure (BP) was 190/120 mm Hg and his heart rate was 90 bpm. The electrocardiogram revealed sinus rhythm with 2 to 3-mm ST-segment elevations in leads V2–V5 (Fig. 1). In the emergency room he received aspirin, clopidogrel and 5,000 U of heparin IV. The patient was taken for an emergent cardiac angiography, which revealed total occlusion of the midsegment of the left anterior descending (LAD) artery. Circumflex and right coronary artery were patent (Fig. 2). Primary percutaneous coronary intervention was performed. The initial restoration of patency of the artery revealed a small atherosclerotic plague with thrombus in the place of the previous occlusion (Fig. 3). The patient was given abciximab, and a drug-eluting stent was deployed in the midsegment of the LAD. The result of the procedure was good and TIMI 3 grade flow was restored (Fig. 4). The rest of his hospital course was unremarkable. Echocardiography revealed hypokinesis of the anterior wall and left ventricular ejection fraction of 55%. The patient was discharged after 6 days. Mephedrone is an organic derivative of cathinone used as a stimulant and empathogen. It has been illegal in the European Union since 2010 but is still available on the black market in the form of crystals, powder, tablets, or capsules. The typical side effect of mephedrone is activation of the sympathetic nervous system, characterised by increased BP and tachycardia. Case reports exist of cerebrovascular accident, aortic aneurysm rupture, and sudden deaths in association with mephedrone use. So far there have been no publications proven by coronary angiography of ACS being the immediate consequence of the use of mephedrone. Our case highlights the potential health hazards associated with mephedrone. Taking into account the growing popularity of psychoactive substances, in the coming years we can expect more cardiovascular complications in people who use “bath salts”. People with asymptomatic atherosclerosis are in a particularly high-risk group. Figure 1. Electrocardiogram on admissionIn recent years there has been an increase in the number of acute coronary syndromes (ACS) as a direct consequence of the use of psychoactive drugs. While knowledge of cardiovascular complications after the use of ‘classic narcotics’ is quite extensive, knowledge about the harmful effects of new psychostimulants, so-called ‘bath salts’, is little. ‘Bath salts’ is a colloquial name for different kinds of products that contain psychoactive substances that are consumed in order to give effects characteristic of narcotics. A 26-year-old man with a medical history of hypertension and smoking was transferred to our Department from a District Hospital, presenting with severe retrosternal chest pain. The pain had begun at night immediately after drinking alcohol and insufflating mephedrone. His blood pressure (BP) was 190/120 mm Hg and his heart rate was 90 bpm. The electrocardiogram revealed sinus rhythm with 2 to 3-mm ST-segment elevations in leads V2–V5 (Fig. 1). In the emergency room he received aspirin, clopidogrel and 5,000 U of heparin IV. The patient was taken for an emergent cardiac angiography, which revealed total occlusion of the midsegment of the left anterior descending (LAD) artery. Circumflex and right coronary artery were patent (Fig. 2). Primary percutaneous coronary intervention was performed. The initial restoration of patency of the artery revealed a small atherosclerotic plague with thrombus in the place of the previous occlusion (Fig. 3). The patient was given abciximab, and a drug-eluting stent was deployed in the midsegment of the LAD. The result of the procedure was good and TIMI 3 grade flow was restored (Fig. 4). The rest of his hospital course was unremarkable. Echocardiography revealed hypokinesis of the anterior wall and left ventricular ejection fraction of 55%. The patient was discharged after 6 days. Mephedrone is an organic derivative of cathinone used as a stimulant and empathogen. It has been illegal in the European Union since 2010 but is still available on the black market in the form of crystals, powder, tablets, or capsules. The typical side effect of mephedrone is activation of the sympathetic nervous system, characterised by increased BP and tachycardia. Case reports exist of cerebrovascular accident, aortic aneurysm rupture, and sudden deaths in association with mephedrone use. So far there have been no publications proven by coronary angiography of ACS being the immediate consequence of the use of mephedrone. Our case highlights the potential health hazards associated with mephedrone. Taking into account the growing popularity of psychoactive substances, in the coming years we can expect more cardiovascular complications in people who use “bath salts”. People with asymptomatic atherosclerosis are in a particularly high-risk group. Figure 1. Electrocardiogram on admission

26-letni mężczyzna z ostrym zespołem wieńcowym (STEMI) po zastosowaniu mefedronu

In recent years there has been an increase in the number of acute coronary syndromes (ACS) as a direct consequence of the use of psychoactive drugs. While knowledge of cardiovascular complications after the use of ‘classic narcotics’ is quite extensive, knowledge about the harmful effects of new psychostimulants, so-called ‘bath salts’, is little. ‘Bath salts’ is a colloquial name for different kinds of products that contain psychoactive substances that are consumed in order to give effects characteristic of narcotics. A 26-year-old man with a medical history of hypertension and smoking was transferred to our Department from a District Hospital, presenting with severe retrosternal chest pain. The pain had begun at night immediately after drinking alcohol and insufflating mephedrone. His blood pressure (BP) was 190/120 mm Hg and his heart rate was 90 bpm. The electrocardiogram revealed sinus rhythm with 2 to 3-mm ST-segment elevations in leads V2–V5 (Fig. 1). In the emergency room he received aspirin, clopidogrel and 5,000 U of heparin IV. The patient was taken for an emergent cardiac angiography, which revealed total occlusion of the midsegment of the left anterior descending (LAD) artery. Circumflex and right coronary artery were patent (Fig. 2). Primary percutaneous coronary intervention was performed. The initial restoration of patency of the artery revealed a small atherosclerotic plague with thrombus in the place of the previous occlusion (Fig. 3). The patient was given abciximab, and a drug-eluting stent was deployed in the midsegment of the LAD. The result of the procedure was good and TIMI 3 grade flow was restored (Fig. 4). The rest of his hospital course was unremarkable. Echocardiography revealed hypokinesis of the anterior wall and left ventricular ejection fraction of 55%. The patient was discharged after 6 days. Mephedrone is an organic derivative of cathinone used as a stimulant and empathogen. It has been illegal in the European Union since 2010 but is still available on the black market in the form of crystals, powder, tablets, or capsules. The typical side effect of mephedrone is activation of the sympathetic nervous system, characterised by increased BP and tachycardia. Case reports exist of cerebrovascular accident, aortic aneurysm rupture, and sudden deaths in association with mephedrone use. So far there have been no publications proven by coronary angiography of ACS being the immediate consequence of the use of mephedrone. Our case highlights the potential health hazards associated with mephedrone. Taking into account the growing popularity of psychoactive substances, in the coming years we can expect more cardiovascular complications in people who use “bath salts”. People with asymptomatic atherosclerosis are in a particularly high-risk group. Figure 1. Electrocardiogram on admissionIn recent years there has been an increase in the number of acute coronary syndromes (ACS) as a direct consequence of the use of psychoactive drugs. While knowledge of cardiovascular complications after the use of ‘classic narcotics’ is quite extensive, knowledge about the harmful effects of new psychostimulants, so-called ‘bath salts’, is little. ‘Bath salts’ is a colloquial name for different kinds of products that contain psychoactive substances that are consumed in order to give effects characteristic of narcotics. A 26-year-old man with a medical history of hypertension and smoking was transferred to our Department from a District Hospital, presenting with severe retrosternal chest pain. The pain had begun at night immediately after drinking alcohol and insufflating mephedrone. His blood pressure (BP) was 190/120 mm Hg and his heart rate was 90 bpm. The electrocardiogram revealed sinus rhythm with 2 to 3-mm ST-segment elevations in leads V2–V5 (Fig. 1). In the emergency room he received aspirin, clopidogrel and 5,000 U of heparin IV. The patient was taken for an emergent cardiac angiography, which revealed total occlusion of the midsegment of the left anterior descending (LAD) artery. Circumflex and right coronary artery were patent (Fig. 2). Primary percutaneous coronary intervention was performed. The initial restoration of patency of the artery revealed a small atherosclerotic plague with thrombus in the place of the previous occlusion (Fig. 3). The patient was given abciximab, and a drug-eluting stent was deployed in the midsegment of the LAD. The result of the procedure was good and TIMI 3 grade flow was restored (Fig. 4). The rest of his hospital course was unremarkable. Echocardiography revealed hypokinesis of the anterior wall and left ventricular ejection fraction of 55%. The patient was discharged after 6 days. Mephedrone is an organic derivative of cathinone used as a stimulant and empathogen. It has been illegal in the European Union since 2010 but is still available on the black market in the form of crystals, powder, tablets, or capsules. The typical side effect of mephedrone is activation of the sympathetic nervous system, characterised by increased BP and tachycardia. Case reports exist of cerebrovascular accident, aortic aneurysm rupture, and sudden deaths in association with mephedrone use. So far there have been no publications proven by coronary angiography of ACS being the immediate consequence of the use of mephedrone. Our case highlights the potential health hazards associated with mephedrone. Taking into account the growing popularity of psychoactive substances, in the coming years we can expect more cardiovascular complications in people who use “bath salts”. People with asymptomatic atherosclerosis are in a particularly high-risk group. Figure 1. Electrocardiogram on admission

Ventricular fibrillation in a marathon mountain bike racer

A 41-year-old man with no concomitant chronic diseases, an amateur cyclist and runner, was admitted because of ventricular fibrillation preceded by chest pain which took place on a 32 km marathon mountain bike race. After a fourth defibrillation performed by medical emergency services, sinus rhythm was restored and ST-elevations in anterior and lateral leads occurred (Fig. 1). The patient was immediately transferred to the catheterisation laboratory. On admission he was conscious with Glasgow Coma Scale 15. Signs of cardiogenic shock including tachycardia, decreased blood pressure (80/40 mm Hg), tachypnoea and hypoxemia were present. During coronary angiography, left anterior descending (LAD) artery occlusion with proximal thrombus was demonstrated (Fig. 2). Other coronary arteries were normal. After thrombectomy, atherosclerotic stenosis of LAD was revealed and consequently a zotarolimus-eluting stent was implanted (Fig. 3). The patient was treated with glycoprotein IIb/IIIa receptor antagonist. The laboratory tests demonstrated signs of tissue hypoperfusion: metabolic acidosis (pH = 6.9; base excess = –23), hypoxemia (partial pressure of oxygen = 57 mm Hg, oxygen saturation = 86%), elevated creatinine (270 μmol/L [n 42,000 μg/L [n < 500]). The first measured troponin I level was normal (0.05 μg/L [n < 0.1]). After coronary angioplasty, immediate cardiac output improvement was achieved with an increase of oxygen saturation and normalisation of blood pressure. Transthoracic echocardiography delineated akinesia limited to the left ventricular apex with preserved global ejection fraction of 55%. During the first day of hospitalisation, some complications of standard antiplatelet (aspirin, clopidogrel, abciximab) and antithrombotic (unfractionated heparin) treatment appeared. The patient had subconjunctival haemorrhages, a massive haematoma of the tongue affecting swallowing and speech, and nasal mucose membrane bleeding. These complications are fairly frequently observed in patients with acid-base imbalances and do not require modification of the antiplatelet therapy. Of the risk factors for the development of coronary artery disease (CAD), only abnormal blood lipid level was present (total cholesterol = 6.0 mmol/L, low-density lipoprotein cholesterol = 3.9 mmol/L). This case shows that a combination of extreme physical activity and competition between non professional athletes might be a strong stressor for the cardiovascular system and furthermore a possible cause of sudden cardiac death in individuals with concomitant CAD. This emphasises the need for thorough medical work-up for people wanting to participate in amateur, organised competition, especially those aged over 35.

Patient with sudden cardiac arrest, peripartum cardiomyopathy and pulmonary embolism

Peripartum cardiomyopathy is a type of dilatated cardiomyopathy, occuring with symptoms of heart failure (HF) during last month of pregnancy or within 5 months after labour. Authors are presenting the case of patient admitted to hospital primary with diagnosis of non-high risk pulmonary embolism 6 weeks after delivery, who developed episode of sudden cardiac death followed by symptoms of cardiogenic shock. Peripartum cardiomyopathy was additionally diagnosed. After HF treatment with bromocriptine supply, gradual clinical improvement was achieved. The patient was discharged after 15 days of hospitalisation with diagnosis of peripartum cardiomyopathy with non-high risk pulmonary embolism.

STEMI-RVD SCALE: THE NEW TOOL TO RECOGNIZE RIGHT VENTRICULAR DYSFUNCTION IN PATIENTS WITH FIRST STEMI

Right ventricular (RV) function provides strong prognostic information in patients treated with PCI for myocardial infarction. Identifying accurate and reliable parameters for the assessment of the RV dysfunction (RVD) is still a challenge. The aim of this study was to attempt to develop an optimal