Takotsubo cardiomyopathy (TCM) represents an acute systolic left ventricular dysfunction typically triggered by severe psychological or physical stress. Oncological patients due to emotional distress of the diagnosis, proinflammatory and prothrombotic nature of cancer and also physical stress often following complex anticancer therapies are at high-risk of TCM. Moreover, there are also few reports of TCM associated with oncological treatment, mostly chemotherapy. Recent data from large registries indicate a surprisingly high incidence of malignancy in TCM, significant differences in clinical characteristics and unfavorable short- and long-term clinical outcomes in this specific group of patients. Therefore, we present two case reports of TCM that occurred during active anticancer therapy. Both women were admitted with suspicion of acute coronary syndrome. The first patient underwent mastectomy two years before due to hormone receptor-positive breast cancer and on admission she was during adjuvant hormonotherapy with tamoxifen. The admission of the second patient was preceded by fifteen fractions of adjuvant external beam radiotherapy due to intermediate-risk endometrial cancer after radical hysterectomy. Based on coronary angiography type I of acute coronary syndrome was excluded. Both patients negated stressful situations in the period immediately before the symptoms onset. Within hospital course baseline apical ballooning observed in both cases fully recovered and enabled subsequent completion of oncological treatment in accordance with adopted treatment protocols without recurrence of TCM. To our knowledge, presented cases are the first reports showing direct relationship between TCM and adjuvant hormonotherapy with tamoxifen or pelvic radiotherapy.

B a c k g r o u n d: Heart failure (HF) is a life-threatening condition which aff ects up to 2% of contemporary populations. Generally, it is a chronic and progressive disease, however in many cases it can be prevented or treated. Nevertheless, effective control of this disease requires awareness of symptoms in the society.

A i m s: The aim of the study was to assess the level of HF knowledge in the Polish population.

M e t h o d s: The questionnaire concerning knowledge about HF prepared by the Competence Network HF under the patronage of the European Heart Failure Association of the ESC, was used. The survey included 534 contributors who formed three groups: medical students — in vast majority at fi rst half of the study course (MS) — 198 (37.1%), HF Awareness Day participants (HFDP) — 134 (25.1%) and other (OP) — 202 (37.8%).

R e s u l t s: Study groups diff ered in terms of gender, age and level of education. As predicted, MS achieved the highest score (22.5 [20.0–24.0]), compared to HFDP (20.0 [17.0–22.0], P <0.001) and OP (19.0 [16.0– 21.0], P <0.001). Knowledge on typical HF symptoms was alarmingly low in the analyzed groups — dyspnea (MS — 96.0%, HFDP — 78.4%, OP — 74.6%), ankle edema (MS — 79.8%, HFDP — 50.6%, OP — 32.2%), body weight gain (MS — 14.1%, HFDP — 17.2%, OP — 4.5%). By multivariate model medical education (β 3.372, 95% CI 2.738–4.005) and own illness or having relatives or friends with HF (β 0.654, 95% CI 0.066–1.242) independently aff ected the score of awareness questionnaire.

C on c l u s i o n s: The basic knowledge on HF in Poland is not sufficient. It is moderately better among MS. Further campaigns improving HF awareness are necessary.

Congestive heart failure (CHF) is the fi nal stage in several heart diseases. The diagnosis of CHF in older patients is a challenge. Preserved left ventricular systolic function is a characteristic type of CHF in seniors. The purpose of the study was to characterize elderly patients with CHF and to highlight specific features of the conditions in seniors. The most common etiology of HF in this group of patients is hypertension and coronary heart disease. In seniors atypical presentations of chronic heart failure is much more common than in younger patients. Malnutrition, limitations of exercise and sedentary lifestyles or comorbid diseases have an influence on asymptomatic, early stage of HF. Th ere are better outcomes of treatment in obese individuals. It is called the obesity paradox. Open communication with a patient and his/her family may improve their response to therapy. When heart failure becomes an incurable disease and aggressive treatment is ineffective, palliative care should be considered in end-of-life heart failure patients. The goal of treatment in the remaining moments of life last moments of life should be maximizing the patient’s comfort.