Persistent ductus arteriosus in a 72-year-old woman with paroxysmal atrial fibrillation and depression syndrome: a therapeutic and diagnostic problem.

Treating the elderly is often problematic, especially when congenital heart disease is diagnosed. The aim of this study is to present the case of a 72-year old woman with depression syndrome, paroxysmal atrial fibrillation and past cerebral stroke, in whom persistent ductus arteriosus Botalli was diagnosed. Due to exacerbation of the depressive syndrome, she did not give her consent to further diagnostics, possible interventional procedures and treatment with oral anticoagulants. After intermission of the therapy she was treated with dabigatran. The patient is still undergoing outpatient treatment and so far, no cerebrovascular episodes have been recorded.

Recurrent syncope and hypocalcaemic cardiomyopathy as manifestations of Fahr's syndrome.

In our report we would like to present a case of a 60-year-old patient with epileptic seizures, affective disturbances, only mild neurocognitive disorders and cardiomyopathy. A female patient was taken to the internal ward with a tentative diagnosis of recurrent syncope. Laboratory results disclosed severe hypocalcaemia, hypoparathyroidism, and hypothyroidism. An echocardiogram revealed left ventricle systolic dysfunction. Computed tomography revealed massive intracranial calcifications typical for Fahr's syndrome. Our patient demonstrated only mild neurological and psychiatric symptoms, but developed hypocalcaemic heart failure. It is possible that some cases of Fahr's syndrome remain undiscovered, particularly patients taken to internal wards with mild neurological or psychiatric signs.

[The usefulness of Duplex-Doppler sonography in estimation of hepatic veins and inferior vena cava in the group of patients treated for congestive heart disease]. / Przydatnosc badania Duplex-Doppler przeplywu krwi w zylach watrobowych i zyle glównej dolnej u chorych leczonych z powodu zastoinowej niewydolnosci krazenia.

UNLABELLED: Duplex-Doppler sonography is commonly used diagnostic method. THE AIM OF THIS STUDY: To evaluate the usefulness of Duplex sonography of hepatic veins (HV) and inferior vena cava (IVC) in the group of patients with congestive heart disease (CHD) who underwent intensive pharmacological treatment. MATERIAL AND METHODS: 31 patients with CHD and 35 healthy volunteers underwent clinical and sonographical examination. The examination was performed at the beginning of the therapy and at the end of the hospitalization. The HV Doppler flow patterns, the diameter of the middle hepatic vein (MHV) and IVC, the collapsibility of IVC were estimated. The results were compared with the group of healthy volunteers and with clinical findings. RESULTS: The changes of diameter of the HV and changes of diameter and collapsibility of IVC are significant tools to estimate the results of pharmacotherapy in patients with CHD. Clinical and sonographic findings were different in 8 patients (26.6%). CONCLUSION: Duplex-Doppler sonography of the HV and IVC supplements clinical evaluation of the patients suffering from CHD.