BRIEF COMMENTS
EXPERT: Lidia Tomkiewicz-Pająk MD, PhD
Afiliacja: Department of Cardiac and Vascular Diseases, John Paul II Hospital, Krakow, Poland
COMMENT
Due to good exercise tolerance, physical abstinence from alcohol and increased cardiac monitoring of the patient during the current pharmacotherapy with psychological support is proposed. Due to the history and characteristics of alcoholic liver damage ASA as the prevention of thromboembolic complications is preferred. Furthermore, in case of heart transplant indications alcoholism is disqualifying factor from this operation, which further increases the importance of this issue.
EXPERT: Prof. Jadwiga Nessler
Afiliacja: Department of Coronary Disease and Heart Failure, John Paul II Hospital, Krakow, Poland
COMMENT
In this patient alcoholism increases the risk of bleeding complications of the treatment with vitamin K antagonist. It is reasonable to start VKA prophylaxis if the patient will obey abstinence, otherwise aspirin therapy at a dose of 75 mg to be considered.
EXPERT: Prof. Andrzej Rudziński
Afiliacja: Department of Cardiology, Pediatric Institute, Jagiellonian University Medical College, Krakow, Poland
COMMENT
Cautious administration of aspirin at a dose of 75 mg for the prevention of thromboembolism and carvedilol due to heart failure.
EXPERT: Grzegorz Kopeć MD, PhD
Afiliacja: Department of Cardiac and Vascular Diseases, John Paul II Hospital, Krakow, Poland
COMMENT
ICD implantation seems reasonable. Prophylaxis of thromboembolic complications depending on abstinence from alcohol and cooperation of the patient.
CONCLUSIONS
1. The patient should be offered implantation of a cardioverter-defibrillator as a primary prevention of sudden cardiac death.
2. Psychological help and treatment in the addiction therapy center is recommended.
3. Currently as prevention of thromboembolism treatment with ASA 75 mg x 1 should be initiated, together with a proton pump inhibitor.
4. Considering administration of beta-blocker with prolonged effect and optimalization of the dose of aldosterone receptor antagonist (spironolactone or eplerenone).
EXPERTISE 1
EXPERTISE 2
EXPERTISE 3
“Development of the European Network in Orphan Cardiovascular Diseases”
„Rozszerzenie Europejskiej Sieci Współpracy ds Sierocych Chorób Kardiologicznych”
