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We report a case of 49-year-old female patient with no previous history of coronary artery disease, which was admitted to Bieganski Hospital of Łódź with diagnosis of NSTEMI from a public hospital. On admission, the patient gave history of 18 hours of retrosternal pain. Elevated troponin I level was noted. Pharmacological treatment administered in public hospital resulted in regression of ailments. In ECG transitory ST segment elevation in aVR and III lead and ST segment depression in other leads was observed. These ECG changes disappeared with retrosternal pain retreat. Cardiologic diagnostic did not indicated necessity of urgent coronary angiography. Cardiovascular risk stratification methods like GRACE, SCORE, DTI and TIMI have been used. Coronary angiography revealed distal stenosis of left main trunk (LMT), stenosis of left anterior descending artery (LAD) and left circumflexing artery (LCx). The patient was consulted by a cardiac surgeon and CABG was recommended. The patient was operated in Cardiochirurgical Center of Łódź. We would like to discus the problem of proper interpretation of ST segment changes in aVR lead of a resting ECG and estimation of risk factors when urgent invasive cardiologic diagnostic is under consideration. [ABSTRACT FROM AUTHOR]

Cardiovascular disease which develops on the basis of atherosclerosis is the main cause of mortality and morbidity in adults and is a huge financial burden. The very beginning of dyslipidemia modern therapy was discovery of fibrates and statins. Fenofibrate is a major representant of the fibrate drug class that is widely used not only in monotherapy but also in combined therapy. There are several formulations of fenofibrat, among them the modern suprabioavailable tablet, with contains 160 and 215 mg of active substance. The new formulation combines micronisation technology with a new microcoating process. Suprabioavailable tablet provides more reliable and predictable drug absorption. In comparison to other fenofibrate formulations, suprabioavailable tablet absorption is less dependent from food effect. Dissolution of tablets is much faster then other formulations. In those conditions lower dose of fenofibrate provides equivalent pharmacokinetic parameters. Clinical trials have proved, that Fenofibrate inhibits significantly progression of atherosclerosis and reduces a risk of cardiovascular events especially in diabetic patients and patients with metabolic syndrome. Suprabioavailable fenofibrate is a safety and well tolerated drug. [ABSTRACT FROM AUTHOR]

Stable angina is one of the most often occurred disease in the present world. Many studies indicate, that there is a relationship between elevated heart rate and increased risk of cardiovascular events. The treatment of stable angina is leaning on many methods including pharmacological treatment and revascularisation treatments. One of the newest medicines applied in the treatment of coronary heart disease is ivabradine. It is a selective sinus node If channel inhibitor. Studies showed, that ivabradine reduces heart rate without affecting cardiac systolic function and function of peripheral vessels. Moreover previous studies showed that ivabradine prevents myocardial ischemia so same effectively, as beta-blockers and calcium channel blockers without their adverse side effects. At present studies are checked the possibilities of applying it patients with acute coronary syndroms, which intolerate beta-blockers and in treatment patients with hard compromised left ventricular function in association with vasoactive and inotropic agents. These clinical trials are underway, and maybe they will help to evaluate fully the therapeutic potential of If inhibition in patients with coronary artery disease and another diseasey. [ABSTRACT FROM AUTHOR]

The paper presents some basic data on treating patients with coronary heart disease and sexual dysfunctions. It is reported the opinion of the Second Princeton Consensus Panel (2005). Erectile dysfunction may be the earliest syndrome of cardiovascular disease. Patients after myocardial infarction feel grat prejudice while returning to their sexual activity. Patients fears are an important problem for cardiologist. Discussed reports show correlation between sudden death and taking cardiological medications with PDE-5 inhibitors at the same time. Sildenafil is recommended for men with erectile dysfunction and heart dissease. PDE-5 inhibitors should not be used in combination with alpha-blockers. Patients treated with nitrates should not take sildenafil and vardenafil in 24 hours, and tadalafil in 48 hours after a nitrate. The interactions between cardiological medications and phosphodiesterase-5 inhibitors are also disscused. [ABSTRACT FROM AUTHOR]