COVID-19 is a systemic infectious and inflammatory disease primarily transmitted via the respiratory route and associated with significant cardiovascular involvement. SARS-CoV-2 can induce myocardial, pericardial, and endothelial inflammation, thereby increasing the risk of perimyocarditis, vascular inflammation, thrombosis with pulmonary embolism, and cardiac arrhythmias. Emerging evidence indicates persistent cardiovascular abnormalities, including increased arterial stiffness and hemodynamic alterations, even following mild acute infection. Diagnostic evaluation in patients with cardiac symptoms includes laboratory testing, electrocardiography, echocardiography, and cardiac magnetic resonance imaging, as well as Holter monitoring and tilt-table testing for suspected postural orthostatic tachycardia syndrome (POTS). Therapeutic approaches focus on individualized rehabilitation programs and targeted medical therapy, including beta-blockers for tachycardia and thromboprophylaxis in patients increased thrombotic risk.
Homozygous familial hypercholesterolemia (HoFH) is a rare and severe condition associated with extremely high cholesterol levels and significant cardiovascular morbidity and mortality at an early age during adolescence. Despite combination therapy with multiple lipid-lowering drugs, including PCSK9 inhibitors, the majority of affected patients also require lifelong, time-and resource-intensive lipoprotein apheresis. Evinacumab is a new, innovative lipid-lowering agent whose mechanism of action is independent of the LDL receptor. It has been approved in 2021 as an adjuvant therapy for reducing LDL-C in adults and children with HoFH, filling a crucial gap in the treatment landscape for the disease. Data from several randomized controlled trials, as well as real-world observational studies, have confirmed the safety and effectiveness of monthly intravenous evinacumab administration over treatment periods spanning several years. On average, when used alongside established guideline-based lipid-lowering combination therapy (including PCSK9 inhibitors), it results in an LDL-C reduction of about 45-50%. In some cases, this has allowed patients to discontinue lipoprotein apheresis. Evinacumab thus opens up a promising new perspective in the management of HoFH. J Kardiol 2026; 33: (1-2): 11-6.
Heart failure rarely occurs alone. Heart failure (HF) is a common disease associated with high mortality, frequent hospitalizations and reduced quality of life. Coexisting comorbidities arecommon. HI is classified based on LVEF. Measurement of NT-proBNP and echocardiography have key roles in the diagnosis of HF. Diuretics, ACE-I/ARNI, beta-blockers, MRA and SGLT2-inhibitors are recommended as cornerstone therapies in HF. Aetiology and comorbidities should be considered and addressed.
Post-acute infection syndromes (PAIS) are prolonged disease states that can occur after viral infections and manifest through nonspecific neurological, cardiovascular, and immunological symptoms such as fatigue, exhaustion, and cognitive impairments. These symptoms vary in severity and can persist for months or even years, with fatigue playing a central role. PAIS are not a new phenomenon and have already been documented following past pandemics, such as the Spanish flu or COVID-19 pandemic. Various viral pathogens, including SARS-CoV-2, Epstein-Barr virus, and influenza viruses are associated with PAIS. The pathogenesis is multifactorial and involves potential mechanisms such as viral persistence, subacute inflammation, autoimmune reactions, and gut microbiome-dysbiosis. The rehabilitation of affected individuals requires a personalized management approach. While mild fatigue can improve through tailored physical activity, more severe courses, such as myalgic encephalomyelitis/chronicfatigue syndrome (ME/CFS), require specific strategies such as pacing to prevent overexertion and deterioration. Cardiovascular manifestations such as myocarditis, pericarditis, and perimyocarditis may also occur, and their treatment follows established cardiological guidelines. Regular endurance training has a protective effect against infections and supports immune function. However, further research is needed to develop effective treatment strategies for PAIS and to meet the individual needs of patients. J Kardiol 2025; 32
