RESUMO
During the recent 'first wave' of the COVID-19 pandemic, the National Health Service (NHS) has triaged planned services to create surge capacity. The primary prevention implantable cardioverter-defibrillator (ICD) was in a grey area of triage guidance, but it was suggested as a procedure that could be reasonably stopped. Recent reports have highlighted deaths of patients awaiting ICDs who may have been deferred during the pandemic. In our trust we reorganised our device service and continued to implant primary prevention ICDs during the 'first wave' and, here, report that most patients wished to proceed and underwent uncomplicated implantations. One patient later died from COVID-19, although the transmission site cannot be definitively concluded. With strict adherence to public health guidance and infection prevention strategies, we believe that ICD implantation can be performed safely during the pandemic, and this should be standard practice during subsequent surges.
Assuntos
Estimulação Cardíaca Artificial/efeitos adversos , Seio Coronário/diagnóstico por imagem , Migração de Corpo Estranho/diagnóstico por imagem , Trombose Venosa/diagnóstico por imagem , Eletrodos Implantados/efeitos adversos , Humanos , Implantação de Prótese/efeitos adversos , Radiografia , RetratamentoRESUMO
Syncope occurring in the setting of head and neck malignancy may have several possible causes. Local effects of a tumour in the parapharyngeal area may produce a syncopal syndrome similar to carotid sinus hypersensitivity, but with distinctive differentiating features. This article presents a case of profound vasodepressor syncope in a patient with recurrent pharyngeal malignancy, and discusses the mechanisms by which this occurs and the possible therapeutic options.
Assuntos
Doenças das Artérias Carótidas/etiologia , Seio Carotídeo , Neoplasias de Células Escamosas/complicações , Neoplasias Faríngeas/complicações , Síncope Vasovagal/etiologia , Pressão Sanguínea , Doenças das Artérias Carótidas/diagnóstico , Diagnóstico Diferencial , Humanos , Masculino , Pessoa de Meia-Idade , Recidiva Local de Neoplasia , Síncope Vasovagal/diagnóstico , SíndromeRESUMO
Athletes performing repetitive movements can develop arterial injuries. These are uncommon. We present a case of bilateral subclavian/axillary artery stenosis in a female patient referred to the rapid access chest pain clinic with a presumptive diagnosis of angina. Her symptoms were related to limb ischemia rather than cardiac insufficiency. Detailed history from this patient revealed that she had spent 8 years working as an acrobat being swung by the arms twice daily during performances.