Detection of subclinical LV dysfunction by 2D STE might improve identification of patients with critical LAD stenosis, although visually apparent regional LV dysfunction in the LAD territory is not uncommon finding in this subset of patients.

The QTc interval and myocardial contraction duration are related to the presence of significant CAD in patients without a history of previous myocardial infarction. Myocardial mechanical dispersion has an incremental value to GLS for identifying patients with significant CAD.

Considering the high bleeding risk in patients with ITP and AMI, careful balance between usual anticoagulation and antiplatelet therapy on the one hand, and efforts to raise platelet count on the other hand are needed.

It might be worthwhile to routinely evaluate the polarity of the T wave in lead V1 in patients with suspected CAD, since it appears to have additional risk stratification potential.

Complete recovery usually occurs after dramatic presentation, frequently complicated with acute heart failure. Therapy is empiric and directed towards supportive measures against cardiogenic shock, acute heart failure, dysrhythmias. In-hospital mortality rate is less than 1%, but long-term prognosis is still unknown. In addition to the review of the literature on takotsubo cardiomyopathy, we present the first series of patients with this syndrome detected in Clinical Hospital Center Zemun.

Our report underlines the need of adequate knowledge and training of medical professionals performing pocket-size hand-held echocardiography, since potential misdiagnoses may not be related to limited imaging capabilities of pocket-sized echo devices only, but also to inability of insufficiently trained users to obtain good quality images and interpret them adequately.

Introduction/Objective Chronic obstructive pulmonary disease (COPD) exacerbation is mostly triggered by infectious agents and seriously compromises the patient's quality of life and predicts a poor outcome of the disease as well. If the signs of the probable bacterial cause of COPD exacerbation are presented in an intubated patient, initial antimicrobial management must be launched. Depending on the results of the respiratory system sample cultures, the initial antimicrobials can be changed or continued. The objective of this study is to present in-hospital suggestions regarding the use of the initial antimicrobial management of urgently intubated COPD adults with the probable bacterial cause of exacerbations, considering the source of bacterial acquisition (i.e. facility-or community-acquired bacteria). Methods The cross-sectional study covered 51 patients urgently intubated on admission to the medical Intensive Care Unit of the Zemun Clinical Hospital Center during 2015/2016. The patients were divided into two groups: community-acquired (n = 26) and facility-acquired infection group (n = 25). The respiratory system samples were processed in the Microbiology Laboratory. Results Acinetobacter and Pseudomonas spp. were the most frequently isolated bacteria in both groups, followed by Staphylococcus aureus and Klebsiella spp. as the third most frequent bacteria in the community-and facility-acquired group, respectively. The parallel use of tigecycline and aminoglycosides proved to cover a sensitive microbial spectrum in 52% of examinees of the community-acquired and 32% of examinees of the facility-acquired group. Conclusion The present study suggests the initial management of intubated adults with probable bacterial infection-induced COPD exacerbation by the parallel use of tigecycline and aminoglycosides.

Reaching a diagnosis in unstable patients presenting with symptoms and signs suggestive of acute cardiovascular pathology usually requires a focused patient’s history, physical examination, 12-lead electrocardiogram, and additional laboratory tests and imaging studies. It seems unarguable that echocardiography fits better than any currently available imaging technique for use in challenging emergency situations: it is low-cost, non-invasive, widely accessible, portable, and accurately describes cardiac morphology and function. It can be rapidly performed virtually everywhere while the instantly available results of the examination allow prompt initiation of appropriate therapy. These facts may explain the evolving use of echocardiography by non-cardiologists or cardiologists without specific expertise, and the increasing trend of using focus cardiac ultrasound (FoCUS) as a bedside, point-of-care diagnostic test during initial evaluation in cardiac emergencies.