Faculty of Medicine

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    Caseous Mitral Annular Calcification - Rare Cause of Severe Mitral Valvular Dysfunction
    (National Society of Cardiology of North Macedonia, 2022-11)
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    Siljanovski, Nikola
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    Milacic, Branka
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    Jovanoski, Mario
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    MARIJUANA-INDUCED ACUTE CORONARY SYNDROME IN A YOUNG PATIENT
    (Department of Anaesthesia and Reanimation, Faculty of Medicine, Ss. Cyril and Methodius University in Skopje, R.N. Macedonia, 2023)
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    Jovanoski, Mario
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    Andov, Mishel
    Introduction: Acute coronary syndrome (ACS) is generally a natural consequence of the progression of coronary atherosclerosis. But in minority of cases, it might be developed due to non-atherosclerotic reasons including recreational marijuana use. Possible pathophysiological mechanisms include inflammation, procoagulant state and vasoconstriction (vasospasm) of the coronary arteries. Marijuana adverse effects on cardiovascular system are various and well documented. Case report: We present a 29-years old male who was referred to our Clinic due to chest pain and morphologic ECG changes. The patient has been previously hospitalized in local hospital due to hematochezia. Because of the chest pain, ECG was performed, and blood sample was taken there to determine the troponin level (hs-Tn I). ST-segment elevation and high level of hsTn I were indication for urgent transfer of the patient to our clinic. After admission, the patient underwent coronary angiography and PCI. Thoroughly taken history revealed that the patient was occasionally smoking marijuana in recreational purposes. He was a cigarette smoker, but he had no additional known risk factors for CAD. Conclusion: Recreational marijuana use may be a trigger factor for an acute coronary syndrome. We should always think and suspect marijuana and other recreational drugs as a potential risk factor for adverse cardiovascular events in young patients.
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    MISDIAGNOSIS OF CERVICOBRACHIAL SYNDROME WITH SUBOCCLUSION OF THE LEFT SUBCLAVIAN ARTERY
    (Faculty of Medicine, Ss. Cyril and Methodius University in Skopje, 2023)
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    Nikolovski, Robert
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    Introduction: Cervical spondylosis (degenerative osteoarthritis) and subclavian occlusion, mostly caused by atherosclerosis, share similar symptoms. Both are diseases of the advanced age. Thus, there are similarities of overlapping or misdiagnosis of both diseases. The aim of this case report was to present diagnosis and treatment of subclavian subocclusion and possibility of misdiagnosis with cervicobrachial syndrome. Case report: We present the case of a 71-year-old woman with noncontrolled hypertension. For many years she complained of occasional pains and tingling in her neck, left shoulder, and hand, coolness in the fingers of the left hand, headache and occasionally dizziness. An x-ray finding of the cervical spine was in favor of spondyloarthrosis on the neck vertebrae, and after consulting an orthopedic specialist, she was diagnosed and treated as cervicobrachial syndrome for many years without success. Cardiology examination detected different high blood pressure readings in both arms and that induced us to perform a computerized angiography (CT). CT showed subocclusion on the left subclavian artery after which our patient underwent angiography and stent implantation. After the procedure, the blood pressure difference decreased and the symptoms disappeared. Conclusion: Due to similar symptoms, whenever cervicobrachial syndrome is diagnosed, the blood pressures in both arms should be measured. In case of their difference, subclavian stenosis should also be considered and appropriate investigations should be made, especially if the difference in pressures is high.
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    Uncommon Cases of Venous Thromboembolism
    (Македонска академија на науките и уметностите, Одделение за медицински науки = Macedonian Academy of Sciences and Arts, Section of Medical Sciences/Walter de Gruyter GmbH, 2023-07-01)
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    Vuchinikj, Aleksandra Gulevska
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    Anguseva, Tanja
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    There is a growing incidence of new cases of venous thromboembolismworldwide.Some of these patients do have a predisposition to the development of thrombosis, some of them do however have various risk factors associated with this event, but few of them have unrecognized etiology. This paper aimsto describe different scenarios of venous thromboembolism.
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    Hypertension in athletes
    (MIT University, 2023-03)
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    Furnadjiski, Atanas
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    Mitevski, Goran
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    Nikolovski, Robert
    Hypertension is the most common cardiovascular disease in athletes. Prompt diagnosis and management is crucial for ensuring safe sport participation and prevention of long term complications in athletes. Many diagnostic tools are involved in the management algorithm of the hypertension starting from good anamnesis especially the family history, as well as other simple and sophisticated paramedical imaging techniques, as ECG, Echocardiography, 24 Hours ambulatory ECG monitoring, cardiac MRI and many others. Distinguishing an athlete heart from pathological heart muscle hypertrophy is the key step for the differential diagnosis. Conclusion: Proper pharmacological and non pharmacological measures will facilitate satisfying long term prognosis for the athletes.