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Abstract

Takotsubo cardiomyopathy (TCM) represents an acute systolic left ventricular dysfunction typically triggered by severe psychological or physical stress. Oncological patients due to emotional distress of the diagnosis, proinflammatory and prothrombotic nature of cancer and also physical stress often following complex anticancer therapies are at high-risk of TCM. Moreover, there are also few reports of TCM associated with oncological treatment, mostly chemotherapy. Recent data from large registries indicate a surprisingly high incidence of malignancy in TCM, significant differences in clinical characteristics and unfavorable short- and long-term clinical outcomes in this specific group of patients. Therefore, we present two case reports of TCM that occurred during active anticancer therapy. Both women were admitted with suspicion of acute coronary syndrome. The first patient underwent mastectomy two years before due to hormone receptor-positive breast cancer and on admission she was during adjuvant hormonotherapy with tamoxifen. The admission of the second patient was preceded by fifteen fractions of adjuvant external beam radiotherapy due to intermediate-risk endometrial cancer after radical hysterectomy. Based on coronary angiography type I of acute coronary syndrome was excluded. Both patients negated stressful situations in the period immediately before the symptoms onset. Within hospital course baseline apical ballooning observed in both cases fully recovered and enabled subsequent completion of oncological treatment in accordance with adopted treatment protocols without recurrence of TCM. To our knowledge, presented cases are the first reports showing direct relationship between TCM and adjuvant hormonotherapy with tamoxifen or pelvic radiotherapy.

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Authors and Affiliations

Konrad Stępień
Karol Nowak
Paweł Pasieka
Konrad Warmuz
Adam Stępień
Jadwiga Nessler
Jarosław Zalewski
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Abstract

Introduction: Interventional cardiology (IC) is a rapidly expanding fi eld of medicine. Medical studies should provide students the necessary level of knowledge about new techniques in IC. The aim of the study was to assess the medical students’ knowledge about various new areas of IC. Material and methods: Self-designed questionnaire was used to assess student’s knowledge. It contained 31 questions. Th e initial 3 questions concerned general information, the remaining ones were related to diff erent IC techniques: Transcatheter Aortic Valve Implantation (TAVI), Bioresorbable Vascular Scaff old (BVS), percutaneous mitral regurgitation repair methods, Left Atrial Appendage Occlusion (LAAO), Renal DeNervation (RDN), Balloon Aortic Valvuloplasty (BAV) and Atrial Septal Defect/Persistent Foramen Ovale (ASD/PFO). One point for each correct answer was awarded. Results: In our study participated 104 students. Mean score was 15.9 ± 5.8 points. 24% of participants were 3rd year students, 38% — 4th, 20% — 5th and 18% — 6th. Th ere was no diff erences in level of knowledge between students of diff erent years of studies (p = 0.2). Students from Students Research Groups (SRG) achieved higher score in comparison with students no attending SRG (19.3 ± 6.3 vs 13.3 ± 3.7; p <0.001) as well as students interested in cardiology comparison with other (19.6 ± 5.9 vs 13.0 ± 3.8; p <0.001). Students from SRG and interested in cardiology reached also higher results in practically every area of IC in comparison with other. Conclusions: Participants have insuffi cient, outdated and incomplete knowledge of new methods in IC. Th ere was no signifi cant diff erence in students of diff erent years of studies. Students belonging to cardiological SRG and interested in cardiology have greater knowledge in IC.
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Authors and Affiliations

Konrad Stępień
Karolina Połetek
Michał Komornik
Zbigniew Siudak
Tomasz Tokarek
Dariusz Dudek
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Abstract

B a c k g r o u n d: Heart failure (HF) is a life-threatening condition which aff ects up to 2% of contemporary populations. Generally, it is a chronic and progressive disease, however in many cases it can be prevented or treated. Nevertheless, effective control of this disease requires awareness of symptoms in the society.

A i m s: The aim of the study was to assess the level of HF knowledge in the Polish population.

M e t h o d s: The questionnaire concerning knowledge about HF prepared by the Competence Network HF under the patronage of the European Heart Failure Association of the ESC, was used. The survey included 534 contributors who formed three groups: medical students — in vast majority at fi rst half of the study course (MS) — 198 (37.1%), HF Awareness Day participants (HFDP) — 134 (25.1%) and other (OP) — 202 (37.8%).

R e s u l t s: Study groups diff ered in terms of gender, age and level of education. As predicted, MS achieved the highest score (22.5 [20.0–24.0]), compared to HFDP (20.0 [17.0–22.0], P <0.001) and OP (19.0 [16.0– 21.0], P <0.001). Knowledge on typical HF symptoms was alarmingly low in the analyzed groups — dyspnea (MS — 96.0%, HFDP — 78.4%, OP — 74.6%), ankle edema (MS — 79.8%, HFDP — 50.6%, OP — 32.2%), body weight gain (MS — 14.1%, HFDP — 17.2%, OP — 4.5%). By multivariate model medical education (β 3.372, 95% CI 2.738–4.005) and own illness or having relatives or friends with HF (β 0.654, 95% CI 0.066–1.242) independently aff ected the score of awareness questionnaire.

C on c l u s i o n s: The basic knowledge on HF in Poland is not sufficient. It is moderately better among MS. Further campaigns improving HF awareness are necessary.

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Authors and Affiliations

Karol Nowak
Konrad Stępień
Patrycja Furczyńska
Izabella Owsianka
Aleksandra Włodarczyk
Jarosław Zalewski
Jadwiga Nessler
Andrzej Gackowski

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