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Atrial cardiomyopathy (ACM) represents a novel paradigm in cardiovascular medicine, encompassing structural and functional changes within the atria that contribute to adverse clinical outcomes, notably stroke. This review explores the multifaceted implications of ACM, particularly its relevance independent of atrial fibrillation (AF) and its potential applications in stroke prevention and management. Advancements in imaging modalities, notably speckle-tracking echocardiography, offer valuable insights into atrial remodeling and dysfunction, facilitating early detection of ACM. Markers such as P-wave terminal force, NT-proBNP levels, and left atrial dimensions serve as diagnostic indicators for ACM, aiding in risk stratification in individuals devoid of AF history. Ischemic strokes are one of the most common causes of cardiovascular morbidity and mortality. A significant proportion of patients with ischemic stroke are suspected of embolic stroke without a specific embolic source being found (ESUS). The most recent related clinical trials evaluated tailored anticoagulation strategies in ACM-associated stroke, signaling a shift beyond conventional AF management. In conclusion, ACM emerges as a pivotal concept in stroke prevention, offering opportunities for personalized interventions and refined risk stratification beyond AF.

Background: Coronavirus disease (COVID-19) is a pandemic disease, infecting more than 673 million people. Accurate prediction of the risk of progression of COVID-19 is needed at the time of hospitalization. Material and Methods: A retrospective study was conducted between December, 2020 and December, 2021. A total of 165 patients admitted with severe COVID-19 infection were enrolled. The data were collected from the electronic medical records of Alexandrovska Hospital. Results: The mean age of the patients was 64.6±15, of whom 44.8% were men. The median duration from symptom onset to hospitalization was 8.2 days, and from symptom onset to discharge or death was 24.00 days respectively. In-hospital mortality was 23.3%, and post-discharge one-year mortality was 3.7%. 27 (16.7%) patients received invasive mechanical ventilation, 37 (23%) were admitted to the ICU, and 26 (15.8%) received vasopressors. Common acute complications among inpatients included acute pulmonary embolism (2.6%), acute stroke (0.6%), and minor bleeding (3.7%). 12 patients (7.7%) who survived COVID-19 hospitalization were readmitted for additional treatment of other diseases. Several laboratory markers were linked with increased in-hospital mortality: GFR < 55 ml/min, ferritin > 705 µg/L, PaO2 < 7.93 kPa; SpO2 < 93%, oxygen requirements > 12.5 l/min. Mortality risk was higher in patients having hypertension, coronary artery disease, previous ischemic stroke, valvular heart disease, chronic heart failure and atrial fibrillation. Conclusion: The mortality rate was higher in older patients with cardiovascular comorbidities and reduced renal function. Early recognition of high-risk patients may help to improve care and reduce mortality.

Aneurysms of the Valsalva sinuses are rare among cardiovascular disorders, with an incidence rate of 0.15%. Most cases are accidentally diagnosed or constated postmortem. Usually, this type of pathology is asymptomatic and might go undetected for a long time before the aneurism erupts. Patients with larger coronary aneurysms often complain of from chest pain, shortness of breath, and arrhythmia. Another extremely rare cardiovascular pathology is the aneurysm of the subclavian artery, which has a reported rate of 0.13%. Smaller subclavian aneurysms have no clinical manifestation, whereas larger ones cause murmur, pulsation phenomenons, neuropathic pain and ischemia of the upper limb due to compression of the brachial plexus and major vessels. Herein, we report a rare case of a very large aneurisms involving all three coronary sinuses and the whole aortic root in combination with a bilateral giant subclavian aneurism. These findings were made during a routine cardiological examination and further hospitalizations of a 54-year-old woman with chest pain and high blood pressure complaints with known ankylosing spondylitis. Despite their rarity, aneurysms of the sinuses of Valsalva and subclavian arteries are of utmost clinical significance due to the life-threatening complications which might arise from their rupture. Furthermore, such aneurysms pose significant technical difficulties during angiographic procedures. Therefore, detailed knowledge of such pathologies is essential for correctly diagnosing and treating such patients.

Background: Depression and anxiety are common in patients with heart failure (HF). They are associated with adverse outcomes such as reduced adherence to treatment, poor ventricular function, increased hospitalizations, and higher mortality rate. However, despite the importance of these concomitant conditions, depression and anxiety often remain underdiagnosed and undertreated in patients with HF. Aim: The aim of the study is to evaluate the prevalence and severity of depression and anxiety in patients with HF. Materials and methods: 138 patients with chronic HF, a mean age of 70.29 ± 9.73 years and male/female ratio – 63 (45.7%)/75 (54.3%) were included in this cross-sectional study. Tests for depression (Hamilton Depression Rating Scale; HAM-D) and anxiety (Hamilton Anxiety Scale; HAM-A) were performed in all participants. Results: 114 (82.6%) of the patients with HF have depression and 98 (71%) – anxiety disorder. Mild depression was found in 38 (33.3%) patients and moderate – in 49 (42.9%). Severe depression was found in 21 (18.4%) of the patients and very severe – in 6 (5.3%). In our cohort, women more often were diagnosed with depression than men (71.4% vs. 28.6%, (p