Cor et Vasa Case Reports
Svazek | Volume 8 • Číslo | Number 1
Únor | February 2026
S. Lietava, J. Vlašínová, T. Novotný
We present a case report of a 74-year-old patient with heart failure due to dilated cardiomyopathy who had an implantable cardioverter-defibrillator implanted for the primary prevention of sudden cardiac death. Three years after the implantation, the patient presented with a failure of pacing function at her regular follow-up and was referred for revision of the system. Twiddler syndrome was identified as the cause of ICD lead dislocation. This case report demonstrates a rare cause of implantable device electrode dislocation by its repeated rotation in the subcutaneous pocket.
D.Broniš, J.Kamelander, D. Bartušek, J. Hustý, J.Hlásenský, P. Kala
(When a complicationoftheforamenovaleapertumis not a complicationoftheforamenovaleapertum, ormanifestationsofhereditaryhemorrhagictelangiectasia) Wepresentthe case report of a patientwith a historyofhereditaryhemorrhagictelangiectasiawithfrequentepistaxis and ahistoryoftransientischemicattack. The presence offoramenovalepatenswasconsidered in thedifferentialdiagnostics, whichwas not confirmed by therightheartcatheterization and thebubblecontrastechocardiography. The test did not detectbubblepassingthroughthe septum, however, withan interval ofapproximately 5 seconds, theleft atrium wasfilledwithcontrastdye. Theresultraisedthesuspicionofpulmonaryarteriovenousmalformations and the presence ofshuntswasverified by CT scan and subsequentlyclosed in thecollaborationwiththeinterventionalradiologist. Thepatient has stayedfurther in thehematologicaldispensarization.
T. Štípalová, R. Panovský, M. Rezek, V. Feitová
(Multimodalityimaging and itsimportance in patientwithmalignantvasospastic angina presentingwith out-of-hospitalcardiacarrest) Malignant vasospasm is a rare but likely underdiagnosed, life-threatening condition. The pathophysiology is complex and the etiology often unknown. We present a case of a patient suffering an out-of-hospital cardiac arrest due to ventricular fibrillation, without an evidence of significant coronary artery stenosis on coronary angiogram. Magnetic resonance of the heart was highly suspected of subacute myocardial infarction with typical subendocardial ischemic pattern of late gadolinium enhancement (LGE). Patient underwent repeated coronary angiographies where, in contrast to the initial finding, multiple flow limiting spasms in several coronary territories were observed, with their complete resolution after intracoronary nitrates administration. The patient’s medication was adjusted according to current recommendations and an implantable cardioverter-defibrillator (ICD) was implanted in a secondary preventative indication. Four months later, the patient was readmitted to hospital due to recurrent chest pain. Soon after admission, cardiac arrest due to ventricular fibrillation occurs, despite repeated defibrillation shocks from the ICD and prolonged cardiopulmonary resuscitation, the patient dies. Autopsy findings confirmed signs of old and new myocardial infarction without any evidence of thrombi in the coronary arteries.
N. Suková, T. Roubíček, R. Polášek, P. Kuchynka
(Myocarditis-like episodes as a manifestation of arrhythmogenic left ventricular cardiomyopathy) Recurrences of myocarditis are considered to be rare. In these patients arrhythmogenic left ventricular cardiomyopathy needs to be evaluated in differential diagnosis. Arrhythmogenic left ventricular cardiomyopathy is a genetically determined disease characterized by progressive myocardial atrophy and its replacement by fibrous and fatty tissue. Clinically, it mainly manifests as life-threatening arrhythmias. The case report describes a young man repeatedly hospitalized with symptoms of acute myocarditis who was diagnosed with arrhythmogenic left ventricular cardiomyopathy based on a desmoplakin pathogenic mutation.
