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Amaç: COVID-19 pandemisi dünya genelinde bir saðlýk krizine neden olmuþ ve çok sayýda ölüme yol açmýþtýr. Pandeminin kronik durumu olan ya da acil hastalarýn medikal taný ve tedavi zamanlamasýna olan etkisi bilinmemektedir. Biz bu çalýþmada, COVID-19 döneminde ST-segment yükselmeli miyokart enfarktüsü (STYME) tanýsý alan hastalarýn primer perkütan koroner giriþim (PPKG) yapýlana kadar geçen sürelerini deðerlendirdik.
Yöntemler: COVID-19 döneminde ev kýsýtlamasýnýn en yoðun olduðu zamanda STYME tanýsý alan ve bu nedenle PPKG iþlemi yapýlan ardýþýk hastalar çalýþmaya alýndý. Hastalarýn klinik ve anjiyografik özellikleri deðerlendirildi. Kontrol grubu olarak geçen yýl ayný dönemde ayný taný nedeniyle hastaneye baþvuran hastalar çalýþmaya dahil edilerek iki grup karþýlaþtýrýldý.
Bulgular: Geçen sene ayný dönemde göre COVID-19 döneminde STYME ile baþvuran ve PPKG yapýlan hasta sayýda önemli derecede azalma olduðu saptandý (174 ve 90). COVID-19 döneminde baþvuran hastalarda önceki süreç baþvuranlara göre aðrý-balon [Odds oraný (OO) 2.0, %95 güven aralýðý (GA) 1.1–10.2) ve kapý-balon (OO 5.4, %95 GA 3.1–22.8] sürelerinin daha uzun olduðu görüldü. Bu hastalarýn miyokart iskemisi sürelerinin daha uzun olduðu deðerlendirildi.
Sonuç: COVID-19 pandemisi sýrasýnda STYME tanýsýyla baþvuran hastalarda semptom baþlangýcý ile PPKG arasýnda geçen sürede artýþ mevcuttur.

Objective: The coronavirus disease 2019 (COVID-19) pandemic caused by the emergence of severe acute respiratory syndrome coronavirus 2 has resulted in a health crisis and a significant number of deaths worldwide. The full effect on access to medical care and the treatment for patients with chronic diseases and acute conditions is still unknown. This is an investigation of access to primary percutaneous coronary intervention (PPCI) for patients diagnosed with ST-segment myocardial infarction (STEMI) during the pandemic.
Methods: Consecutive patients who were diagnosed with STEMI and underwent PPCI during the ongoing COVID-19 pandemic were included in the study. Clinical and angiographic characteristics of the patients were assessed. A control group of patients diagnosed with STEMI and who underwent PPCI during the same time interval a year prior to the outbreak of the disease was analyzed retrospectively for comparison.
Results: There was a significant reduction in the number of STEMI cases during the COVID-19 crisis period. Furthermore, these patients had a prolonged ischemic time; they were more likely to have a longer pain-to-balloon (Odds ratio [OR]: 2.0, 95% confidence interval [CI]: 1.1–10.2) and door-to-balloon time (OR: 5.4, 95% CI: 3.1–22.8).
Conclusion: Patients diagnosed with STEMI during the pandemic experienced a significant delay between the onset of symptoms and PPCI.

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Amaç: Ýnternal karotis arterdeki orta ve þiddetli darlýklar tüm inmelerin %10–15’ine neden olmaktadýr. Bu çalýþmada, üçüncü basamak bir referans merkezde karotis arter stentlemesinin (KAS) güvenliðini ve kýsa dönem etkinliðini deðerlendirmeyi amaçladýk.
Yöntemler: Üçüncü basamak merkezimizde Ocak 2017 ile Mayýs 2018 arasýnda KAS uygulanan hastalar geriye dönük olarak deðerlendirildi. KAS uygulanan 145 hasta çalýþmaya dahil edildi.
Bulgular: Hastalarýn ortalama yaþý 70.1±8.6 yýl idi ve tüm grubun %75.2’si erkek olup %37.9’unda hipertansiyon mevcuttu. Hastalarýn 81’i (%55.9) semptomatik, 64’ü (%44.1) asemptomatik olarak gruplandýrýldý. Semptomatik hastalarda koroner giriþimler daha çok KAS sonrasý (%38.9) yapýlýrken, asemptomatik grupta ise KAS öncesi (%25.9) ve sonrasýnda (%25.9) benzer oranlarda yapýldýðý görüldü ama gruplar arasýnda istatistiksel fark yoktu. Semptomatik hastalarda (%59.2), asemptomatik hastalarda (%78.7) olduðu gibi distal emboli koruyucu cihaz (EKC), proksimal EKC’ye göre daha fazla kullanýldý. Ancak proksimal EKC, semptomatik hastalarda asemptomatik hastalara kýyasla anlamlý olarak daha fazla kullanýldý. Hastane içi ölüm görülmedi ve tüm popülasyonda 5 (%3.4) hastada inme veya geçici iskemik atak (GÝA) gözlendi. Asemptomatik grupta GÝA veya inme gözlenmedi, semptomatik grupta 2 hastada (%2.4) inme ve 3 hastada (%3.7) GÝA görüldü.
Sonuç: Bu çalýþma kabul edilebilir komplikasyon oranlarý ile KAS’ýn güvenirliðini ve uygulanabilirliðini ortaya koymuþtur. KAS prosedürü, deneyimli giriþimciler tarafýndan optimal týbbi tedavi altýnda, agresif risk modifikasyonu ile EKC kullanýlarak, uygun hastalarda en az komplikasyonla gerçekleþtirilmelidir.

Objective: Moderate and severe carotid artery stenosis in the internal carotid artery causes 10% to 15% of all strokes. The aim of this study was to evaluate the safety and short-term efficacy of carotid artery stenting (CAS) performed at a tertiary referral center.
Methods: The records of patients who underwent CAS between January 2017 and May 2018 at a tertiary care center were analyzed retrospectively and a total of 145 patients were included in the study.
Results: The mean age of the patients was 70.1±8.6 years, 75.2% of the study group was male, and 37.9% had hypertension. Of the patients evaluated, 81 (55.9%) were classified as symptomatic and 64 (44.1%) were classified as asymptomatic. A percutaneous coronary intervention was performed after CAS more often in symptomatic patients (38.9%), while it was observed at the same rate both before (25.9%) and after (25.9%) CAS in the asymptomatic group, but the difference between the groups was not statistically significant. A distal embolic protection device (EPD) was used in symptomatic patients (59.2%) and in the asymptomatic group (78.7%); however, a proximal EPD was used significantly more often in symptomatic patients (45.6%) compared with asymptomatic patients. No patient death was recorded while in hospital, and stroke/transient ischemic attack (TIA) development was observed in 5 (3.4%) patients. Stroke was seen in 2 patients (2.4%) and TIA in 3 patients (3.7%) in the symptomatic group; TIA or stroke was not seen in the asymptomatic group.
Conclusion: The results of this study revealed that CAS was a safe and practical procedure with an acceptable complication rate. In the appropriate patients, experienced interventionists can achieve good results when aggressive risk modification is applied and an EPD and optimal medical therapy are used.

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Amaç: Koronavirus hastalýðý 2019 (COVID-19), ilk kez Aralýk 2019’da Çin’in Wuhan kentinde bildirilen ve o zamandan beri dünya çapýnda hýzla yayýlan ve devam eden pandemiye neden olan bulaþýcý bir hastalýktýr. CHA2DS2-VASc skoru, atriyal fibrilasyonda inmenin yaný sýra çeþitli durumlarda morbidite ve mortaliteyi tahmin etmek için iyi doðrulanmýþ bir risk sýnýflandýrma skorudur. Bu çalýþmada, COVID-19 hastalarýnda CHA2DS2-VASc skoru ile hastane içi mortalite arasýndaki iliþkiyi deðerlendirmeyi amaçladýk.
Yöntemler: Bu çok merkezli retrospektif çalýþmaya 15 Mart ile 15 Nisan 2020 tarihleri arasýnda hastaneye yatýrýlan toplam 349 COVID-19 hastasý dahil edildi. Her hastanýn CHA2DS2-VASc skoru hesaplandý. Ölüm sonuçlarý 25 Nisan 2020’ye kadar takip edildi.
Bulgular: Hayatta kalmayan COVID-19 hastalarýnda CHA2DS2-VASc skorlarý hayatta kalanlara göre anlamlý olarak yüksekti (p<0.001). Ýleriye doðru aþamalý lojistik regresyon analizinde, CHA2DS2-VASc skoru ≥3 ([odds oraný]OO=12.613, %95 GA: 3.092–51.451, p<0.001), baþlangýçtaki lökosit sayýsý (OO=1.327, %95 GA: 1.145–1.538, p<0.001), baþlangýçtaki C-reaktif protein düzeyi (OO=1.010, %95 GA: 1.002–1.018, p=0.012), ve baþlangýçtaki ferritin düzeyinin (OO=1.005, %95 GA: 1.003–1.007, p<0.001) hastane içi mortalitenin baðýmsýz öngördürücüleri olduðu saptandý.
Sonuç: CHA2DS2-VASc skoru, atriyal fibrilasyondan baðýmsýz olarak COVID-19 hastalarýnda hastane içi mortaliteyi öngörmektedir.

Objective: Coronavirus disease 2019 (COVID-19) is an infectious disease that was first reported in December 2019 in Wuhan, China, and has since spread rapidly around the world, resulting in the ongoing COVID-19 pandemic. The CHA2DS2-VASc score is a well‐validated risk stratification tool for predicting stroke in atrial fibrillation (AFib), as well as morbidity and mortality in several entities. The aim of this study was to evaluate the relationship between the CHA2DS2-VASc score and in-hospital mortality in patients with COVID-19, regardless of AFib.
Methods: This multicenter, retrospective study included a total of 349 patients with COVID-19 who were hospitalized between March 15 and April 15, 2020. The CHA2DS2-VASc score of each patient was calculated. Mortality outcomes were followed up until April 25, 2020.
Results: The CHA2DS2-VASc score was significantly higher in non-survivor COVID-19 patients than in survivor COVID-19 patients (p<0.001). Forward stepwise logistic regression analysis demonstrated that a CHA2DS2-VASc score of ≥3 (odds ratio [OR]: 12.613, 95% confidence interval [CI]: 3.092–51.451; p<0.001), and the leukocyte count (OR: 1.327, 95% CI: 1.145-1.538; p<0.001), C-reactive protein level (OR: 1.010, 95% CI: 1.002–1.018; p=0.012), and ferritin level (OR: 1.005, 95% CI: 1.003–1.007; p<0.001) on admission were independent predictors of in-hospital mortality of COVID-19 patients.
Conclusion: The CHA2DS2-VASc score predicted in-hospital mortality in patients with COVID-19, regardless of AFib.

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Amaç: “No reflow” distal embolizasyon, mikrovasküler oklüzyon, uzamýþ miyokardiyal iskemi ve hasardan oluþan bir fenomendir. Primer perkütan koroner giriþim sonrasý hastalarýn yaklaþýk %5 ila %10’u oranýnda ortaya çýkar.CHA2DS2-VASc skoru günlük uygulamada kolayca uygulanabilir ve bu skorun komponentleri ile no reflow’un risk faktörleri benzerdir. Kronik böbrek hastalýðý hiperkoagülopati riskini getirir ve ST segment yükselmeli miyokart enfarktüsünde (STYME) artmýþ no reflow riski ile iliþkilidir. Böbrek di̇sfonksiyonu olan hastalarda modifiye CHA2DS2-VASc skorlamasý geliþtirilmiþtir. Bu çalýþmanýn amacý, no-reflow geli̇þen hastalarda CHA2DS2-VASc skorlama sisteminin prognostik önemini araþtýrmaktýr.
Yöntemler: Bu çalýþmaya, geriye dönük olarak, STYME olup no reflow geliþen 75 hasta ile no reflow geliþmeyen 1138 hasta alýndý. Ýki grup arasýnda CHA2DS2-VASc skoru ve RCHA2DS2-VASc skoru karþýlaþtýrýldý.
Bulgular: Medyan CHA2DS2-VASc skoru ve medyan RCHA2DS2-VASc skoru no reflow geliþen gruptan istatistiksel olarak anlamlý olup yüksek bulundu (her ikisi için de, p<.001). Ayrýca, CHA2DS2-VASc skorunun tüm bileþenleri iki grup arasýnda istatistiksel olarak anlamlý derecede farklýydý. RCHA2DS2-Vasc ≥2 puaný, %83 sensivite ve %62 spesifite ile no reflow öngördürücüsü olarak kullanýlabilir.
Sonuç: RCHA2DS2-VASc skoru no reflow geliþmini öngörmede basit, ucuz ve kolay eriþilebilir bir skordur.

Objective: No-reflow is a phenomenon that can arise due to factors such as distal embolization, microvascular occlusion, or prolonged myocardial ischemia and damage. It occurs in about 5% to 10% of patients after primary percutaneous coronary intervention. The CHA2DS2-VASc score can be easily calculated in daily practice and the components of this score are similar to common risk factors for no-reflow. Chronic renal disease generates a hypercoagulable state, which is associated with increased risk of no-reflow in cases of ST-segment elevation myocardial infarction (STEMI). A modified CHA2DS2-VASc score has been developed to include patients with renal dysfunction. The aim of this study was to investigate the prognostic significance of this scoring system, the RCHA2DS2-VASc score, in patients with no-reflow.
Methods: A total of 75 patients with no-reflow and 1138 patients without no-reflow after STEMI were retrospectively enrolled in this study. The CHA2DS2-VASc and RCHA2DS2-VASc scores of the two groups were compared.
Results: The median CHA2DS2-VASc score and the median RCHA2DS2-VASc score were significantly higher in the no-reflow group (p<.001, for both). There was a statistically significant difference between the groups in all of the components of the CHA2DS2-VASc score. An RCHA2DS2-VASc score of ≥2 was a predictor of no-reflow with a sensitivity of 83% and specificity of 62%.
Conclusion: The RCHA2DS2-VASc score is a simple, inexpensive, and easily accessible score to predict no-reflow.

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Amaç: Bu çalýþmanýn amacý, koroner arter hastalýðý (KAH) olan hastalarda CETP rs289714 gen polimorfizminin, serum lipit profili ve diðer metabolik parametreler üzerindeki etkilerinin araþtýrýlmasýdýr.
Yöntemler: CETP geni rs289714 polimorfizmi 104 KAH hastasý ve 77 kontrol örneklerinde PZR-RFLP yöntemiyle incelendi.
Bulgular: CETP rs289714 genotip ve alel daðýlýmlarý gruplar arasýnda istatistiksel olarak farklý bulunmamýþtýr (p>0.05). KAH erkek hastalarýnda vücut kitle indeksi (VKÝ) deðerleri G aleli taþýyanlarda AA genotipi taþýyanlara göre daha yüksekti (p=0.05). Lojistik regresyon analizinde, erkek KAH hastalarýnda G alelinin varlýðý VKÝ’nin ≥27 kg/m2 olmasý ile iliþkili idi (GR: 0.269; %95 GA=0.075–0.966; p=0.044). Kadýn hastalarda G aleli AA genotiplilere göre daha düþük HDL-K düzeyleriyle iliþkili bulundu (p=0.049).
Sonuç: Bu bulgular, CETP rs289714 polimorfizminin erkek hastalarda VKÝ ve kadýn hastalarda HDL-K deðerleri üzerine etkilerinden dolayý KAH geliþiminde risk oluþturabileceðini düþündürmektedir.

Objective: The aim of this study was to investigate the effects of the CETP gene rs289714 polymorphism on the serum lipid profile and other metabolic parameters in Turkish patients with coronary artery disease (CAD).
Methods: The CETP rs289714 variant was examined in 104 patients with CAD and 77 controls using the polymerase chain reaction-restriction fragment length polymorphism method.
Results: The CETP rs289714 genotype and allele distribution was not statistically different between the groups (p>0.05). The body mass index (BMI) values in men with CAD were higher in patients with the G allele compared with those carrying the AA genotype (p=0.05). Logistic regression analysis showed that the G allele in male CAD patients was a risk factor for a BMI of 27 kg/m2 (odds ratio: 0.269, 95% confidence interval: 0.075–0.966; p=0.044). The G allele in female patients was associated with lower HDL-C levels than the AA genotype (p=0.049).
Conclusion: The results suggest that the CETP rs289714 polymorphism may cause risk for the development of CAD due to its effects on high-density lipoprotein cholesterol values in male patients and BMI in female patients.

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Amaç: Akut dekompanse kalp yetersizliði (ADKY) hayati tehlike arz eden bir týbbi durumdur ve akut böbrek hasarý (ABH), ADKY nedeniyle hastaneye yatýrýlan hastalarýn %30’undan fazlasýnda geliþerek hem mortalite hem de morbidite oranlarýný arttýrmaktadýr. Önceki çalýþmalar ABH’nin geliþimini öngörmek için çeþitli biyobelirteçler kullanýlabileceðini bildirmiþtir. Biz bu çalýþmada, ADKY hastalarýnda baþvuru sýrasýndaki laktat düzeyleri ile ABH arasýndaki iliþkiyi araþtýrmayý amaçladýk.
Yöntemler: Haziran 2018 ile Aralýk 2018 arasýnda ardýþýk toplam 154 ADKY hastasý çalýþmaya ileriye yönelik olarak alýndý ve dýþlama kriterleri sonrasýnda toplam 91 hasta incelendi. Hastalar ABH geliþen ve geliþmeyen olmak üzere iki gruba ayrýldý.
Bulgular: Hastalar ABH geliþmeyen 63, ABH geliþen 28 hasta olmak üzere iki gruba ayrýldý. ABH geliþen grupta, ABH geliþmeyen gruba göre daha yüksek kronik böbrek hastalýðý öyküsü, daha yüksek kreatinin seviyeleri, daha düþük GFR seviyeleri, daha düþük HCO3 seviyeleri, daha yüksek laktat seviyeleri ve daha düþük LVEF deðerleri vardý (tüm parametreler için p<0.05). Akut böbrek hasarýnýn geliþmesinde baðýmsýz belirleyicileri belirlemek için çoklu lojistik regresyon analizi yapýldý. KBH öyküsü (odds oraný [OO] 4.003, %95 GA [güven aralýðý] 1.295–12.371, p=0.016) ve laktat seviyeleri (OO 1.545, %95 GA 1.222–1.954, p<0.001) akut böbrek hasarýnýn geliþmesinde baðýmsýz öngördürücü parametreler olarak saptandý.
Sonuç: Akut böbrek hasarý ADKY hastalarýnda en büyük sorunlardan biridir ve yüksek laktat seviyeleri akut böbrek hasarýnýn erken teþhisinde yardýmcý olabilir.

Objective: Acute decompensated heart failure (ADHF) is a life-threatening medical condition and more than 30% of patients hospitalized for ADHF develop acute kidney injury (AKI), which increases the rate of both mortality and morbidity. Previous research has indicated that several biomar-
kers may help to predict the development of AKI. The aim of this study was to investigate the relationship between lactate level at the time of admission and AKI in ADHF patients.
Methods: A total of 154 consecutive ADHF patients were prospectively enrolled from June 2018 to December 2018, and after applying the exclusion criteria, a total of 91 patients were included in the study. The patients were divided into 2 groups: those with and without AKI.
Results: There were 63 patients in the group without AKI and 28 patients in the group with AKI. The AKI group had a higher percentage of a history of chronic kidney disease (CKD), a higher creatinine level, lower glomerular filtration rate level, lower bicarbonate level, higher lactate level, and a lower left ventricular ejection fraction compared with the non-AKI group (p<0.05 for all parameters). Multiple logistic regression analysis determined that CKD history (odds ratio [OR]: 4.003, 95% confidence interval [CI]: 1.295–12.371; p=0.016) and lactate level (OR: 1.545, 95% CI: 1.222–1.954; p<0.001) were independent predictive parameters for developing AKI.
Conclusion: An elevated lactate level may help to make an early diagnosis of AKI, an important concern in ADHF.

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Amaç: Koroner yavaþ akým (KYA) patofizyolojisi tam manasýyla açýklýða kavuþturulamamýþtýr, dahasý artmýþ fruktoz tüketiminin, KYA patofizyolojisinde rol oynayabilecek oksidatif stres ve inflamasyon ile iliþkili olduðunu gösteren birçok çalýþma vardýr. Bu çalýþmanýn amacý, fruktoz tüketimi ile izole KYA arasýndaki iliþkiyi araþtýrmaktýr.

Yöntemler: Aralýk 2018-Nisan 2019 tarihleri arasýnda koroner anjiyografi uygulanan kararlý anjina pektorisli hastalar deðerlendirildi. Ýzole KYA’lý 45 hasta, hasta grubu (KYA grubu) ve 50 normal koroner akým paterni (NKAP) olan birey kontrol grubu olarak kabul edildi. Besin tüketiminin ayrýntýlarýný saðlamak için katýlýmcýlar diyet kaydý kullandý, iki gruptan gelen tüm veriler karþýlaþtýrýldý.

Bulgular: KYA grubunda yüksek-hassasiyetli CRP (Hs-CRP) düzeyleri (p=0.024), beyaz kan hücresi sayýsý (p=0.038) ve sigara içme oraný (p=0.012) daha yüksekti. Toplam enerji (p=0.029), karbonhidrat (p=0.047) ve fruktoz tüketimi (p<0.001) KYA grubunda daha yüksekti. Çok deðiþkenli lojistik regresyon analizleri, daha yüksek Hs-CRP seviyeleri, fruktoz tüketimi ve sigara içmenin KYA ile baðýmsýz olarak iliþkili olduðunu gösterdi.

Sonuç: Çalýþmamýzda KYA grubunda fruktoz tüketimi daha yüksektir. Yüksek fruktoz tüketimi, KYA patofizyolojisinde rol oynama potansiyeline sahiptir.

Objective: The precise pathophysiology of slow coronary flow (SCF) has not yet been clarified; however, many studies have shown that significant fructose consumption is associated with oxidative stress and inflammation, which may play a role in the pathophysiology of SCF. The aim of this study was to investigate the association between fructose consumption and isolated SCF.

Methods: Patients with stable angina pectoris who underwent coronary angiography between December 2018 and April 2019 were evaluated for this study. In all, 45 patients with isolated SCF were selected as the patient group (SCF group) and 50 patients with a normal coronary flow pattern were enrolled as a control group. Participants used a dietary record to provide details of nutrient consumption and all of the data from the 2 groups were compared.

Results: The high-sensitivity C-reactive protein (Hs-CRP) level (p=0.024), white blood cell count (p=0.038), and smoking rate (p=0.012) were higher in the SCF group. Total energy (p=0.029), carbohydrate (p=0.047), and fructose consumption (p<0.001) were also higher in the SCF group. Multivariable logistic regression analysis demonstrated that a higher level of Hs-CRP, fructose consumption, and smoking were independently associated with SCF.

Conclusion: The SCF group demonstrated a higher level of fructose consumption. Excessive fructose consumption may play a role in SCF pathophysiology

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Akut kalp yetersizliði en sýk görülen kardiyak acil durumlardan biridir. Kalp yetersizliðinden kaynaklanan akciðer ödemi, akciðer bilgisayarlý tomografi taramalarýnda eksüdatif bir hastalýðý taklit edebilir. Aralýk 2019’da Çin’de Coronavirus Hastalýðý-2019 (COVID-19) salgýný baþlamýþ ve kýsa sürede tüm dünyaya yayýlmýþtýr. Bu pandemi döneminde, akut dispne ile baþvuran hastalarda COVID-19 pnömonisini dýþlama eðilimi artmýþ olup bu durum benzer semptomlar ile gelen akut dekompanse kalp yetersizliði olan hastalarýn taný ve tedavisinde gecikmeye yol açabilmektedir. Bu yazýda, akut miyokart enfarktüsü geçirmesinden bir hafta sonra dispne ile acil servise baþvuran diyabetik bir hastayý sunuyoruz. Amacýmýz kalp yetersizliði ve COVID-19 pnömonisinde ayýrýcý tanýya dikkat çekmektir.

Acute heart failure (HF) is one of the most common cardiac emergencies. Pulmonary edema caused by HF may mimic an exudative disease on chest computed tomography scans. Coronavirus disease 2019 (COVID-19) emerged in China in December 2019 and quickly spread around the world. During this pandemic period, the need to exclude the possibility of COVID-19 pneumonia in patients with acute dyspnea may cause a delay in the diagnosis and treatment of patients with acutely decompensated HF who have similar symptoms. This case report describes a diabetic patient admitted with dyspnea one week after she suffered an acute myocardial infarction. The objective of this report is to draw attention to the differential diagnosis of HF and COVID-19 pneumonia.

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SARS-CoV-2’nin neden olduðu Coronavirus hastalýðý 2019 (COVID-19) sadece hafif grip benzeri semptomlardan aðýr progresif pnömoniye kadar deðiþen geniþ bir klinik prezentasyona sahiptir. Enfeksiyonun seyrinde miyokardit, akut miyokart enfarktüsü, kalp yetersizliði, kardiyak ritim bozukluklarýný içeren kardiyak tutulum gözlenebilir; ama önceden COVID-19 tanýsý almýþ çok nadir sayýda hastada kardiyak tamponat tanýmlanmýþtýr. Elli sekiz yaþýnda kadýn hasta iki hafta önce baþka bir hastanede atipik pnömoni nedeniyle hastaneye yatýrýlmýþ. Nazofaringeal sürüntü incelemesinde COVID-19 pozitif saptanmýþ. Hasta komplikasyonsuz bir hospitalizasyon süreci geçirmiþ ve bir hafta önce taburcu edilmiþ. Hasta acil servisimize nefes darlýðý ve bacaklarda þiþme þikayeti ile geldi. Yatak baþý yapýlan transtorasik ekokardiyografide (TTE) global olarak azalmýþ sol ventrikül sistolik fonksiyonlarý ile birlikte ejeksiyon fraksiyonu (EF) %30 ve tüm kalbi çepeçevre saran ve diyastolik doluþta restriksiyona yol açan ciddi perikardiyal effüzyon görüldü. Hasta perikardiyal tamponat tanýsý ile koroner yoðun bakým ünitesine (KYBU) kabul edildi. Yatakbaþý perikardiyosentez yapýldý ve serohemorajik sývý drene edildi. COVID-19 enfeksiyonu olan hastalarda dispne geliþmesi veya dispnenin kötüleþmesi durumunda perikardiyal effüzyon ve perikardiyal tamponat ayýrýcý tanýda düþünülmelidir

The clinical presentation of coronavirus disease 2019 (COVID-19), which is caused by severe acute respiratory syndrome coronavirus 2, can range from only mild, flu-like symptoms to severe progressive pneumonia. Cardiac involvement may be observed during the course of the infection and may include myocarditis, acute myocardial infarction, heart failure, and cardiac rhythm disturbances, but cases describing cardiac tamponade in patients previously diagnosed with COVID-19 are very rare. A 58-year-old female had been hospitalized in another hospital 2 weeks prior to the currently described presentation due to atypical pneumonia. A nasopharyngeal swab specimen was positive for COVID-19. The hospitalization was uncomplicated and she was discharged after a week. She presented at our emergency department with symptoms of shortness of breath and swelling in both legs. A bedside transthoracic echocardiography showed globally depressed left ventricular contraction with an ejection fraction of 30% and there was significant pericardial effusion, which surrounded the entire heart and restricted diastolic filling. The patient was admitted to the coronary intensive care unit with the diagnosis of pericardial tamponade. Bedside pericardiocentesis was performed and serohemorrhagic fluid was drained. Pericardial effusion and pericardial tamponade should be considered in the differential diagnosis of patients with COVID-19 exhibiting dyspnea or worsening of dyspnea. A 58-year-old female has been hospitalized in another hospital two weeks ago due to atypical pneumonia. Her nasopharyngeal swab specimen was positive for COVID-19. She had an uncomplicated course during the hospitalization and was discharged a week ago. She presented to our emergency department (ED) with symptoms of shortness of breath and swelling in both legs. We performed bedside transthoracic echocardiography (TTE) which showed globally depressed left ventricular contraction with ejection fraction (EF) of 30% and there was significant pericardial effusion which surrounded the entire heart and restricted diastolic filling. The patient was admitted to the coronary intensive care unit (CICU) with the diagnosis of pericardial tamponade. Bedside pericardiosentesis was performed and serohemorrhagic fluid was drained.
Patients with COVID-19 infection who develops or have worsening dyspnea, pericardial effusion and pericardial tamponade should be considered in differential diagnosis.

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Ventriküler erken vurular (VEV), klinikte en sýk karþýlaþýlan aritmilerden birisidir. Genellikle iyi huylu olarak kabul edilmesine raðmen, kardiyomiyopati geliþimine sebep olabilir ve nadiren de ani kardiyak ölüm ile iliþkili olabilir. Yakýn zamanda Amerika Kardiyoloji Koleji Elektrofizyoloji Konseyi VEV’lere iliþkin tanýsal ve tedavi edici hususlar hakkýnda klinik pratiðe iliþkin son durumu bildiren bir derleme yayýnlamýþtýr. Biz bu yazýda güncel raporlarýn ýþýðýnda VEV’lerin tanýsý, yaklaþým ve tedavi yöntemleri hakkýnda önemli noktalarý sunduk.

Premature ventricular complexes (PVCs) are one of the most common arrhythmias seen in daily practice. Although PVCs are generally considered benign, they can lead to the development of cardiomyopathy and, rarely, can be associated with sudden cardiac death. Recently, the American College of Cardiology Electrophysiology Council published a state-of-the-art review on PVCs to provide diagnostic and therapeutic considerations for clinical practice. Presented are some important points about the diagnosis, approach, and treatment of PVCs.

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