A complicated chinese herbal medicine nephrotoxicity.

Chinese herbal medicine is widely used globally. In many instances, it is associated with severe adverse outcomes. We report case of a Chinese herbal nephropathy occurring in a 43-year-old woman showing renal impairment, metabolic acidosis, Stokes - Adams syndrome, hypernatremia, and hypokalemia, characteristics not usually encountered in published cases.

[Morgagni-Adams-Stokes after adenosine injection in a patient with WPW syndrome--a case report]. / Zespól Morgagni-Adams-Stockesa po wstrzyknieciu adenozyny u pacjentki z zespolem WPW.

A case of a 16-year-old girl with left sided accessory pathway is presented. Following adenosine-induced termination of atrio-ventricular reentrant tachycardia the patient developed polymorphic ventricular tachycardia followed by preexcited atrial fibrillation with very rapid ventricular response and syncope. Arrhythmia was terminated by amiodarone infusion. Potential complications after adenosine injection are discussed.

[Adams-stokes syndrome due to neuroleptic agents].

Data on an investigation and analysis of 8 cases taken neuroleptics followed by Adams-Stokes syndrome were reported. All patients were diagnosed as schizophrenia without cardiovascular diseases previously. In the process of treatment with 1 or 2 kinds of neuroleptics, Adams-Stokes syndrome appeared, while the potassium was in a range of 1.1--3.8 mEq/L. EKG profile varied, such as showed hypokalemia, ventricular flutter or fibrillation, frequent multifocal ventricular premature beat including bigeminy, and complained with second or third A-V block. The authors deem that neuroleptics may give rise to hypokalemia and then result in cardiac arrhythmias. Damage to heart tends to happen when more than one kind of neuroleptics were medicated. The treatment measures depend above all upon the active and effective attendance to hypokalemia. The patients may die from ventricular fibrillation without proper treatment.

Total atrioventricular block with syncopes complicating carbamazepine therapy.

At case of carbamazepine-induced intermittent total atrioventricular block with asystole and Stokes-Adams attacks is reported. The diagnosis was proved by repeated administration of carbamazepine after insertion of a demand pacemaker. If syncopes occur or change nature in a patient treated with carbamazepine, evaluation of cardiac conduction is recommended.

[Syncope. An important border-line between neurology and internal medicine (author's transl)]. / Der synkopale Anfall. Ein wesentliches Grenzgebiet zwischen Neurologie und Innerer Medizin.

It is important for the neurologist to know the variations of the Adams-Stokes's attack so that the important differential diagnosis between an epileptic reaction and an Adams-Stokes's attack due to cardiac rhythmic disorder can be made. The Adams-Stokes's syndrome is not only due to asystoles in the sense of cardiac arrest but also to ventricular fibrillation and especially to the very common syndrome of the pathological sinoauricular node. The great importance of digitalis overdose is pointed out as an eliciting factor for the kind of arrhythmia which runs a course similar to that of the Adams-Stokes's syndrome.

[Paroxysmal ventricular tachycardias complicated with Adams-Stokes syndrome during lidoflazin treatment (author's transl)]. / Mit Adams-Stokesschem Syndrom einhergehende paroxysmale Kammertachykardie während einer Clinium-Behandlung.

A case is reported of ventricular extrasystole occurring during Lidoflazin treatment. It is considered that Lidoflazin is an effective pharmacon, but that it may enhance the ventricular irritability. Attention is drawn to the necessity of the frequent control of Lidoflazin-treated patients.

Advanced heart block aggravated by carbamazepine.

This report presents a serious adverse reaction to the anticonvulsant compound carbamazepine. A woman was admitted to hospital for recurrent attacks of syncope. She suffered from atrioventricular block of the Mobitz type II. Carbamazepine suppressed the conduction in her already defective Purkinje fibres and induced ventricular stand-still with subsequent Adams-Stokes attacks.