Journal of Rare Cardiovascular Diseases

Dear Readers,
Gaining more experience and exchange of knowledge in one thing is the only way to advance the field of rare cardiovascular diseases (RCD). Taking care of RCD patients on a daily basis quickly leads to realization that working to gether in multidisciplinary teams is the only way to deliver the best possible management to the patients. The cases presented in this issue of the Journal are perfect examples that such cooperation is more than recommended – it is often mandatory in RCD patients. What possibly could we have achieved without eye specialists or rheumatologists in Marfan syndrome or without hematologists in amyloidosis or without vigilant obstetricians in poor female with peripartutm cardiomyopathy? Our recitations are endless. Please stop for a second to reflect how often we simply forget to ask for a second opinion from a college who is only few meters away… The 10th (another anniversary!) issue of the Journal starts with the educational Review on the contemporary therapies in pulmonary hypertension, putting the  special strength on chronic thrombo-embolic pulmonary hypertension (CTEPH). Dr Barbara Widlińska under the leadership of dr Grzegorz Kopeć elaborate not only on pharmaco-therapy but also on novel invasive treatment of CTEPH which is balloon pulmonary angioplasty (BPA). Importantly, our Center is one of the few places in Poland where actually such treatment can be offered to the patients who are disqualified from surgical pulmonary endatherectomy due to prohibitive operative risk. The true “salt” of the Journal are clinical cases. The first, authored by Dr Pawel Rubis and colleagues, concerns peripartum cardiomyopathy. This is a very rare condition that affects pregnant women at the end of third trimester or as it was in this case few months after uneventful delivery of twins. Thanks to the vigilant obstetrician, who could have also easily dismissed the patient, she was promptly send to our Department where appropriate treatment including Bromocriptine was initiated. Fortunately, all ended well and the patient was discharged home in good clinical status to take care of her babies. The second case, reported by Dr Monika Komar and co-workers, concerns the middle-age patient with very rough course of cryptogenic patent foramen ovale (PFO) and related complications. After few cardiac interventions, including primary angioplasty for acute myocardial infarction and percutaneous closure of PFO and diagnosis of thrombophilia(mutation of Leiden V factor) the  patient was eventually discharged home with life-long oral anticoagulation. Next case comes from our Partners from Chrzanow and is about the patient with multiple myeloma and systemic amyloidosis as a long-term complications. The case is enriched with a well-written discussion which gives an overview on amyloidosis and cardiac amyloidosis in particular. The forth case is from Katowice and once again touches the  problem of mediastinal masses. After exhaustive diagnostic work-up it turned out the observed mediastinal pathology is probably result of allergic alveolitis or ectopic thymus tissue. Despite its close proximity to the  cardiac tissue, the joint decision has been made to monitor the tumor and do not rush with hasty intervention. The last case, authored by dr Natalia Dłużniewska, is about coronary anomaly – Bland-White-Garland syndrome mimicking myocardial infarction. The authors discuss the problem of coronary anomalies in detail and surly this is a  piece to read as paradoxically it is not so rare to encounter coronary anomaly during routine coronary angiography. The  final part of this issue is a  report, prepared by Dr Lidia Tomkiewicz-Pająk, on the recent Congress on Congenital Heart Diseases in Adults that was organized under the  auspices of Polish Cardiac Societywitha significant participation from the Krakow CRCD Center. Such meetings are very important as most of those diseases are truly unique and require high level of expertise and experience. Therefore, opportunity to exchange thoughts and opinions is of utmost importance. The Editors hope that the current issue of the Journal will, again, serve its main purpose which is to raise awareness on the complexity of rare disease that may occasionally require multi-disciplinary to truly help our patients.Piotr Podolec
Editor-in-Chief
Journal of Rare Cardiovascular Diseases