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K Gorican

Publications and source records attributed to K Gorican.

At least 19 recordsLinked to original sources
PubMed2006

Lyme borreliosis infection as a cause of dilated cardiomyopathy.

The relatively low percent of patients affected with the cardiac form of Lyme borreliosis is difficult to diagnose, especially if the disease manifests itself in ways other than atrio-ventricular blockade. The advanced stage of Lyme carditis manifesting as dilated cardiomyopathy is a special case of this affliction. The authors of this report present clinical experience with an attempt to support the working hypothesis about involvement of Lyme borreliosis infection in the development of dilated cardiomyopathy. The patients were clinically examined thoroughly with special attention to the cardiovascular system. In addition to the basic clinical methods, the following procedures have been employed: dynamic Holter's electrocardiography, exercise ECG test, coronarography, and myocardial biopsy. From laboratory methods pertaining to the detection of Borrelia, ELISA method, Western blot, PCR, electron microscopy and histopathological analysis were used. In all three cases, clinical and laboratory findings provided the evidence of the borreliosis infection involvement in the development of dilated cardiomyopathy.

Adult↗
PubMed2005

[Value of duplex ultrasound examination of the proximal part of the common carotid artery].

A significant part of patients with carotid artery stenosis is operated on without preoperative angiography, to reduce the risks and cost of such examination. Duplex ultrasound often cannot reliable visualise the proximal parts of the aortic arch vessels. We evaluated the ability of duplex ultrasound to identify those types of lesions and ascertain their prevalence. We analysed retrospectively carotid duplex scans and carotid angiography in 448 carotid arteries. 17 significant proximal lesions (3.89%) were identified on the duplex scan and confirmed by angiography. Lesions of the proximal parts of the aortic arch vessels are rare and may be reliably detected by duplex ultrasound.

Adult↗
PubMed2005

[Cardiac abnormalities of lyme borreliosis].

The article summarizes basic characteristics of Lyme borreliosis, its incidence, epidemiology, pathogenesis and clinical image. Particular attention is given to the review of papers aimed at the cardiac abnormalities--the Lyme carditis. Though they are not very frequent, due to the variability of their clinical course and due to various forms, which are difficult to diagnose, they can represent a specific problem. Major part of the article is given to the authors' own experience with the dilated cardiomyopathy of the Borrelia origin and namely to the perspective study of the patients after the skin form of the disease erythema migrans, who were treated "lege artis" in the early phase of the disease with antibiotics. Authors were interested how many of those patients would develop later the cardiac abnormalities.

Cardiomyopathy, Dilated↗
PubMed2005

Lyme borreliosis--waiting for Lyme carditis? A long-term prospective study.

A long-term prospective study of patients with confirmed non-cardiac form of Lyme disease (n=221) over a mean follow-up period of 40.6 months is reported. The study revealed no case of Borrelia-related cardiac involvement developed after several years in patients who had received antibiotic therapy in the early period. Therefore, these patients do not need follow-up by a cardiologist.

Adolescent↗
PubMed2004

[Mobile thrombus at the origin of the internal carotid artery].

Stroke is the third leading cause of death in many countries worldwide. The vast majority of acute strokes is ischaemic, caused often by embolisation from the large arteries of the head and neck, less frequently by cardiogenic embolisation. A case report of a patient with mobile thrombus at the origin of the internal carotid artery diagnosed by duplex sonography is presented. The patient refused surgery, two days later a recurrent severe stroke occurred caused by embolisation of the found thrombus.

Carotid Artery Thrombosis↗
PubMed2001

Borrelia infection as a cause of carditis (a long-term study).

BACKGROUND: Although the frequency of Lyme carditis is not high, it is one of the most challenging conditions in terms of diagnosis. No long-term studies that would help expand our body of knowledge concerning the circumstances of its development and the natural course of this form of Lyme borreliosis (LB), the most widespread anthropozoonosis in Central Europe, have been reported to date. AIM: The authors sought to describe and assess the consequences of a less common form of Lyme carditis (LC). An assessment of the following aspects was made: a) the forms, natural history and sequelae of the less common clinical appearances of LC, b) the role of antibiotic therapy with reference to the late manifestations of LB. METHODS: Three patients were selected from a group of 60 consecutive patients with demonstrated LC during a follow-up period from 1987 to 2000. Patient no. 1 was being followed for myocarditis with frequent ventricular extrasystoles, patient no. 2 for pericarditis, and patient no. 3 for dilated cardiomyopathy as a late manifestation of LB. In addition to routine examination at entry, the patients were subjected to a standard 12-lead ECG, continuous 24-hour Holter ECG monitoring, exercise testing (bicycle ergometry), investigations of antibodies using ELISA and Western blot, investigation of thyroid (T3, T4, TSH tests) and mineral levels. RESULTS: The study showed no significant correlation between the clinical course and levels of specific antibodies. It confirmed the concept that inadequate or no therapy with antibiotics in the initial stage of the disease has a significant effect on the development of late sequelae. CONCLUSION: Based on the long-term treatment of three patients with less common, yet clinically urgent findings, the authors conclude that even a relatively serious clinical course is associated with no major limitations for affected individuals after an interval of several years.

Adult↗
PubMed2001

[Multiple extrarenal complications in Wegener granulomatosis].

This is a case report of a patient with Wegener's granulomatosis (WG), who initially presented with a corneal perforation. In addition to the eye involvement, the pauciimmune necrotizing glomerulonephritis with crescent formation, E.N.T. and pulmonary involvement were diagnosed. The patient also suffered from the acute myocardial infarction, most likely due to coronal arteritis. In addition to the coronal ischaemia she also had vasculitis of the aortic valve due to the WG. Another rare complication was the massive intestinal bleeding. The patient had also a skin vasculitis and non-specific symptoms such as artralgias and fever. The correct diagnosis was supported by positive cANCA. A clinical and laboratory remission of the disease was achieved by combined immunosuppressive therapy. Subsequently, she developed a subglotic stenosis possibly due to reparative changes.

Adult↗
PubMed1999

Borrelia burgdorferi as a cause of Morgagni-Adams-Stokes syndrome. Long time follow-up study.

According the literature atrio-ventricular blockade (AVB) is the most frequent and well-known symptom of Lyme carditis. Typical signs of complete AVB include fatigue, lethargy and syncope- Morgagni-Adams-Stokes syndrome (MAS). The authors present their results and experience with 5 patients selected from a long-term study (conducted between 1987 and 1998) comprising 58 patients who developed MAS. The authors tried to evaluate the changes especially in the cardiovascular system. They correlated the clinical state with ECG findings, as well as with the levels of the Borrelia burgdorferi antibodies. The following results were obtained: 1) all patients had typical syncope, 2) the clinical course was not complicated (except one patient who developed ventricular fibrillation), 3) two patients had frequent symptomatic and asymptomatic arrhythmia including chest pain and episodic rest dyspnea, 4) subjective difficulties (usually palpitations) correlated with ECG findings (Lown 3a, 3b). The authors also looked for any relationship between clinical difficulties and levels of antibodies. The results obtained with an early permanent pacemaker were less favourable than those reported in the literature. Despite early treatment 2 patients had repeated palpitations and ECG correlates during the next years.

Adams-Stokes Syndrome↗
PubMed1998

[Structure and dynamics of electrocardiographic changes in patients with Lyme carditis (pilot study)].

A maximum of 10% of the patients suffering from Lyme borreliosis suffer from cardiac damage. This affection is usually the source of diagnostic doubts, mainly because of the significant variability of clinical manifestations, the objectivization of which is difficult. Great variability is pathognomic also for electrocardiograms. For a three-month period 7 patients aged 43 years (29-53) were followed up under conditions of ambulatory ECG monitoring, i.e. using Holter s dynamic electrocardiography (HM) and ECG transmission by telephone (TTM). The focus of interest and objective of this pilot study was evaluation of the structure and dynamics of ECG changes, in particular from the aspect of types and frequencies of ectopic activity of the atria and ventricles and the ECG correlate of symptomatic events. Findings pertaining to the incidence of symptomatic (total 67) as well as asymptomatic events (total 25) are valuable. Systematic ECG checks of patients with Lyme carditis revealed a relatively large number of cases of impaired rhythm with a completely asymptomatic course.

Adult↗
PubMed1996

[Borrelia burgdorferi as a cause of sick sinus syndrome?].

The authors describe the case of a 42 years old man, who was implanted a permanent pacemaker on the basis of the sick sinus syndrome, suspected to have been induced by the infection with Borrelia burgdorferi. The review of world literature has indicated that it is an exceptional indication of permanent cardiac stimulation.

Adult↗
PubMed1996

[Thromboembolic complications in nephrotic syndrome].

Thromboembolic complications of nephrotic syndrome are very frequent. They can occur in the arterial or venous circulation. Venous thromboses are frequently asymptomatic and are manifested only by pulmonary embolism. Thrombosis of the renal vein may be dramatic and include renal failure. For the diagnosis various isotope, X-ray and ultrasound methods are used. Anticoagulation or thrombolytic treatment is used; in some instances also thrombectomy may be used. In patients with albumin levels lower than 20-25 g/l prophylactic administration of acetylsalicylic acid is useful. The clinical picture and therapeutic procedure are demonstrated on three brief case-histories.

Adult↗
PubMed1996

[Transmission of the electrocardiogram via telephone. Analysis of 10 years' experience].

BACKGROUND: The problem of impaired cardiac rhythm is in recent years in the foreground of the interest of cardiologists. This was influenced not only by the conclusions of the CAST study which changed the therapeutic pattern used for some years but above all the diagnostic pitfalls of impaired rhythm as regards detection and identification. The objective of the present study was to provide evidence of the advantages and usefulness of the method of telephone transmission of the electrocardiogram within the complex of other diagnostic procedures. METHODS AND RESULTS: The group was formed by 251 patients, incl. 186 men and 65 women, average age 51.7 years (range 19-85 years). The transmission of the ECG by phone was implemented by the system TESLAR (VUIS-CVUT) which comprises recording units and a terminal with a graphic outlet. A total of 3,727 electrocardiographic tracings were assembled. During their analysis the arithmetic mean was used as the characteristic of the position of the group or groups on the scale, the error of the mean expressing the ratio of the standard deviation to the number of cases. In nominal variables most frequently percentage expression was used, frequently with a confidence interval obtained from tables. Evidence of the usefulness of the method is the high rate of detected arrhythmias within emergency calls (88.5%), as compared with normal calls (10.6%) where the yield is close to that of Holter monitoring, however, with the advantage of time ad libitum and thus also a higher yield. CONCLUSIONS: The presentation of long-term experience with electrocardiograms by telephone confirms unequivocally the assumption that the method extends existing diagnostic possibilities in short-term, symptomatic, but sporadic arrhythmias, that it makes possible dispensarization of risk patients as well as patients with permanent pacemakers and that it improves the tactics of antiarrhythmic treatment.

Adult↗
PubMed1995

[Lyme carditis].

The authors present in the submitted paper the basic characteristics of Lyme carditis as one of the forms of Lyme borreliosis. They mention briefly the clinical symptoms, diagnostic possibilities and causal and symptomatic therapeutic procedures. In the second part they present conclusions which they obtained by comparison of data in the literature and their own experience with dispensary care of 50 patients during several years. In the conclusion they emphasize the great interindividual variability of the clinical picture not only in the acute stage of the disease but also for years after treatment.

Adolescent↗
PubMed1995

Lyme carditis.

Explore the source record for details and available documents.

Adolescent↗
PubMed1989

[Arrhythmia as a major manifestation of Lyme borreliosis].

The submitted case-history is focused on one of the leading manifestations of cardiac affection in Lyme borreliosis. The authors recapitulate and analyze the patient's complaints, her electrocardiographic and other findings and confront them with data from the literature on this "new" nosological unit.

Adult↗
PubMed1989

[Initial experience with modification of dosage of anti-arrhythmic agents using telephone transmission of the electrocardiogram].

Despite the doubtless advances in the knowledge of cardiac electrophysiology, the mechanism of action of antiarrhythmia and the considerable clinical experience with these drugs, treatment of arrhythmia remains on a trial error basis. The authors tried to use the system serving the transmission of one lead electrocardiograms by telephone as a means of checking and correcting antiarrhythmia treatment. It is a method which despite its unpretentious character and reliability is used on a very limited scale. As compared with other contemporary means of the control of the effect of antiarrhythmia treatment, i.e. above all Holter's method or investigation of plasma levels of antiarrhythmia drugs, it is less time consuming and cheaper. The preliminary results of the authors, based on initial experience, are encouraging.

Adult↗