Background: Blood viscosity is a strong predictor of cardiovascular events. However, the relationship between blood viscosity and acute arterial occlusion (AAO) has not been studied adequately so far. Objectives: The aim of the present study was to assess the relationship between whole blood viscosity (WBV) and AAO. Material and methods: The study included 93 patients who were diagnosed with AAO between January 2017 and September 2019, and 90 age- and sex-matched healthy controls. WBV was assessed using a validated calculation formula derived from hematocrit and total plasma protein levels, both as a low (LSR) and a high (HSR) shear rate. Results: There were no significant differences between the two groups in regards to the baseline characteristics, with the exception of smoking and LDL cholesterol levels. Subjects with AAO presented significantly higher WBV values both at LSR (32.2 ± 5.0 vs. 26.6 ± 5.0, p <0.001) and HSR (6.2 ± 0.3 vs. 5.7 ± 0.3, p <0.001). The ROC analysis revealed a cut-off value of 27.4 for WBV at LSR (sensitivity 66%, specificity 64%, AUC = 0.770, p <0.001) and a cut-off value of 5.29 in case of HSR (sensitivity 69%, specificity 74%, AUC = 0.801, p <0.001) for predicting AAO. Multivariate analysis, both LSR (OR 3.33, 95% CI: 1.20–9.43, p = 0.006) and HSR (p = 0.020, OR: 1.70, 95% CI: 1.020–1.123) were independent predictors of AAO. Conclusions: This study demonstrated that WBV levels at both HSR and LSR are significantly higher in the AAO group than in the control subjects, indicating that an increased WBV may be associated with the development of AAO.

Introduction: Cardiopulmonary resuscitation is a direct intervention for the prevention or postponement of death in patients with cardiac arrest. The fatigue of rescue workers is of high significance when performing cardiopulmonary resuscitation effectively. The present study aimed to investigate the effect of a cardiac massage facilitator device on the fatigue of rescue workers in cardiopulmonary resuscitation. Materials and Methods: This experimental study was carried out on 30 emergency medical aid non-continuous bachelor students, divided equally into two groups: one group performed cardiac massage using the device and the other without the device. Fatigue levels were assessed using a visual analog scale to evaluate fatigue severity. Results: The mean age of participants was 23.42 ± 2.02 years, the mean height was 175 ± 4.43 cm, and the mean weight was 65.45 ± 5.02 kg. There was a statistically significant difference between the mean fatigue scores of the two groups: 0.06 with the device vs. 0.57 without the device. Conclusion: Our results suggest that the cardiac massage facilitator device presented in this study could be effective in improving the quality of cardiac massage and be helpful in cardiopulmonary resuscitation.

Introduction: Brugada syndrome represents the clinical manifestation of a rare disease with genetic etiology. The syndrome is characterized by ventricular dysrhythmias associated with syncope or sudden cardiac death in the lack of any structural cardiac disease. The diagnosis of Brugada syndrome is established if a type 1 electrocardiographic (ECG) pattern of STsegment and QRS morphology is present, in association with certain clinical manifestations and/or familial history. Case presentation: A 31-year-old male patient, without any medical history, presented in the emergency department (ED) of a clinical center. His only complaints consisted in palpitations, chest discomfort, and emotional stress related to the recent death of his wife. Earlier on the same day, his wife, a 25-year-old female was brought via emergency medical services (EMS) to the ED after presenting ventricular fibrillation. The female patient presented a long term history of chest pain and one year prior to this episode she presented idiopathic ventricular fibrillation, for which she had undergone implantation of an automated cardioverter defibrillator. As the couple were cousins, the EMS specialist suspected the presence of a familial cardiac disorder. The electrocardiogram of the male patient revealed a coved-type ST-segment elevation of 4 mm in leads V1–V3 compatible with type 1 Brugada syndrome. Conclusion: In case of Brugada syndrome, a genetic disorder associated with increased risk of SCD, the patient’s first-degree relatives should be investigated as well, in order to identify the presence of the syndrome and to prevent SCD. As the sole established effective therapeutic measure for patients diagnosed with Brugada syndrome, ICD implantation should be considered in order to decrease the risk of syncope and SCD. This case is particular because a rare disease with familial etiology was identified in both husband and wife, who were cousins.

Congenital aortic stenosis (AS) occurs in around 0.2–0.5% of newborns, and its clinical severity is quite variable. Some of the newborns with AS require urgent medical care: prostaglandin infusion, balloon aortic valvuloplasty, or surgical intervention. Despite having a severe clinical evolution in neonates, the prenatal diagnosis of congenital AS is quite low. We present the case of a fetus with critical AS, who had been prenatally diagnosed at 35 weeks of gestation, via fetal cardiac ultrasound. The echocardiographic parameters revealed a severely depressed left ventricular systolic function, with dilated chambers, with a severe aortic stenosis. Offline speckle-tracking analysis was performed in order to aid in deciding the optimal methods and timing of delivery. Left ventricular analysis revealed a severely impaired global longitudinal strain of 2.1%, LVEF 18.4%, increased LV volumes, while the right ventricular function was only mildly depressed. Therefore, the decision was to delay the premature delivery, and the fetus was born at a gestational age of 38 weeks, in a hospital with a neonatal cardiovascular surgery department. The patient had undergone surgical repair of the cardiac anomaly at 3 days after birth.