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Isolated right ventricular myocardial infarction (RVMI) is a very rare complication of ischemic heart disease. Generally it accompanies infero-posterior or antero-septal myocardial infarction cases. Right ventricular myocardial infarction is a strong predictor of acute right ventricular failure, bradyarrythmia, ischemic and mechanical complications and is frequently complicated by cardiogenic shock which often leads to death. Acute right ventricular ischemia (RVI) and RVMI are big problem particularly during and early post-operative cardiosurgery procedures. Atherosclerotic changes and heart blood flow disturbances predispose to RVI or RVMI that occur more often in cardiosurgical patients, especially in early postoperative period. On the other hand early intraoperative diagnosis and longer reperfusion period result in the correction of heart function and better prognosis.

Objective: The paper presents a review of cases with fetal extrasystole coexisting with different cardiac and extracardiac pathology., Design: The aim of the study is to analyse the results of echocardiographic examinations of fetuses with premature atrial contractions (PAC) quantitatively significant (bigeminy, trigeminy) or coexisting with other abnormal findings in fetal heart or other extracardiac pathologies., Material and Method: Selected group of 33 (24%) fetuses from 135 with fetal extrasystole was analyzed. The mean gestational time of diagnosis was 29.2 + 4.1 weeks., Results: Quantitatively significant arrhythmia (bigeminy, trigeminy) was diagnosed in 14 fetuses. Blocked PAC (2:1) occurred in two cases causing fetal bradycardia. Premature atrial extrasystole coexisting with different type of arrhythmias were diagnosed in 10 cases (4 x with SVT, 4 x with sinus bradycardia, 2 x with ventricular extrasystole). Heart defects in the analyzed group with PAC were recognized in two fetuses (1 x d-TGA, 1 x heterotaxy syndrome--common a-v canal). Myocarditis was diagnosed in 3 (9%) cases. From the group of 33 fetuses 6 newborns died (1 x d-TGA, 1 x T18, 1 x myocarditis, 1 x circulatory centralization). Mortality in the analyzed group was 18.2%., Conclusion: In cases of fetal arrhythmias echocardiography should be widely applied in order to evaluate the kind of arrhythmia, sufficiency of circulation and coexistence of heart defects, extracardiac malformations or functional abnormalities with arrhythmia in fetal circulation.

Objective: The paper presents review of different kinds of fetal arrhythmias, diagnosed in our centres., Design: The aim of our study was to analyse results of echocardiographic examinations of 141 fetuses with diagnosed arrhythmias referred for fetal cardiac examination in years VI. 1996-V. 2001 and neonatal outcome., Results: Premature contractions were recognised in 113 (80%) fetuses, tachyarrhythmias in 7 (5%) cases and complete atrioventricular block in 5 (4%). Heart defects were diagnosed in three cases. Three fetuses developed congestive heart failure (2x SVT, 1x HLHS + block a-v III*). From all group 6 newborns died., Conclusion: In case of fetal arrhythmias echocardiography should be widely applied in order to evaluate the kind of arrhythmia, sufficiency of circulation and coexistence of heart defects or functional abnormalities with arrhythmia in fetal circulation.

Frequency of emergency calls for ambulance help to patients with acute myocardial infarction (MI) as well as a number of infarct complications and the influence of immediate professional help on survival of prehospital phase of acute MI is reviewed. The diagnosis of acute MI was based on a typical history of chest pain and electrocardiographic findings. Acute MI was also diagnosed in all cases of sudden cardiac death. Out of 3674 calls for ambulance help, MI was diagnosed in 379 patients what amounts for 10.1% of all interventions in life-threatening cases and for 61% of patients with acute MI in the analysed period of time. Complicated MI was observed in 61.7% of all patients, including 70.5% of men and 49.3% of women. Arrhythmic complications occurred in 54.5% of patients. Ventricular ectopic activity was the most frequent arrhythmia and amounted to 46.6%. The II0 or III0 atrioventricular block occurred in 4.5% of patients. Haemodynamic complications occurred in 12.3% of cases. Sudden cardiac death occurred in 23.6% of patients with acute MI, including 21.9% cases of ventricular fibrillation or flutter and 1.7% of asystole. 28.5% of those patients were successfully resuscitated. 61% of patients died in the prehospital phase of acute MI including 63.4% of males and 57.2% of females. Out of 61% of patients who died before admission to the hospital, 53% had died before ambulance team arrived and 7.9 died being under the care of the ambulance team. 80% of patients who survived prehospital phase of acute MI were admitted to the hospital within 60 min after the call for the ambulance.(ABSTRACT TRUNCATED AT 250 WORDS)

The key problem of modern cardiology is determination of prognostic factors in acute myocardial infraction which could make possible a proper assessment of the condition of the patients and outlining of guidelines for further therapeutic management. The newest reports on various parameters of prognostic significance in acute myocardial infraction and have a decisive importance of the further fates of the patients after completic of infarction necrosis, are discussed.